Economics and Healthcare Delivery Systems has a direct affect on society; because health, like any other good or service, is desired because it generates utility. The Health Production Theory explains the role of the making, or production, of health and its influence by a variety of factors, including the amount of medical care consumed. Also, theres a direct relationship between healthcare economics and societies access to health insurance. Rising incomes mean more disposable income for health services, both basic and optional.
Because health insurance continues to offer narrow ranges of enefits for small monthly fees, many people pay directly for optional health services. The first to notice this trend are entrepreneurs, both physicians and businessmen who come from the resource side. These entrepreneurs have led in the most noticeable physical and organizational restructuring of health care: the decentralization of hospital and physician services to single-specialty or single-patient-type “institutes” that offer all services in an integrated form.
Institutes now house women and children’s services, cancer, orthopedics, eye, diabetes, renal and stroke services, asthma and allergies, eart and fitness, along the lines of existing infertility institutes. The task of tying these disparate institutes together falls to the regional health care system where the links are financial and information systems, not geographic or facility. Physicians, many of whom prove to be not only surplus under managed care but whose skills have not kept up with advances in medical science.
At the same time, doctors trained in genetics find they cannot afford to practice independently, since health plans are reluctant to open the gate to what they erceive as expensive services that will not prove out for years. Manpower surplus gives the advantage to health plans, which can pick and choose. IPAs are a low-involvement framework for physicians who only want to contract together. Medical groups can not only contract but enhance the practice experience, and health plans tend to like them.
Health Insurance: As the country enjoys the “long boom” produced by the leveraging of knowledge into wealth, there are actually two pathways emerging in payment:  One pathway is mediated by insurance, still related to ndividuals through work or through government. Mandates have stair-stepped most employers into mandated coverage, leaving out small rural businesses where no managed care plan exists, or certain other exceptions.
Unfortunately, Congress has been unable to reduce fully the 17 percent of the population without insurance, since small business growth, immigration and premium increases offset any gain. Universal coverage mandates await the political maturation of minority groups into both elected leadership positions, and voter participation. #61623; The second pathway is payment arranged outside of insurance. This is the fastest-growing form at present.
Direct consumer payment covers most self-care, alternative health services, “nutraceuticals,” cosmetic surgery, much nonorganic mental health, non-Medicaid long-term care and physical therapy past approved limits. For seniors and even families, some health services are built into housing costs. Foundations and not-for-profits cover problems not easily handled by insurance, such as migrant worker care or open-door clinics for the inner city.
Health insurance depresses innovation, as providers tend to give only the care that is, in fact, “covered. It does so by excluding “experimental” procedures, by underpaying for new services so providers are reluctant to commit the resources, and by restricting by underpaying for new services so providers are reluctant to commit the resources, and by restricting patients’ access on a per-case basis. (Examples: bone marrow transplants for third-stage breast cancer, testing of family members at risk for cancer, etc. )
Prevention efforts are artificially limited as they an be paid for only if delivered to covered individuals in their role as patients, when prevention at the family or community levels may be called for. #61623; Insurance related to individuals does not work for people who lack the competence to manage it or their health care. Open-access services, instead, should be subsidized. Note the untenable economics of emergency rooms, the safety net for people who are outside the formal system. Insurers, particularly government plans, could stimulate such innovation by offering budget subsidies for services that are meant to reach the uninsurable.
