Impact of User Fees in Healthcare

Impact of drug exploiter Fees in Health look at cosmosAn old proverb offers a world of insight when it says that wellness is riches. Truly with by wellness nonhing in life is worth it be it a million dollar bill Ferrari or a state of the art beach ho uptake. Looking at the statistics, the overall health of the community across the globe is deteriorating and no amount of medical technology or innovation is able to suppress the position that throng be really getting sicker and need treatment. Method of unconstipated upment differs from one cracker-barrel argona to another and within countries as well. The true nations assert their citizens by subsidizing health reverence and make it save in some cases. The exploitation nations amaze government hospitals which offer treatments at subsidized rates. The health care burden that the developed nations are facing is colossal. In an attempt to reduce this burden, some suggestions of introducing a co- carryment are being made in the developed nations. The rationale behind this suggestion is that batch who are cover with insurance tend to over use medical operate because they dont agree to pay anything off of pocket. However, critics argue that introduction or rise of existing co-payments testament profoundly erode the will to get treatment done and many individuals will end up not going to doctors for ingrained treatment. The proponents of co-payments assume that every individual is insured and able to afford co-payment. This is contrary to reality where many quite a little are unable to pay for even the most basic necessary medical interventions. I support the latter. One of the primary reason behind my conclusion is that this would add the burden on the bourgeois and the unretentive population for their health care and worsen their condition.Background on drug user fees in health careHealthcare is generally price inelastic. People who have used these services pay the predetermined pric es, at least for critical care, absolutely essential visits to the physician and prescribed medicines. Moral hazard arises when an insured person chooses excess/ more than expensive form of healthcare because she/he knows that the insurance company will be remunerative for it(Banerjee, 2010).Developing countries like India and China have made their health care services such that the mickle get more of health care at a subsidized rate due to the incident that 29.5 % of the population in India lies below the beggary line (Kaul, 2013). The ultra-low-cost position of hospitals in countries like India may not seem surprising because the wages are signifi tummytly lower than those in the developed countries for instance the U.S. and U.K. However, the health care available in these hospitals is cheaper even when the wages are adjusted For example, even if Indian neurologic hospitals pay their doctors and staff salaries of U.S. level, their be of open-heart surgery will still be one- fifth of those in the U.S(Vijay Govindarajan, 2013).nether such circumstances, if the government increases the rates of health care services, it would antedate to under usage of these services because the people would have lesser access to hospitals due to the gamyer costs as compared to their salaries and savings. Not many people in such countries choose to insure themselves for health because of the perceived limited requirement of hospital services as compared to high payments to the health insurance companies.Rationale for introducing exploiter feesThe rationale behind keeping drug user fees could be that they could generate additional tax income for the health industry when financial help from outside sources were minimal, financial obligation refunds were shooting up and the governments of medium income countries were feeling the pressure on their internal finances. at that place was also a philosophical shift in the functioning of the healthcare industry in the early 19 90s during which, the outline of out-of-pocket payments was introduced. In this, the forbearings were asked to pay for the services they get from the hospitals which in turn motivated the healthcare workers and increase their efficacy (Action). Quality arse be improved with better finances and remuneration. And quality is a significant aspect of health care which cannot be compromised under any circumstances. In the later years, after implementation of totally free health care, it was realized that some patients actually over used medical services. Introduction of a user fees greatly reduced this moral hazard. Secondly, bulk billing and abolition of user fees leads to an change magnitude burden on the government financially. The rising cost of health care compels the government to introduce a system where the consumer is liable to pay some amount. Supporters of user fee also claim that universal health care is a myth and the citizens ultimately bear a much higher cost (than the user fee) for the so called free medical treatment.User fees compounded povertyUser fees inconsistently scathe the health of poor and middle class people. They tend to push families into debt and poverty thus compelling them to hunt money through illegal means or from financiers, or to sell or hypothecate ancestry or resources that they depend upon to earn a living. The charges can especially pressurise women who have fewer resources to assert on.Such circumstances tend to create a brutal condition where in there is a constant increase in poverty which leads to malnutrition and the ailments they live with. This results in poorer health which ultimately results in big issues each time there is a need to pay for healthcare emergencies.The World Health governing body estimates that 100 million people each year are forced into poverty by these sharp healthcare costs (Action).When reporting to the hospital becomes excruciating because of high costs, people are more presumable to plight care at home. This increased load of care in addition to other mansion work usually puts burden on women and girls This may force them to entrust their education or jobs to take care of the ill (Action).Studies done by the World Health Repot Report of 2010 show that the distress of non-communicable diseases is emerging and is already a major drawback even in the poorest countries and the people are unable to have access to the services they need to prevent or control these diseases due to financial incompetency or inability to access those services (Priyanka Saksena, 2011).Household burden due to specific non-communicable and chronic illnessesA get along of studies demonstrated that the kinsfolk burden led to financial crisis from specific illness and conditions like, diabetes in India for example, presented that 596 diabetic patients taken as sample group at a private and public hospital in Chennai showed that in the private hospital, the poorest sample of patients sp ent 24.5% of their income on services for diabetes, compared to 3.5% in the richest group. This was mainly demonstrated because of the increased out of pocket costs. On the other hand, in the public hospital, where middle class family income was much lesser than in the private hospital, the poorest group payed 3.3% of their income on diabetes care while the richest cluster almost 0% of their incomes on care.another(prenominal) research that was done in 2006 on the total economic cost of illness for households was continuously above 10% of household income. As an illustration, total household charges of malaria per annum were as large as 18% of one-year income in Kenya and 13% in Nigeria. Total expense for all forms of illness added up to 11.5% of monthly household income in Sri Lanka, and about 11% of average monthly income in Nigeria. Some of the researches are concerned that even 10% of household income being disbursed by health care expenditure as potentially bleak where the m edical expenditure levels are prone to drive households to cut their consumption of other basic needs, knowledgeableness productive asset sales or high levels of debt, and lead to impoverishment. It is clear that this is a somewhat natural cut-off point and expenditure levels lower than this may be catastrophic for very poor families. Furthermore, it is not notwithstanding the level but also the timing of health care expenses, which have to be paid in full at the time of illness in the case of out-of-pocket payments that determine whether or not there are catastrophic consequences for a household. This is related to the unexpected nature of most medical expenditure, the fact that the magnitude of payments is heavily influenced by the provider, and that this is precisely the time when income may be lower than usual(Diane McIntyrea, 2006).Current perspectives on User fees in health sector in medium and low income countriesEquitable approaches to financing health services are crucia l for achieving the goal of universal coverage of health services. When user fees are designate to a particular service, they become an inequitable financing mechanism which produces barriers to access for a large build of people. Though in some of the Public Health Centres, revenue is provided by the government, it is almost al shipway that it turns out to be inadequate and a persistent challenge in the developing countries(Rohan Sweeney, 2011). This thus leads to imposition of user charges which hinders the poor from using the available services.Another example of this is that under the Alma Ata declaration of Health for all, developing countries like Bangladesh tried to design country health care programs but had continuously failed to do so because of the problem of increased health care needs and decreased available resources. Hence, when user charges were imposed, there were sound interferences between the two most vulnerable groups which are the poor and the women and the maintenance of patient profile (Stanton B, 1989).There have been studies that show that when user fees were introduced, there was a substantial decrease in the use of health care facilities that ranged from 5% to 51% immediately after the intervention but a significant increase in the use of most curative services was seen that ranged from 30% to 50% when the policy was changed again (WP, 2014).Unfortunately, it is hardly the user fees that the researches and economists concentrate on to reduce moral hazard. Doctors are well equipped to judge whether a patient requires treatment or not. When such wide spread reliance is placed on doctors regarding treatment, wherefore cant the same doctors be trusted not to over treat a patient? It must be made mandatory for doctors and other health practitioners to take steps to prevent themselves from doing treatments that could be otherwise be tamed.How do the hospitals function with low prices of healthcare services?Three major practices have allowed the hospitals of low and medium income countries to cut costs while still improving their quality of care.A hub-and-spoke system DesignIn order to reach the people in need of care in the rural and other remote areas, hospitals must create hubs in major the city areas and open smaller clinics in rural areas that transfer patients to the main hospital that has all the diagnostic facilities and other resources.This would reduce the need for duplicating the personnel office and equipment in every village and the most expensive equipment and expertise in the hub, thus eventually decrease the cost burden on the village population. It would also create specialists at the hubs who, while performing great numbers of focused procedures, develop the experience that will improve the overall quality. This can also lead to proper and frequent utilisation of machines. For example, an MRI machine if installed in every village separately, would do alone 1-2 scans per day. But if a commo n machine is installed in the main hub, it would scan about 10-20 patients per day.Task displacementThe hospitals can transfer responsibility for routine tasks to lower-skilled workers like the newly graduated and less experienced doctors, leaving expert doctors to handle only the most complicated procedures. Again, such countries always face problems because of shortage of highly skilled doctors. Thus, hospitals have to maximize the duties they perform. Doctors at these hospitals tend to become incredibly productive as they can focus on only the critical parts of the surgical procedures and the final decision making during the diagnosing of diseased conditions. This allows them to perform 6-7 surgeries in a day rather than just 1-2 surgeries in other developed countries like the U.S.This innovation would ultimately reduce the costs. After shifting tasks from doctors to nurse practitioners and nurses, multiple number of hospitals can create a lower tier of paramedic employees with two years training after high school to perform the most routine medical jobs. In some hospitals, these workers can comprise more than half of the workforce.Good, Old-Fashioned FrugalityNecessity is the mother of invention- Hospitals of lower income countries should come up with wiser ways of sterilization techniques and safely reusing the surgical products that are otherwise discarded after a single use in other developed countries. These hospitals must concentrate less on building designing and making it attractive and spend more on the amenities that would be needed for the welfare of the general population using them. They have also developed local devices such as stents or intraocular lenses that cost tenth the price of imported devices.These hospitals can be innovative in rewarding doctors. In the program where fees are payed for every service, an incentive to perform unnecessary procedures and tests is created. Thus, the doctors at some hospitals must be paid inflexible sa laries, irrespective of the number of tests they order. Other hospitals can employ team-based compensation, which produces peer pressure to avoid unnecessary tests and procedures (Vijay Govindarajan, 2013) stopping pointIn conclusion, it can be stated that the user charge has an abundance negative implications in the socio-economic, socio-cultural, semipolitical and administrative and management dimensions. Developing country administrators must wipe out fees for essential healthcare and choose a program of financing that will best improve access to health services for their most do by groups. This should be suitable to existing institutional structures, cultures and traditions, and to their economic progress. This could be through taxation with healthcare costs paid by the government. Putting an end to user fees is likely to see a rise in the use of services. Governments of developed countries should provide foreseeable aid, committed for the long term, to give developing countr ies the confidence to eliminate fees. The World Bank and other international institutions must stop prescribing user fees to countries as part of decreed or unofficial policy advice and provide more financial assistance to scrap fees. The low pay and poor conditions of health workers must be addressed to stop informal fees being tolled(Action).ReferencesAction, H. P. Key Facts User Fees for Health Services. Retrieved from http//www.healthpovertyaction.org/policy-and-resources/health-systems/user-fees-for-health-services/key-facts-user-fees-for-health-services/Banerjee, R. (2010). HEALTH INSURANCE AND MORALHAZARD. Retrieved from https//www.academia.edu/938630/Economics_Insurance_and_Moral_HazardDiane McIntyrea, M. T., Gran Dahlgrenb, Margaret Whiteheadb. (2006). What are the economic consequences for households of illness and of paying for health care in low- and middle-income country contexts?. Social Science Medicine, 62(4), 858-865. Retrieved from http//www.sciencedirect.com/sci ence/article/pii/S0277953605003631Kaul, V. (2013). Required A new poverty line that shows 67% of India is poor. Retrieved from http//firstbiz.firstpost.com/economy/required-a-new-poverty-line-that-shows-67-of-india-is-poor-43862.htmlPriyanka Saksena, K. X., David B. Evans. (2011). Impact of out of pocket payments for the treatment of non-comuunicable deseases in developing countries a literature review. Retrieved from http//www.who.int/health_financing/documents/dp_e_11_02-ncd_finburden.pdfVijay Govindarajan, R. R. (2013). Indias Secret to Low-Cost Health Care. HBR Blog Network,Retrieved from http//blogs.hbr.org/2013/10/indias-secret-to-low-cost-health-care/