Introduction
The health care system of the United States of America is considered to be one of the most effective around the world, but this system also has its drawbacks and problems that serve as obstacles on the way of its development.
First of all, the health care system is currently characterized by the labor supply shortages, the developing complexity of health care issues connected with the aging of the American population, and the shifts that are inevitably caused by the two above factors to the patterns of organizational responsibility in the area of health care. The development of US health care is also currently complicated by the need to modify the resource allocation policies and handle ethical challenges in the process of nursing and health care. The current research paper concentrates on the above health care aspects and examines them in detail referring to the scholarly knowledge in the area.
Health Care Issues
Health Care Labor Shortages
Beginning the consideration of the topic of health care in the United States, it is impossible to ignore the issue of labor supply shortages that have been bothering the industry since the late 1990s. According to Penner (2003), the main factors that condition labor supply shortages in any market as such, and in the health care market, in particular, include the emergence of the alternative labor markets with higher wages, the increase of prices for education and licensing in health care, demographics of the population in a particular moment (p. 27). Penner (2003) argues that physicians, therapists, and nurses are the professions in which the toughest labor shortages are observed.
According to Pizzi & Lofland (2005), the shortage of nurses is conditioned by two major factors, i. e. insufficient wage levels and demographic trends, according to which the American population is aging and by 2010 there will be a shortage of nurses amounting to over a million people (p. 7). Thus, both financial and demographic factors shape the currently observed labor supply shortages in US health care. Demographics and the aging US population are viewed by numerous scholars as to the dominant determinants of the health care system developmental trends.
American Socio-Demographics Changes and Aging of Population
The fact that the American population is currently aging and will continue aging over the next decade can be proven by the US Census Bureau reports and by the projections compiled by US Census Bureau (2005) and scholars like Garrett, Baillie, & Garrett (2001), and Kimmel (2008). Thus, the data by the US Census Bureau (2005) evidence that the population of the United States has been on the way of aging over at least the recent two decades, as beginning from 1995 the populations of people aging 55 years and older have been displaying steady growth rates (Table 1):
Table 1: US Population Aging 1995 – 2010 (in millions).
Accordingly, the evidence of the above figures is that the US population is aging and has too major implications for the health care system of the United States. First, the increase in the aging population means the decrease of the young population, which could become the health care professionals and solve the problem of the health care labor supply shortages. Second, the increase of the aging population means the increase in occurrence rates of various diseases that the health care system will have to face. This second point also means the development of the organizational responsibilities in the health care system.
Organizational Responsibility Implications
Needless to say, the first and foremost organizational responsibility of a health care facility is to ensure the high quality and professional help provided for its clients and patients. However, scholars like Cherry and Jacob (2005), stress the importance of other responsibilities observed in health care. First, the organizational responsibility of a health care provider is to ensure assigning a specialist to a patient based on this patient’s assessment needs and the specialist’s specializations and professional levels (Cherry and Jacob, 2005, p. 371).
As well, a health care provider is responsible for employing only the highly qualified personnel, and checking the educational record and background of every potential employee is one of the major organizational responsibilities in health care (Cherry and Jacob, 2005, p. 427). Finally, Marquis & Huston (2008) consider “facilitating the evidence-based practice” (p. 379) to be a major responsibility for a health care organization and its employees. Accordingly, working in conformity with the organizational responsibilities demands proper allocation of resources, both human and financial ones, and the respective handling of violations of the major health care ethical principles.
Resource Allocation
Human Resources
The allocation of the health care resources is a challenging task and, as Cherry and Jacob (2005) argue, it should be based on three major aspects of the intended health care development in the country, i. e. intended place of health care in the economy, planned quality of services, and the target customers of the health care system activities (p. 114). The allocation of human health care resources is complicated by the currently observed labor supply shortages and socio-demographic trends in the United States.
The first aspect of health care to be considered in this respect is the planned share of health care in the national economy. As in the United States, the health care system covers the needs of the total population, the bulk of the resources should be allocated to creating the favorable conditions for the development of greater numbers of health care professionals lacking at the moment. The nature of the US health care determines the ways of allocating the human resources in this system in respect of services quality and target customers as well.
Financial Resources
The allocation of the financial resources in the health care system should be based on the same three principles argued about by Cherry and Jacob (2005). In other words, financial resources should be allocated in conformity with the national health care strategy, the planned quality of the national health care, and the assessed needs of the target customers, i. e. patients (p. 114). Accordingly, the determinant point in allocating the financial resources for the health care system is realizing the share of the country’s GDP that can be provided for health care needs. Cherry and Jacob (2005) argue that the United States provided 14.9% of its GDP in 2002 for health care needs, which totaled $1.6 trillion (p. 114).
Drawing from this, the United States attributes much importance to its health care system. The same can be said about the quality of health care services and the coverage of all the groups of target customers by those services (Cherry and Jacob, 2005, pp. 114 – 115). In the light of the current labor supply shortages in health care, the increased amounts of resources should be allocated to health care as a means of creating favorable conditions for attracting the lacking labor force to the system.
Ethical Considerations
Scholars like Cherry and Jacob (2005), Marquis & Huston (2008), and Payne (2005) argue that the development of the health care system in the United States of America is considerably complicated by ethical issues like fraud, patient dumping, and transferring. The danger of health care fraud is especially evident as the fraud is the policy used illegally by some health care organizations to get additional benefit from providing health care services or employing the people whose health care qualifications are doubted or obtained in illegal ways.
For example, Marquis & Huston (2008) argue about the danger of employing medical workers whose licenses are obtained through fraud or can be allowed for use by other, non-licensed, employees to get employed (p. 113). According to Cherry and Jacob (2005), health care fraud can also be expressed in illegal employing foreign professionals for work by the fabricated documents (p. 271), while Payne (2005) stresses the danger of fraud in billing patients for medical services received from a health care provider or a particular specialist (p. 265). Thus, health care fraud can concern both health care providers and patients, and fighting the fraud is especially important in the currently observed problematic conditions for the American health care system.
Another important ethical challenge for US health care is the so-called patient dumping, i. e. the situation when a health care facility refuses to provide medical services to a patient, whose health care insurance will not cover the costs of the services (Payne, 2005, p. 8). Such cases can be observed in the US health care, especially about the elderly patients, and in the light of the above reported demographic trends in the American society, the ethical challenges connected with health care fraud and patient dumping and transferring should be investigated and eliminated from the health care system.
Conclusions
On the whole, the health care system of the United States of America is considered to be one of the best in the world. However, labor supply shortages, socio-demographic changes, and the aging population, often improper resource allocation, both human and financial, and considerable ethical challenges connected with health care fraud and dumping, constitute the basic issues observed in the US health care.
The labor supply shortages are caused by the labor market conditions and demographic changes in the US population. The latter is characterized by population aging, which in its turn leads to the need for health care providers to reform the system of their organizational responsibilities and resource allocation. Finally, the above issues result in cases of health care fraud and dumping that must be fought for the further development and improvement of American health care.
References
Cherry, B. & Jacob, S. (2005). Contemporary nursing: issues, trends, & management. Elsevier Health Sciences.
Garrett., T.M., Baillie, H.W., & Garrett, R.M. (2001). Healthcare ethics: Principals and problems (4th ed). Upper Saddler River, NJ: Prentice-Hall.
Kimmel, J. (2008). How do we spend our time?: evidence from the American time use survey. W.E. Upjohn Institute.
Marquis, B. & Huston, C. (2008). Leadership Roles and Management Functions in Nursing: Theory and Application. Lippincott Williams & Wilkins.
Payne, B. (2005). Crime and elder abuse: an integrated perspective. Charles C Thomas.
Penner, S. (2003). Introduction to health care economics & financial management: fundamental concepts with practical applications. Lippincott Williams & Wilkins.
Pizzi, L. & Lofland, J. (2005). Economic evaluation in U.S. health care: principles and applications. Jones & Bartlett Publishers.
US Census Bureau. (2005). Statistical Abstract of the United States. Web.