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Understanding HealthCare

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Understanding HealthCare
Discussion Week One
Hospitals and other health care institutions, whether voluntary or for-profit, need to be financially solvent to survive growing market pressures. In what ways has this “bottom line” focus changed the nature of the US health care system?
The establishment of health services now depends almost entirely on its profitability. The predominant view of corporate-minded politicians at federal, state and municipal levels is that government does not belong in the health care business and should divest itself of its health care assets. To save themselves the hospitals must cut costs, merge in order to realize greater economies and capture markets and generally begin to function similar to other competitive business entities. The hospital, the final holdout in the total commodification of health care, must now drastically rewrite its traditional mission statement if it is to survive.
If present tendencies continue, two developments are likely to occur. First, the hospital will become a thoroughgoing creature of the marketplace. The financial bottom line will displace the clinical base line, wherever it not already done so. Hospital mergers “downsizing” and “shrinkages” are likely to accelerate. Hospital staff will continue to be replaced by machines wherever it is economically and technically feasible. The ideal patient will be one who’s got lots of insurance coverage, but isn’t particularly sick. Second, those without insurance coverage will receive less medical care. As private hospitals tighten admissions policies to maximize reimbursements, the poor and uninsured will be caught in a double bind. The cash-strapped public system will close its clinics or restrict access, cut back on services, and be generally less capable of providing quality care.
Discussion Week Two
Although your textbook states that "ambulatory care is the predominant mode of health care delivery in the United States" (p. 121), the CDC's National Center for

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