The governments role in healthcare has many different facets, as regulator,
purchaser of care, provider of health services, sponsor of applied research and
demonstrations and the education and training programs for healthcare
professionals (Corrigan et al, p 58) It also manages licensure, structure or
competency requirements for hospitals. The government also regulates the
requirements for Medicare and Medicaid and the integral part of the clinical
management process of Veterans Health Administration, Department of
Defense and Tricare (Corrigan et al, p 59) The impact to the different health
organizations may be due to the regulations and if the organization has
achieved higher performance in the quality standards then that organization
may receive bonuses or payments based on diagnosis.
I think that health insurance impacts healthcare delivery in terms of quantity
not quality. In my field of pharmacy, depending on what insurance a person
has is what is covered on their formulary. Those with the state aid or Medicaid
may not have the medication list (formulary) to choose from that someone
with commercial insurance may cover. Then there are those with Medicare
that have to deal with the the 'donut hole" causing medication cost to go
through the roof and medication adherence to be affected due to patients not
being able to afford their medication. If a patient has a special diagnosis that
requires a specialty medication that also may be prohibitive in getting the
medication.
I think that we can reduce the number of uninsured people by making it
available - Having the resources to go and get information for those that are
unemployed or may not have the means to get insurance. If you have a younger
adult that is just out on their own, it is not learned in school about oh by the
way - you need health insurance. There are also barriers such as transportation
and costs and geographic area. The knowledge is also a key. Those that are
employed get the information from the organization they are involved in
Strengthening the resources for those that need the help or need the knowledge
on how to find insurance might point them in the right direction.
References
Corrigan et al (2003) Leadership by Example: The Role of Government with
Healthcare, National Academy of Sciences
