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R193032_MANAGEMENT_IN_HEALTH_AND_SOCIAL_CARE

R193032_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 obtain cost savings, but as described further below, can be
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Health and Social Care 3 employed in any health care system. The internal market programme has been surprisingly successful. The large majority of the measures of which the programme was made up have been adopted in time. Admittedly, there are areas which lag behind (such as free movement of persons). Moreover, it has not always been possible to maintain the rigorous approach originally and a lot remains to be done with regard to implementing the adopted measures at national level. Nevertheless, the essence of the internal market is in place, which finds perhaps its most spectacular expression in the complete abolition of controls on the movement of goods. From an economic point of view, the question whether there is an external dimension to the internal market sounds almost ridiculous. How could, an economist would argue, a policy of economic integration that is as encompassing as the internal market programme and that applies to twelve developed countries which play an important role in international trade not affect trade and economic relations with the outside world? However, from the point of view of law-and policy-making the question could be raised in the early stages, as indeed it has been. One can safely say that until 1988 the attitude of the Community's institutions towards both the external effects of the internal market programme and the relationship between the programme and the Community's external policies was one of benign neglect. Before describing the
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