NATIONAL HEALTH CARE

National Health Care

National Health Care

Introduction

The United States is generally viewed as having the best health care in the world—when best is defined as having the most advanced technology and highly skilled specialists. However, when the United States is compared on basic health status factors against other countries in the world, it comes up deficient. Infant mortality status is a measure of how many children die before their first birthday. On this measure, the United States ranks 42nd in the world behind countries such as Cuba, Portugal, Finland, the Czech Republic and many others (Central Intelligence Agency, 2008). When measured on the average life span of its citizens, the United States was reported in 2006 at 78.0 years, the same as Cuba and Chile and behind countries such as Switzerland (82), Spain (81), Sweden (81), Canada (81), Singapore (80), and the United Kingdom (79). These data suggest that the U.S. population, while enjoying access to the most highly sophisticated medical services available, is not as healthy as other developed and underdeveloped countries (Birk, 2008).

The “New” Consumer

The evolving role of consumers in taking more responsibility for their health and the consequent rise of consumerism in health care have created the need for a shift in the way in which health care executives think about their customers. Compelled to reach deeper and deeper into their pockets to cover the cost of care, customers are more knowledgeable and bring higher expectations to their medical care experience. Effective leadership entails a move away from physician-centric operations to consumer-centric practices, from passive models of customer service to active models, one that measures success from the patient's perspective—which typically is focused on the health care experience (Buell, 2008).

This has implications for the hospital—in a slow economy more patients are unable to pay for medical costs and the hospital is at higher risk of bad debts when the patient cannot pay for services. If, on the other hand, consumers do not get medical care, they go to emergency rooms in acute phases of illness—a very costly alternative to the primary care they might have sought, had they had the financial resources or the will to seek care early (Central Intelligence Agency, 2008).

Corporate Status of Hospitals and Health Systems

Hospitals may be structured as Nonprofit or as for-profit organizations. As with other Nonprofits, this organization structure brings with it the opportunity for tax exemption and the responsibility to provide community benefit. Recent controversies in the hospital sector have questioned whether the levels of charity care, community benefit, and executive compensation provided by not-for-profit hospitals are consistent with mandates of their tax-exempt status and mission statements.

In the United States, about 60% of hospitals are nongovernment—owned Nonprofit community hospitals (about 18% are for-profit corporate entities, and 22% are state and local government — owned hospitals). Along with the significant advantage to be found in tax-exempt status comes the demand that proportionate community benefit should be returned. While this is a basic and long-standing quid pro quo, the criteria by which community ...