193032_Management in Health and Social Care

193032_Management in Health and Social Care - Health and...

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Health and Social Care 1 Running head: MANAGEMENT IN HEALTH AND SOCIAL CARE Management in Health and Social Care [Author’s Name] [Institution’s Name]
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Health and Social Care 2 Management in Health and Social Care Since the middle of the 1980s, health care reform has been one of the top policy initiatives of most Western industrialized states. A new wave of reform has emerged that focuses on harnessing competition to more efficiently achieve social justice ends. Managed competition reform and traditional single structured management models represent an important change from the traditional approach to health care reform. This traditional approach focuses on reducing the resources available to a health care system (e.g. the hospital beds, nursing services, technology, etc.). This traditional approach assumes that physicians, when faced with restricted resources, will allocate resources optimally amongst various medical needs. By contrast, the new reform models require purchasers—government-appointed authorities, private insurers, or risk-bearing groups of health providers—to proactively manage and allocate resources amongst different health care needs. Purchasers are expected to manage treatment decision-making by physicians and other health providers. Managed competition and traditional single structured management combine elements of both government planning and market approaches. Managed care, another concept that is often referred to in the context of health care reform, is the mechanism through which managed competition proposals seek to
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Health and Social Care 3 obtain cost savings, but as described further below, can be employed in any health care system. Before describing the competition-oriented reform models, a preliminary question must be addressed: why is health care reform needed? A number of factors have converged creating strong pressures for health care reform in developed countries. These factors include: concerns over increases in total spending on health care services; concerns over rapidly increasing government spending; access and rationing concerns; and concerns over the cost-effectiveness and, indeed, effectiveness of many services supplied. Let us look more closely at the forces contributing to reform throughout the 1980s and 1990s, beginning first with the concern over growth in total health care spending. Throughout the 1970s there were significant increases in the proportion of gross domestic product (GDP) (the total value of all goods and services produced by a country) absorbed by health care spending. Between 1972 and 1982 there was a 36-percent, 30- percent, 26-percent and 25-percent increase, respectively, in the percentage of GDP spent on health care in the US and UK, and the Netherlands. Between 1982 and 1992 there was only a 2-
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Health and Social Care 4 percent increase in the Netherlands, but the US, New Zealand, and the UK still saw increases, respectively, of 36 percent, 12 percent, and 20 percent. These increases were partly due to the
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193032_Management in Health and Social Care - Health and...

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