There reaches a point in time where principles that governed the operation of a given activity cease to apply or have any significant impact. A change occurs in the minds of the people who are entrusted with the responsibility of delivering services although they may continue doing business as usual, they grow frustrated and doubtful the way various functions within a given industry are executed. Although the industry in question does not come to a standstill, there is a sentiment of confusion and general murkiness engulfs all activities linked with it. When an industry reaches this point, then revolution in the whole system is inevitable. When we clearly look the health care system in the United States of America, it has reached a point where revolution in the whole system is indispensable because the fundamental principles that kept it rolling nolonger apply. Although it is not tottering, it is slowly but constantly revolving into a new form. The troubles that have hit the industry have led to warfare among various key players of the industry, that is; doctors and other health professionals, hospitals and insurance companies with each trying to blame the other for the problems that the industry is experiencing. Of importance to note is that the health policy expert whose exclusive role for generations has been to address inefficiency in the industry, economies and distribution is poorly equipped to handle the health care revolution that is underway (Ronald 2000).
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In his article ‘the cultural revolution in health care’ Ronald says that nurses and other health professionals are trying to expand the scope of their practice into areas that have traditionally been preserved for doctors. Also the doctors are marching into the hospital domains by running surgery centers. Ronald continues to say that the Hospitals are trying to assume risks thus operating like insurance companies. On the other han, the insurance companies are trying to make heath care decisions thus assuming the fundamental prerogative of doctors and nurses. In this article Ronald says that each group believes it is through magnifying the scope of their functions that it will be able to survive because they believe that the old roles are sacrosanct even though the new ones are not yet defined (Ronald 2000).
When look in history, culture revolution has had a great impact on the form of health care system to be found in a given country and its success. For instance Maoist china which was not a rich country was able to come up with a universal health care in which health services were provided for free or at a very low cost. In this system health care was based and guided by principles of cooperation and egalitarianism. This is something that rich countries like the United States of America are still struggling up to date to achieve. The Obama administration is trying very hard to contain the escalating cost of health care through the adoption of the universal health care insurance. During the culture revolution on Maoist china, the focal point of health care and expenditure shifted to the countryside even as the overall health care was enhanced in major cities. This led to availability of health services even in the country’s most remote areas. By the early 1970s Shanghai had the lower infant mortality rate as compared to New York at the same time. Also life expectancy under Mao doubled from 32 years in 1946 to 65 years in 1976. All these improvements were attributed to the socialist revolution in china upon which all revolutions in the health sector were based (Lotto 2006).
The United States of America is often described as ‘a liberal welfare regime’ because it represents resdualism, individualism and punitive view of poverty. These issues have dominated the US social policies and welfare debbates for instance the introduction of ‘workfare’, criticism of the underclass and exclusion of long term dependants. When we look at the US social policies, there is no unified welfare system. Federalism means that important functions are held by the states these includes public assistance, health schemes and social care for instance the state of Hawaii has had mandatory state funded health care system and health insurance since 1976. The current health reforms proposed by the government, for instance ‘universal health insurance will break that diversity.
Despite viewing the ‘US as liberal regime’ in practice it is a pluralistic because of the transformations that are constantly taking place. There is significant departure from the residual model for instance social insurance, state schooling or services for military personnel, veterans and their families which provide for at least 60 million people (Klass 2004 ). Also in addition to federal and state activity, there are wide-ranging private, mutualist and corporate interest in social welfare provision. This has led to more complex and unusually expensive systems.
Due to global recession and increased retrenchments, many developed countries including the US have moved towards general coverage of the costs of hospital care and adoption of more all-encompassing social protection policies. There has also been a great diversification of the basis of coverage through an amalgamation of governmental and nongovernmental organization. This has lessened the magnitude of inequality (Mishra, 2000).
In conclusion we can say that the health system seems to be evolving to unknown direction. Even the experts, managers and policy makers who have contributed to this Cultural Revolution seem to have little they can do or predict but to just watch as the whole health care system reshapes into the unknown.
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