Resource Allocation in Health Care – Examination of resource allocation in the health-care industry is complicated because the market characteristics differ from those in a perfectly competitive market. The market for health-care services is considered an imperfect market because – 1)Health care is a heterogeneous product, as the patient can experience a range of outcomes; 2) Patients who are insured have third-party payers covering their direct medical expenses; and 3) A “market price” is lacking, i.e., no feedback mechanism exists that reflects the value of the resources used in health care.
- While the perspectives of consumers, producers, and society converge in a perfectly competitive market, hospital patient costs in the health-care market are different for patients (consumers), health-care providers (suppliers), insurance companies (third-party payers), and society.
- The economic impacts of pain and suffering are of concern to the patient and society, but may not be relevant to a purely economic analysis of costs from the perspective of health-care providers or third-party payers,
Regardless of perspective, economic thinking provides one common goal: efficiency, or getting the most from available resources. A hospital administrator, for example, is faced with the challenge of organizing resources to meet the organization’s goals.
The relationship between the range of productive inputs utilized and outputs produced can be characterized by a production function, which shows the maximum amount of product that can be obtained from any specific combination of resources (or inputs) used in producing a product (or output). By identifying the relationship between output and inputs, one can find the combination of inputs and output that maximizes economic return.
The classic production function from economic theory follows a standard curve (Figure 2) that demonstrates the relation between one input and one output, This curve involves a variable input as opposed to a fixed input. Changes in the quantity of variable inputs will cause variation in the quantity of output produced (e.g., varying application of a fertilizer to a crop).
- Fixed inputs are those that must be in place before production can begin and do not vary with output levels (e.g., buildings).
- This curve embodies the notion of diminishing marginal returns.
- As one increases an input, a point is reached at which the additional output produced by adding another unit of input begins to get smaller and smaller, ultimately leading to a decline in the total output produced.
The fixed input becomes overextended by the expanded production. For example, adding too much fertilizer to a crop can compromise soil quality and lead to a decline in output. Figure 2. Standard curve of production function, demonstrating the relation between one input and one output. This is a technical relationship that does not yet include dollars. If the organizational goal is to maximize output, a producer would employ I B units of input to produce O B units of output.
- This approach would make sense if inputs were free.
- However, inputs are usually not free.
- This is where an economist steps in.
- At some point before the maximum, the value of the additional output created by an additional unit of input is less than the cost of this additional input (e.g., spending $10 in additional input costs may yield only $8 in additional output value).
The decision rule is to produce only as long as the value of additional output is just equal to the cost of the additional input.1 For this figure, the region where it is “economic” to produce is somewhere between input quantities I A and I B, The information needed to identify these productive relationships in a hospital must come from hospital epidemiologists as well as from hospital accountants.
|A complicating factor omitted from the discussion is time. In a longer view of time, all fixed inputs are considered variable and can be redeployed to some other productive process. Therefore, fixed costs must be covered in the long run. Since fixed costs are ‘sunk” costs (spent before production even begins), it makes sense to keep operating for short time periods (as opposed to shutting down all production) if variable costs are covered.
Emerging Infectious Diseases.2001;7(2) © 2001 Centers for Disease Control and Prevention (CDC) Cite this: Applying Economic Principles to Health Care – Medscape – Mar 01, 2001.
Why is America’s healthcare system flawed?
The United States does not have a uniform health system and has no universal healthcare coverage. The health disadvantage of the U.S. relative to other high-income countries is health disparities in health services. The United States does not have a uniform health system and has no universal healthcare coverage.
- The health disadvantage of the U.S.
- Relative to other high-income countries is health disparities in health services.
- Although the U.S.
- Is renowned for its leadership in biomedical research and cutting-edge medical technology, its medical system faces significant issues such as preventable medical errors, poor amenable mortality rates, and lack of transparency in treatment.
Another problem that Americans are facing is difficulty in finding a good doctor. High costs of care and lack of insurance coverage for low and middle-class families have led to social and economic discrimination in healthcare services. Due to the shortage of nurses, physicians, and specialists in hospitals and health centers, among other rising challenges in public health care, Americans are unable to get the optimal quality of medical care they require.
- The U.S. stands out from many countries in not offering universal health insurance coverage.
- Fifty million people, 16% of the U.S.
- Population, lack insurance coverage.
- Medical expenditures such as pharmaceuticals and medical supplies have increasingly become unaffordable for marginalized communities.
- Therefore, paying medical bills and other medical costs have become high out-of-pocket expenses.
Deprived communities continue to lack access to primary healthcare services and rely on emergency departments to treat chronic diseases and preventive care. The Biggest Problems with the U.S. Health Care System High Costs of Care U.S. healthcare underperforms in most verticals.
- High cost is the primary reason that prevents Americans from accessing health care services.
- Americans with below-average incomes are much more affected, since visiting a physician when sick, getting a recommended test, or follow-up care has become unaffordable.
- These patients have acknowledged the difficulty in paying medical bills and other expenditures.
According to U.S. healthcare experts, the cost of new technologies and prescription drugs has risen. The availability of more expensive, state-of-the-art medical technologies and prescription drugs generate demand for more intense, costly services even if they are not necessarily cost-effective.
The increased costs of medical services occur due to the rise of chronic diseases, including obesity. Nationally, chronic illnesses contribute huge proportions to healthcare costs, particularly during end-of-life care. For example, patients with chronic illness spend 32% of total Medicare spending, much of it going toward physician and hospital fees associated with repeated hospitalizations.
The National Academy of Sciences found that the U.S. has a higher rate of chronic illness and a lower overall life expectancy than other high-income nations. Therefore, medical experts focus more on preventative care to improve health and reduce the financial burdens associated with chronic disease.
High administrative costs are a contributing factor to the inflated costs of U.S. healthcare. The government outsources some of its administrative needs to private firms. The aim is to improve administrative efficiency and provide healthcare quality to the citizens. Lack of Insurance Coverage The majority of U.S.
citizens have health insurance; however, the premiums are rising, and the quality of the insurance policies is falling. In addition, average annual premiums for family coverage have increased, outpacing inflation and workers’ earnings. The lack of health insurance coverage has severe consequences for the U.S.
Economy. The Center for American Progress estimated that the lack of health insurance in the U.S. costs society between $124 billion and $248 billion per year. In addition, shortened lifespans and the loss of productivity are observed due to the reduced health of the uninsured. Health insurance coverage is uneven; minorities and deprived families lack insurance coverage.
As a result, they face more health hardships than insured Americans. Moreover, the uninsured may not seek medical care due to high costs and avoid regular health screenings. Hence, they are also likely to access preventive health services as well. The United States Census Bureau annually reports that around 27.5 million lower-income workers did not have health insurance.
Lack of health insurance is associated with increased mortality, ranging from 30-90 thousand deaths per year. The number of people without health insurance coverage in the United States is one of the primary concerns raised by advocates of health care reforms and policymakers. Lack of Transparency Fraud and cover-ups are widespread in the U.S.
healthcare system. For example, a significant problem is upcoding between providers and insurance providers. The providers “upcode” a procedure to get more money from insurance companies, but insurance charges higher premiums from employers. Hence, health consumers get stuck in the middle without any control over health outcomes and pricing.
Difficulty in finding physicians and specialists With a lack of accessible doctor credentials and accomplishments, health consumers cannot easily find a good doctor. Instead, consumers rely on uninformed online reviews that can help with assessing traits like staff friendliness and wait times. But, these platforms do not evaluate a physician’s skill level in helping people with their health disorders.
A new AAMC study projects a shortfall of up to 139,000 physicians by 2033. According to the study, more physicians are reaching retirement age. More than 2 of 5 active physicians will be 65 or older within the next decade. Each doctor’s retirement plans affect the health system.
- The growing concerns about specialists’ burnout are also rising.
- The shortage of medical specialists has also affected America’s healthcare workforce, leading to a range of problems, from limited patient access to poorer outcomes.
- The increasing lack of physicians and medical experts over the last two decades has demonstrated that the medical system needs to increase the number of physicians to ensure safe and quality health care services for the people.
Unfortunately, despite ongoing efforts by many healthcare leaders and academics to find long-term solutions, there doesn’t seem to be a solution in sight. Health System Need to be Empowered Broad changes are taking shape. For example, payers of health care are increasingly incorporating the concepts of social determinants of health into the way they think about compensating for healthcare services and providing incentives for health care service providers.
The Affordable Care Act (ACA) has made significant changes in the U.S. healthcare system. The provisions included in the ACA are intended to expand access to healthcare coverage, increase consumer protections, emphasize prevention and wellness, and promote evidence-based treatment and administrative efficiency in an attempt to curb rising healthcare costs.A significant provision of the ACA was creating health insurance marketplace exchanges in which individuals provided with a program such as Medicaid or Medicare can shop for health insurance. In addition, individuals with incomes between 100 percent and 400 percent of the federal poverty line would be eligible for advanced able premium tax credits to subsidize insurance costs.A national health service will be provided to low-income communities. The medical services are delivered via government-salaried physicians in hospitals and clinics that are publicly owned and operated—financed by the government through tax payments. In addition, private doctors have specific regulations on their medical practice; they collect their fees from the government.A multi-payer health insurance system provides comprehensive health insurance via “sickness funds,” used to pay physicians and hospitals uniform rates. This health insurance coverage eliminates the issue of paying the medical bills and higher costs of the uninsured, especially for emergency services.Developing consensus protocols that streamline medicine delivery and reduce variability can improve quality and lower costs in health care. However, more research on preventing medical errors from occurring is needed to address the problem.Through technology and innovation, find a qualified doctor that treats the condition properly. Some websites attempt to help to seek out the best doctor but lack updates necessary to keep up with constant changes. New technology will enable the users to quickly identify health experts specific to location and health condition, all within one interface. Online techniques and various resources will help people to get connected with different physicians and experts around the globe.The Affordable Care Act authorizes the state to negotiate the price of prescription drugs and bulk purchasing of prescription medications and durable medical equipment and supplies. This will help to lower the cost, and private insurers can continue to enter into private agreements between providers.
Thus, improving healthcare quality can be viewed on both a macro and a micro-level. It includes collecting data and analyzing patient outcomes, focusing on patient engagement, and collaborating with different organizations to provide access to health care.
Why is healthcare overpriced in the US?
The Increasing Cost of Healthcare Services – Prices are another significant driver of healthcare spending in the United States; the cost of healthcare services typically grow faster than the cost of other goods and services in the economy. In the past 20 years, the Consumer Price Index (CPI) — the average change in prices paid by urban consumers for various goods and services — has grown at an average of 2.4 percent per year while the CPI for medical care has grown at an average rate of 3.4 percent per year. There are many possible reasons for that increase in healthcare prices:
The introduction of new, innovative healthcare technology can lead to better, more expensive procedures and products. The complexity of the U.S. healthcare system can lead to administrative waste in the insurance and provider payment systems. The consolidation of hospitals can lead to a lack of competition or even a monopoly, granting providers the opportunity to increase prices.
More research needs to be done, though, to confirm the reasons that healthcare costs grow so quickly.
What is the American opinion on the healthcare system?
Conclusions – Our review of more than twenty-five years of public opinion regarding health care policy has shown that Americans are, at the same time, both dissatisfied with the current health care system and relatively satisfied with their own health care arrangements, a situation that has not changed substantially since the time of the proposed Clinton health care plan ( Jacobs, Shapiro, and Schulman 1993 ).
As a result of the conflict between these perspectives, there often is a wide gap between the public’s support for a set of principles concerning what needs to be done about the overall problems facing the nation’s health care system and their support for specific policies designed to achieve those goals ( Hetherington 2005 ).
When confronted with the trade-offs, which could include changing their health care arrangements or benefits or raising taxes, the public tends to reject policies addressing the national problems that most concern them. This can be seen in Americans’ widespread support, in principle, of a national health insurance plan and their nearly consensual recognition that Medicare and Medicaid face serious long-term financial problems that need to be fixed.
Despite these conflicting views, the public usually has been unwilling to support those policies that would offer universal coverage or make Medicare and Medicaid financially more secure. Without any major changes in national health care policy, Americans are likely to remain anxious about the impact of future health care costs on their ability to buy health care.
Accordingly, public support for major reform could grow in this environment, particularly if national leaders were again to focus on the issue. The challenge, should the issue reemerge, is that although a majority of Americans express dissatisfaction with the nation’s health care system and say they favor universal health insurance coverage, they do not feel the system is broken beyond repair.
- In addition, they have not reached a consensus on an alternative health care system or on the specific type of national plan to cover the uninsured.
- Another challenge is the growing income inequality in the United States and its impact on the nation’s public policy decision-making process.
- Recent research has shown that government decisions are more responsive to the policy preferences of upper- and middle-income groups ( Bartels 2005 ; Gilens 2005 ; Jacobs and Skocpol 2005 ).
Our analysis found a continuing difference in satisfaction with the current system between those who have higher incomes, have health insurance coverage, and feel secure about their future health coverage, and those who do not. In recent years, this situation may have delayed serious action on major reform, because the more politically influential people remain most satisfied with the status quo.
If, however, financial insecurity about health care expands to more of the middle class and the problem of the uninsured worsens, these anxieties may allow the issue of major reform to reemerge. In addition, this issue is likely to gain more prominence among the public and voters if war and terrorism recede as national priorities.
Without a fiscal crisis in Medicare or Medicaid, the public is unlikely to support major reform in these programs, and so two issues will remain unresolved. The first is whether or not the public will support the tax levels necessary to sustain the Medicare and Medicaid programs in their current form.
How does Nigeria rank in healthcare?
Nigeria is sick, we need system transformation to cure the ailing healthcare system It is not news that Nigeria’s Health Care System is not meeting the needs of its citizens. A 2018 Lancet study of global health access and quality ranked our health system 142 out of 195 countries assessed, a fact that factors such as health worker shortage contributes to.
The doctor-to-patient ratio is about 1:6500, and between 2007 and 2011, there was a net loss of 2,095 doctors from Nigeria due to emigration. All the medical personnel seem to be japaing, Nigeria Healthcare System 101 : The Nigerian health system is decentralised into a three-tiered structure with federal, state, and local government responsibilities.
Local governments manage Primary Healthcare – for example, local dispensaries. Secondary Healthcare is managed at the state level by the State Ministries of Health (SMOH) – for example, General Hospitals. The role of the Federal Ministry of Health is to frame policies and manage Teaching Hospitals and Federal Medical Centers, which constitute Tertiary Health Care.
- The Acts of the Generals : In 1999, an alternative source of healthcare funding was passed into law by a legislative act under the government of President Obasanjo.
- The National Health Insurance Scheme (NHIS) was established as a public-private partnership to provide accessible, affordable, and qualitative healthcare to Nigerians.
Members of the scheme made contributions to a pool. When a contributing member needed healthcare, Health Maintenance Organisations (HMOs) paid for a substantial portion of the cost of care from pooled funds – a risk-sharing arrangement with an eye to enhancing resource mobilisation and equity.
The NHIS also regulated other private health insurance operated by registered HMOs. On paper, the NHIS’ goals and objectives were brilliant. Still, the scheme had a penetration of less than 4% across the nation, impacted by factors such as the earlier referenced medical personnel shortage. The poor penetration of the NHIS led to an overall healthcare delivery system that was inefficient, ineffective, and inequitable.
The not-fit-for-purpose NHIS has now died, the Act repealed by President Buhari in May 2022, another Act signed into law, a more confident sounding reincarnation of the NHIS, the word ‘Authority’ replacing ‘Scheme’ to convey a determination to make healthcare more accessible and affordable for Nigerians, after all, the word ‘scheme’ might convey negative connotations in the Nigerian context.
- All well-wishers of Nigeria are praying that the National Health Insurance Authority (NHIA) will be a vehicle that will drive Nigerians to good or better health.
- In true Nigerianees speak, it is laudable that the NHIA seeks to act not just as an insurer, but as a regulator, an investor, and an implementer.
Public Health vs Population Health – A Health System Failing Population Health : A tenet of healthcare is ‘standard of care’ – the early diagnosis and treatment of disease. If a citizen cannot afford care or get timely access to care, then the existence of a national healthcare system is meaningless to them – thus, that health system is not fit for purpose.
- Nigeria’s major public health challenges are infectious diseases, maternal and infant mortality, poor sanitation and hygiene, disease surveillance, non-communicable diseases, and road traffic accidents.
- The programmes our health system designs to address health care still operate within the realm of public health.
A key driver that causes this is that population-level health and mortality data crucial for evidence-informed policy are non-existent in Nigeria. There has been a marginal increase in health expenditure since 2001, yet health outcomes remain poor compared to countries with at-par or lower health expenditure.
A third of cancer deaths are avoidable. Despite the growing incidence of breast and cervical cancer in Nigeria, many women across the rural/urban divide are not aware of the morbidity of the disease. Women in Nigeria still die of breast and cervical cancer because they were never diagnosed. The saying goes that ‘ Naija no dey carry last ‘, which is indeed the case with the atrocious maternal mortality stats.
Nigeria is ranked number four, behind Chad, for countries with the highest maternal mortality rates- at 814 deaths per 100,000 live births. This failure trickles down from the top, a System failure that fails to address complex strategic issues. Our health system is taking the expensive route to population health – sick care – rather than a dedicated focus on prevention and regulation.
Population Health is the ‘big sister’ of public health, comprising the health outcomes of groups of individuals, including the distribution of such outcomes within the group – extending beyond the provision of health care services, making allowance for factors such as social determinants and other influences that affect health outcomes.
Population Health does share some domains with traditional Public Health, which seeks to protect and promote the health of all people in all communities by harnessing its epidemiology and related analytics, policy support, organisational infrastructure, and access to services.
- A key difference between population health management and public health is that population health interventions can be tailored to groups of population and specific individuals throughout that person’s lifetime.
- Poverty is killing Nigerians : In his work The Moral Determinants of Health, Don Berwick, MD, states that circumstances outside healthcare nurture or impact the individual’s health.
Persistent and extreme poverty is an unfortunate malady in Nigeria. In 2022, 105 million Nigerians live in extreme poverty, an increase from 98 million in 2019, which is 51 percent of the population. Sokoto and Taraba States have the largest percentages of their citizens living below the poverty line, estimated as earning less than ₦855 daily.
- It beggars the mind how citizens cannot be outraged by these figures.
- Food insecurity is rising, with 21 percent of the population experiencing hunger between 2018 and 2020.
- Poverty is simplified as lack of access to safe housing, inadequate nutrition, poor physical, dental, and mental health care, poor early childcare, and disproportionate exposure to environmental toxins.
These all contribute to the stressors that encourage and produce sickness. Nigeria is sick. A rational strategy to improve population health would be to ramp up investment in education, prevention, dedicated regulation of pharmaceutical procurement, a focus on food security – affordability and healthy eating – and a concerted effort to hold organisations to specific standards as pertains to environmental pollution, but Nigeria is unique.
- Lifting people out of poverty must run in tandem with any strategy the stewards of our health system focus on.
- This might seem like a daunting attainable due to the paucity of data in Nigeria.
- With no data on the disease burden in communities, a lack of political will, and little policy, and research to support an opportunity for action and implementation in any given budget cycle, Nigeria’s Health System will keep floundering as the nation gets sicker.
This is not an overly pessimistic opinion. Rather it is a statement of fact supported by data and the observation of our communities. To even attempt any sort of transformation of the Nigeria Health System, to produce a fit-for-purpose system invested in the health of its citizens, the stewards of the said system must re-examine its roles and linkages and then define responsibility.
It is time for the Nigerian Health System to move from public health to population health. To begin this process of transformation, the stewards of the health system must intentionally and aggressively assemble experts and stakeholders to reach a consensus and present a vision for population health in Nigeria.
We must do what has never been done – regard Nigerians as customers and consumers of health and thus seek and listen to their voices. What is the voice of the Nigerian healthcare customer? What do they say about the market? How do they transact? At this point of the article, can I insert – is there an opportunity for a revigorated NHIS NHIA? An eternal optimist invested in transformative healthcare in Nigeria might consider this model: A Hopeful Framework for Transformation : Reorientation is key : Transformation must start with re-orienting the health system, examining the current roles and responsibilities at the macro (federal, state and NHIS), meso (HMOs and HCPs) and micro levels (local government, community providers).
With the paucity of data mentioned earlier, it is imperative to insert the voice of the Nigerian customer in this reorientation. There is a need to map roles at each level of governance to key population health management functions. Work the NHIA : refine the NHIA and authoritatively use the scheme health insurance bill to drive population health management.
Like every health system in the world, the Nigerian health system is complex. We (a broad term for the stewards) must be confident about owning the complexity before we even sit at the consensus table. The stewards can approach the refinement process like a building project, with distinct stages crucial to the success of the building.
- The first step is to own that the NHIA inherited poor penetration from its previous iteration and is not accessible to large swathes of customers.
- After owning that it is a complex, daunting task to transform the system, the next step is to develop the NHIA.
- The NHIA pushes for compulsory enrollment of eligible citizens, makes allowances for a ‘vulnerable fund’ and has a well-defined sharing formula for the Basic Healthcare Provision Fund (BHCPF).
It is great that the framers have called investment the key to success. This is a truth. Keeping existing customers and aggressively recruiting more customers who need services is crucial. Designers of the fund must ensure an allowance for long-term, sustained care of chronic conditions such as cancer, hypertension, and diabetes.
- The conversation of presumptive eligibility (where every Nigerian citizen is presumed eligible) must be stressed, especially as regards medically necessary health services such as routine dental, routine vision screens and pregnancy care.
- How do we ensure that all pregnant women in Nigeria are eligible for services covered by the NHIA? The NHIA must become the safety net for Nigerians at the state and local government levels.
Next is to identify populations at higher risk. At this stage, the weakness of the Nigerian health system due to lack of data is exposed. Registered HMOs must be made to work for their money and provide value to customers. HMOs and HCPs can support data collection.
- They know their customers.
- Not understanding the needs of the population risk stratifying will continue to lead to poor outcomes.
- The perception is that HMOs are in the business of managing cost and amplifying profit, with minimal rigour paid to improve health.
- Relying on predictive analytics for risk stratification lends credence to this perception.
The wealth of knowledge gathered from other data sources, anecdotes, and observations serves the purpose of population health better. The next stage is to provide the best evidence-based care, which is where the heavy lift for our health system will lie.
I must be honest, my optimism starts to wane at this stage, but it is achievable – as they say, Rome was not built in a day. Best evidence-based care can be adopted through many mechanisms that may include enhanced services to address social determinants of health, care management for complex cases, intentional quality improvement initiatives and value-based contracting.
I cannot help but notice that the lingo associated with the NHIA is quality assurance. There is a need to move past assurance to continuous quality improvement. The next stage in this building construction format is maintaining good health and continuity in utilising services.
- The maintenance culture faces challenges in Nigeria, but leveraging HMOs to provide insight into their members’ consumer journey and health status can be an asset.
- The NHIA is a capitation-based system.
- Capitation, as a value-based reimbursement strategy, includes quality measures and standards to deter withholding treatment for financial gain.
The NHIA must insist on paying for value, focusing on clinical outcomes, incentives, and mandatory reporting. This is a proven way to cost control health care, improve quality, population health and reduce waste. Change the game by changing how payment is received, and healthcare is delivered.
- Stewards of our health system and partners such as HMOs, HCPs and doctors need to massively invest in quality improvement initiatives across the network of Nigeria to increase efficiency, gain financial rewards and share the risk of loss.
- The reader might ponder, ‘well, what does massive investment in quality improvement look like?’.
It begins with primary care. Over Investing in Primary Care – A Cure to the Health Care Crisis in Nigeria: The current state of Nigeria reveals a massive under-investment in primary care, especially in our rural communities. Same truth for urban communities.
This is a problem because accessible, quality primary care is the foundation of a well-functioning health system. Primary care is five to six of the population’s health outcomes. No system can be ten over ten, but vital primary care inches the system closer to the goal. Without well-established primary care, our health system will continue to be vulnerable to the low life expectancy of Nigerians, hospitalisations and readmissions, high infant and maternal mortality rates and low customer satisfaction.
I recently read about a government official advising Nigerians to japa legitimately. The japa of qualified physicians is hurting the population’s health. It is easy to write, but it is a truth, to fix our sick health system, our stewards need to invest time and resources in a reinvigorated model that enables primary care doctors to successfully provide care in communities, be fulfilled by the quality of training they have and be fairly compensated for their work.
I know of an excellent primary care doctor whose empathy for his patients is unmatched, but he has a family of five. Even in relatively low-cost Benin City, his compensation barely takes him home, plus he is always burned out. It is not easy queuing for fuel, taking care of the needs of patients, dodging omila on the roads of Benin and then being a present father.
Primary care doctors like this are the first touch points for patients, providing care coordination with other parts of the health system. These doctors are the favourite child a mother will never admit to having, even at the risk of starvation. They treat and maintain their patient’s health in various and differing healthcare settings.
The outstanding primary doctors not only diagnose, treat, and prevent diseases, update themselves with training and share best practices with other health care professionals, but they are also the patient’s advocate, often ‘knowing the patient reach house’, understanding social determinants that impact health outcomes.
If we want to improve health outcomes for Nigerians, lower the cost of care, and create equity, then there must be proper investment and empowerment of primary care. Again, the reader might ponder, ‘how can we over-invest in primary care and empower doctors?’ My response would be ‘get the HMOs to transition my friend and his peers to value-based care by heavily investing in him and his practice and partnering with them to be held accountable for their patient outcomes’.
Here’s where the over-investment comes in, by dedicating funds that would connect doctors to operational, technical and peer support needed to deliver high-quality primary care and improved population health in their communities and by investing in technology, tools and processes that would ease the administrative burden whilst he is caring for patients, our health system can truly be transformed.
In the future, we might explore how doctors can support their patients and build awareness and penetration for the NHIA by talking to them about eligibility for health insurance. We can discuss how my friend can use Telehealth to reach his patients in Igueben.
Even though there is no internet in Igueben, mobile penetration in much of Nigeria is on the rise, and my friend’s patients can be consulted on their affordable smartphones. My friend speaks Edo and Igbo and the majority of dwellers in Benin speak very good pidgin English, so a telehealth consultation in remote parts of Benin will enhance his patients’ experience.
In addition to investing in primary care, the case has to be made for integrating the health system. A moral lesson in unity that many Nigerian parents gave to their children was the physical demonstration with the single broom that broke easily, versus the bunch of brooms that did not break and did not even bend.
- The same thing applies to health systems.
- There are no distinct channels of healthcare.
- For too long, physical, dental, vision, and mental health have operated distinctly from each other.
- We must explore integrating physical health with mental health.
- Nigerians are poor and stressed, and these stressors lend themselves to poor population health outcomes.
All you need is a trip to any downtown in a Nigerian city to realise an urgent need for mental and behavioural health services. An integrated healthcare system can better serve the population’s health. Nwanze is a healthcare professional specialising in Quality Improvement initiatives for State Medicaid members in Ohio, USA, where she leads innovative partnerships with Managed Care Entities, providers, and communities, which advance quality improvement and community engagement to ensure improved outcomes and equity for focused populations.
What is healthcare like in Niger?
Facilities and Health Information – Health facilities are extremely limited in Niamey, and completely inadequate outside the capital. Although physicians are generally well trained, almost all hospitals in Niamey suffer from inadequate facilities, antiquated equipment, and shortages of supplies, particularly medicines.
- Emergency assistance is also extremely limited.
- Travelers must carry their own properly labeled supply of prescription drugs and preventative medicines.
- Malaria is prevalent in Niger.
- Plasmodium falciparum malaria, the serious and sometimes fatal strain found in Niger, is resistant to the anti-malarial drug chloroquine.
Because travelers to Niger are at high risk for contracting malaria, the CDC advises that travelers should take one of the following anti-malarial drugs: mefloquine (Lariam™), doxycycline, or atovaquone/proguanil (Malarone™). The CDC has determined that a traveler who is on an appropriate anti-malarial drug has a greatly reduced chance of contracting the disease.
Other personal protective measures, such as the use of insect repellents, also help to reduce malaria risk. Travelers who become ill with a fever or flu-like illness while traveling in a malaria-risk area, and up to one year after returning home, should seek prompt medical attention and tell the physician their travel history and what anti-malarial drugs they have been taking.
Don’t drink tap water. It is unsafe to drink throughout Niger. Bottled water and beverages are safe, although visitors should be aware that many restaurants and hotels serve tap water. Ice made from tap water is also unsafe to consume.
Is education in Nigeria free?
Middle Education – The first 3 of 6 years of secondary education take place at junior secondary school which may be privately or state funded. Education is intended to be free although most state-owned institutions requite their students to purchase their books and uniforms, something which may be impossible for the poorest people.
What is the most expensive health problem in the United States?
Conclusion – With U.S. health care costs outpacing other high-income nations without added benefits, it makes sense for health care administrators to look closely at controlling costs for the most expensive medical treatments. The first step is understanding the most expensive diseases to treat and developing effective preventive strategies to lower costs and improve patient outcomes.
Is health care Free in the US?
There is no universal healthcare. The U.S. government does not provide health benefits to citizens or visitors. Any time you get medical care, someone has to pay for it. Healthcare is very expensive. According to a U.S. government website, if you break your leg, you could end up with a bill for $7,500. If you need to stay in the hospital for three days, it would probably cost about $30,000. Most people in the U.S. have health insurance. Health insurance protects you from owing a lot of money to doctors or hospitals if you get sick or hurt. To get health insurance, you need to make regular payments (called “premiums”) to a health insurance company. In exchange, the company agrees to pay some, or all, of your medical bills. Learn more about health insurance. You will get most of your care from your “primary care provider” (PCP). After you buy health insurance, you can choose a PCP who is part of your insurance company’s network. If you buy an MIT health insurance plan, you will choose a PCP at MIT Medical, Your new PCP could be a nurse practitioner or a physician. You will see your PCP when you need a physical exam or lab test, when you are sick, or if you need care for an ongoing condition, like diabetes or high blood pressure. Learn more about PCPs. You will usually need an appointment to get medical care. If you want to see your PCP, you will need to call your PCP’s office to make an appointment. When you call, you need to explain why you need the appointment. If you are sick or hurt, you will get an appointment very soon. If you just need a routine physical exam, you might have to wait several weeks or even a month. Learn more about appointments.
NOTE: If you have a medical emergency or urgent need, you can get care immediately. Read more.
What is the number 1 health problem affecting the USA?
AFC Urgent Care Lyndhurst can advise you on which conditions should concern you and how to take action to prevent them. The No.1 health condition in the U.S. is heart disease. It is one of the leading causes of death, comprising more than a quarter of all deaths annually.
Why is healthcare so complex and difficult to reform in America?
“Change is usually slow. It moves in fits and starts and veers left and right. That’s how behavioral systems move. It’s true in every facet of our government: economic policy, foreign policy, transportation policy, education policy. And proposals for policy reform are almost always heavily altered by lawmakers, because we live in an extraordinarily large society—300 million people, who don’t always agree on the proper role of government or on the tradeoffs implicit in various policies. “The prospect of changing the health care system generates resistance because there are huge economic interests vested in the current structure: pharmaceutical, construction, equipment, information technology. It is the largest sector of the U.S. economy and 10 percent of the global economy. “In the era of the iPhone, Facebook, and Twitter, we’ve become enamored of ideas that spread as effortlessly as ether. We want frictionless, “turnkey” solutions to the major difficulties of the world—hunger, disease, poverty. We prefer instructional videos to teachers, drones to troops, incentives to institutions.