The findings indicated that there was no health care system across the OECD where their regular performances could not deliver cost-effective services. In fact, the type of methods used does not matter. Instead, the management styles and efficiency is what counts in the endeavor to create lucrative care. Both the market-based and centralized command and control systems showed vulnerabilities that are closely associated with the inefficient management of resources. While the health outcomes are highly disparate depending on the individuals, the inequalities can become minimized without necessarily compromising the competence levels. The dissimilarities are comparatively small in the states with well-regulated private insurance-based systems. Centralized systems can achieve such levels of efficiency at delivering decent equity outcomes while maintaining little expenditures.
The inefficiency in the health sector is an attribute of the fragmentation of the United States health industry (Improving Health Sector Efficiency: The Role of Information and Communication Technologies). It results in a situation where a patient is under the care of multiple doctors. The defensive strategy with which the system tackles health issues is expensive. The approach focuses more on the development of curative measures for the sick than in preventive and primary care to minimize the risk of the healthy getting ill. Additionally, there is an underuse of generic medicine due to the perception that they are ineffective. The failure to exert control over the supply chains (agents, dispensers, and dispensers) contributes to the overpricing of drugs. The procurement and distribution systems are inadequately controlled. The taxes and duties payable for the importation of the medicine also contribute to the escalation of prices. The market-based system creates an environment where the distributors of medical supplies act as principals in transactions. Subsequently, the markups are excessive (Mark-ups). Incompetent pharmaceutical regulatory measures, as well as the weak procurement system, have led to an influx of substandard and counterfeit medicine. Besides, unethical promotion tactics and incentivized prescription of drugs prompt to the inefficiency. The buyers have limited knowledge regarding the therapeutic effects of the drugs they buy leading to inappropriate consumption of medicine.
Moreover, the supplier-induced demand of health products and services backs the increased cases of over-use. The inefficiency is further alleviated by the application of inappropriate levels of interventions. For instance, it is illogical to fund high-cost interventions that have little effects and failing to do so for high-impact options that are relatively cheaper. The degrees of care (prevention, promotion, and treatment) are imbalanced. Furthermore, a lot of wastage is subject to the low usage of infrastructure. There is an unsuitable level of managerial possessions for administration. Some areas have more than enough hospitals and in-patient beds compared to other regions. It indicates the lack of planning and coordination in the health services infrastructure development. There is an unprecedented level of leakages in the system as well. For instance, the guide for allocation of assets is unclear and undocumented. Additionally, there is hardly any transparency. Poor accountability and governing mechanisms also account for many losses. Again, the health workers get low salaries and wages for their work. Also, the medical services record too many medical errors and cases of suboptimal quality of care. Most employees have insufficient knowledge regarding the application of clinical care standards and protocols. The lack of supervision and guidelines are the factors associated with the wastage. The health department is responsible for the employment faults that have contributed to more losses. For instance, the staff mix in most hospitals is costly. The inflexible contracts of the recruited workers deprive them of the motivation and spirit to work efficiently. These issues draw concern about the department’s non-conformity with the pre-determined human resource policies.
The priority of the health care unit should correct the fragmentation of the health care systems, which, in effect, leads to systemic inequity. Pooling in fragmentation ensures that the risks are spread thus making certain that no individual carries the burden of costs solely. In essence, the healthy pay for the sick, the wealthy subsidize the poor, and the young help ease the costs of services for the elderly. The flip-side of this policy is that the contributors of the prepaid scheme redistribute less than the potential amount in larger pools. It is a high cost to the donors. The fact that fragmentation limits the room for reorganization from the levels of prepaid funds makes the progress impede towards the key objectives of universal coverage. It leads to the duplication of administrative costs and bounds the capacity of the system to use strategic purchases in order to back reforms at the provider level. For instance, there is a lot of wastage arising from the holding of seminars attended by the same people to discuss the same topics and funded by different donors. The states need to move towards the providence of universal coverage by de-fragmenting the pooling process while simultaneously finding a new source of financing (WHO). Universality should get incorporated into the health financing strategies by consolidating the smaller pools and recreating them into large scale and budget-funded schemes. Additionally, there should be an assessment of the training systems and service provisions to reduce the level of duplication.
Another prime consideration should be to enhance the control of drugs. The avoidance of falsified, substandard, deceptively labeled, counterfeit, and expired medicine is the first step towards the minimizing of wastage. It is unfortunate that counterfeit products account for close to ten percent of the global market, as revealed by the United States Food and Drug Administration. Considering that this is the lower limit, the earnings from the sale of these substances is US $32 billion (Economic Department). Moreover, this amount is spent on medicine that does not significantly improve the health of an individual. The states must adhere to the Good Manufacturing Practices (GMP) in the production process of pharmaceuticals to eliminate these drugs. Alternatively, all medical supplies must be bought from the GMP-compliant producers. Thus, this action ensures that the drugs are consistently produced and controlled according to the appropriate standards that guarantee there is no contamination, correct labeling, and the presence of active ingredients. The medicines circulating in the market must meet the requirements of the standard, quality, and efficacy. Additionally, product testing must be conducted to ensure they meet these criteria.
After the procurement of these drugs, steps should be taken to guarantee that they are utilized appropriately. Illogical medication leads to death and drives the resources from effective interventions. The most pervasive problem involves the misuse of antibiotics, with half of them getting sold without prescriptions in the unregulated private markets. For example, the overuse of antibiotics to treat acute respiratory diseases contributes additional thirty-six percent to the cost of care. Less than half of the patients with severe diarrhea receive prescriptions for rehydration salts which are expensive yet ineffective (Economic Department). There should be national medicine policies and programs to encourage suitable use. The patients should be explained about the need to adhere to the prescription as dispensed. Clinical guidelines should be developed to address the common diseases in primary care. Strict measures must be taken against polypharmacy, overuse of antibiotics and injections, failure to comply with the clinical guide, and self-medication. Promotional practices must also be regulated. The prescribing and drug dispensing functions must become separate entities.
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Moreover, the perception regarding generic medicine should be changed among the people. Increased use of these drugs would save the federal government more than US $254 billion (Clark). The pharmacists should be allowed to substitute generics for the prescribed drugs. Moreover, it should promote the active purchasing that is grounded in the principles of assessment of cost and benefits of the alternatives. The taxes and duties payable for the procurement of these medical supplies must be removed. Moreover, the prices of the medicine must become publicized. Finally, there must be transparency in the buying and providing tenders. It is progressive to note that many states signed bills concerning transparency requirements (Cauchi). Manufacturers should file reports about the prices by qualifying the posts on their official websites. They must also inform the buyers about increases in the wholesale acquisition cost of drugs and report specified information regarding the price.
The government should also reform the reimbursement and pricing policies. The current system of external and internal pricing fails in many ways. It does not accurately reflect the value of the medicine in terms of health improvement and buyer expediency. The problem accentuates with the agreement of confidential rebates that create a gap between public list price and the actual paid price. Conversely, therapeutic price referencing is more convenient because it makes considerations on whether the advantages are worth the expenditure. The policy is effective when pharmacoeconomic measures get intensified. In this regard, the prices and relative volumes are linked to clinical effectiveness. It enables the buyer to negotiate the payment based on the ability of the medicine to deliver positive outcomes. (Health Division)
The health care providers should maximize the use of medical technology. According to scientific evidence and best practice, they are pertinent in the providence of quality services. However, these positive outcomes are dependent on the selection and proper application (Economic Department). The USA is reportedly the highest spender on diagnostic imaging referrals with rates of 91.2 MRI examinations per 1000 people. A major proportion of these tests are usually unnecessary (World Health Organization). Furthermore, despite the high expenditure on the acquisition of this equipment, most of them remain idle because they cannot become integrated into the system. The development partners can avoid this wastage by making consultations with recipient institutions confirm the need for such an equipment. Rational management systems must be established by the government to organize the storage of these supplies and checking the devices for compatibility, completeness, and quality. Formulation of a policy to monitor variations in practice patterns could help save the resources while improving the health outcomes.
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It is common knowledge that motivated workers produce the best results. Therefore, this particular idea should become incorporated in the health industry. Medical workers are the heart and soul of health services, which is the reason why ineffective recruitment procedures, inadequate training, lack of supervision, and maldistribution are the obstacles to the success of the sector. Besides, improper compensation leads to high turnover rates. As a result, these failures decrease the productivity of the workforce (World Health Organization). The job descriptions should be clear, indicating the objectives, responsibilities, the authority, and lines of accountability. Hence, this move, along with the in-service training, improves job satisfaction and compliance with standards. The notion of professionalism in the health sector must be promoted. Institutions should show support for the norms and codes of conduct that ensure the health workers behave themselves with integrity and make the patients’ needs their prime consideration. These values must be instilled in every employee. Moreover, their skills must match the particular tasks assigned to them. Supportive supervision and audits also help enhance the workers’ efficacy. Furthermore, this strategy should be extended to the private providers, supervisors themselves, and lay health care providers, who are often neglected. The working environment should be modeled to suit the caregivers. The primary support systems include remuneration, information, infrastructure, and equipment. Stunted performance is an attribute of underpayment. The government should make efforts to provide suitable compensation to the workers. Income supplements such as tuition reimbursement are an example of incentives. (World Health Organization)
Summarily, the primary concern of the health department should be directed towards making health care economically sustainable. The sustenance is dependent on the ability of the government and institutions to make collaborative efforts to correct the loopholes that lead to wastage of resources. The primary sources of wastage are derivatives of human resource, medicine and technology. Indeed, no single approach can completely reform the health care systems. Coherence can be achieved, alternatively, by adopting practices that have worked in the past in various countries. They may be tailored to suit the actual and preferential needs. The core objective is attaining the value for money in the health sector while simultaneously improving the physical conditions of people. Considering the sheer bulk of resources consumed by the health industry, it is paramount to control the management in the field to realize the value for the money. Additionally, the excesses of the unit may be directed to other industries. The failure to achieve effectiveness may result in undermining of the public finances by the demands of the health unit.
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