The book “Health and Health Care 2010: The Forecast, The Challenge” by Roy Amara et al. provides detailed analysis of trends that will affect health care policies and practices by 2010. In particular, the authors have made an excellent effort to forecast stability and volatility of health care in the USA. The authors cover the following topics: health care forecast, demographic trends, health care demands, health insurance, children’s health, medical and information technologies, diversity and the workforce.
Managers and staff members will find the chapters about information and medical technologies of particular interest. Nevertheless, the issue of ablation is paid too little attention. The authors argue that the primary purpose of the book is to make readers aware of critical factors that affect health care system in the beginning of the 21st century. When speaking about demographic trends and burden of disease, they claim that American population will be more ethnically diverse and older. Thus, such situation will be very likely to result in increased number of chronic diseases.
One more important problem is that health care costs have increased meaning that less people can afford highly-qualified medical support. The authors predict growth of Medicare and Medicaid by 2010 due to changes in health care insurance systems. They say that “during the 1990’s, the managed care became the dominant health care insurance and delivery system, covering more than 60 percent of publicly and privately insured lives”. (p. XX) Managed care plays is argued to play important role in controlling national expenditures on health care, and people are provided with coordinated health care.
Nevertheless, managed care is highly criticized by physicians, the media and consumers, but the government decided to make managed care an effective mechanism of controlling costs and delivering health care. The way the health care system is organized is swiftly changing, and surplus of hospital beds will contribute to consumer’s market. However, intermediaries will be entailed with a new role. The authors mention that the negative moment is that little changes were provided in the way the physicians practice medicine. Even the invention of the telephone, the computer and Internet didn’t significantly change medical practices.
Of course, exceptions are present. It is physicians who are the central figures in health care, but surplus of doctors and new roles of health care providers are very likely to shift that paradigm over the next decades. New medical and information technologies are of particular interest for managers and staff members, and they are claimed to be the key driving force in organization of the health care system in the beginning of the 21st century. The problem is that health care industry is the last in implementing information technologies that would increase quality and effectiveness of health care delivery.
The authors write that “beginning in the19th century, medicine has made great strides in verifying the germ theory, creating aseptic surgical techniques, discovering antibiotics, developing anesthesia, and imaging the inside of the body”. (p. 111) Of course, the impact of such innovations is undeniable and huge as physicians gained an excellent opportunity to improve public health, to extend the life span, and to improve the quality of life. Moreover, the quality of health care delivering was heightened as well.
Nine medical technologies are argued to significantly affect the outcomes of patient care and health care delivering: rational drug design, advances in imaging, minimally invasive surgery, genetic mapping, genetic testing, gene therapy, artificial blood, effective vaccines, implementation of stem cells and xenotransplantation. Stem cells “can generate all other types of cells in the body and therefore hold great promise for replacing or repairing tissues and organs damaged by disease”. (p. 131) Researches of stem cells are nowadays one of the most interesting, the most promising and contradictive area of discussions and medical researches.
Many researchers agree that development of the new method would open new doors before medicine. Some scientists say that creating of new human embryo must be prohibited, because it s morally unacceptable and religiously unethical. The authors continue that medical management is implemented sporadically nowadays. In particular, medical management is defined as an active management of the care of the population. Today, medical management fully depends on information systems that are used for monitoring and tracking medical processes and outcomes.
Disease management programs positively impact medical practices and patient management. When speaking about public health, the authors admit that “over the past 30 years the public health system has operated under pressures of resource scarcity, limits in leadership, and organizational fragmentation”. (p. 9) Public health system is safety-net medical provider, and economic problems make its performance hardly bearable. Over the next decades global forces will the context in which public health systems will be very likely to operate.
The authors conclude that global economies increase health risks and, therefore, public health system should be embedded in the context of global threats and opportunities. Cost-effective technologies should be developed for enhancing surveillance, screening and environmental health. Finally, public health strategies should aim at employing ecological strategies as ecology is human and structural determinant of health behavior. Managed care will remain dominant in health care insurance. References Amara, R. et al. (2003). Health and Health Care 2010: The Forecast, The Challenge (2nd ed. ). Princeton, NJ: Jossey-Bass.
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