Health care system

I need help with a Communications question. All explanations and answers will be used to help me learn.

 

Reply to each classmate with atleast 450 words in current APA format with two scholarly sources and 1 biblical reference. (correct grammar etc a must)

classmate #1-

For-profit health care systems are able to provide profitable returns to owners or investors (Wendt, Frisina, & Rothgang, 2009). According to the author, a for-profit health care system differs from a not-for-profit health care system primarily in relation to the profits of that the system is able to return (Wendt et al., 2009). By increasing the prices of services provided to patients, for-profit health care systems are able to accomplish this goal (Wendt et al., 2009). This usually occurs in an area where one company has control over the health care system in that particular area (Wendt et al., 2009). Of course, when any one company takes the majority control over any market, there becomes issues. In this case, it would be easy to increase the prices to whatever the controlling company wanted it to be because many people in the area would not have a choice between paying the higher price or going somewhere outside of that area (Wendt et al., 2009). Additionally, Herrera, Rada, Kuhn-Barrientos, and Barrios (2014) explain the concept of market power which can be defined as the amount of power a company has on the price of goods being provided. This concept can be seen in for-profit health care systems. This price control and inflation benefits not only the companies in charge of the system, but also the insurance companies (Herrera et al., 2014). Of course, this has a negative effect on the patients. One example of company influenced price increases that always comes to my mind is the EpiPen price increase. From what I can remember, the price increase by nearly 10 times the original amount. Many people, including my own brother, depend on this device in their every day lives. This obviously puts a huge financial strain on patients who have no choice but to pay the inflated amounts.

In contrast, non-profit can be defined as an organization that works to provide communities with necessary services while not profiting from those services (Prentice, 2016). Not-for-profit organizations seek to provide services “with the intent of benefiting a major interest group” (Harrington, 2016, p. 12). Our textbook explains that many hospitals and organizations fit into this category (Harrington, 2016). Not-for-profit organizations seek to keep their costs as low as possible so that they can continue to provide services to as many people as possible (Prentice, 2016). While some profits may occur due to the non-profit status of the organization, that amount is typically low and is still reported to the government as income (Prentice, 2016). Of course, with a not-for-profit organization, providers and insurance companies do not receive the same amount of income or profit due to the lower costs. The patients, however, greatly benefit from a not-for-profit system (Prentice, 2016). There may be lesser interest in provider participation with this type of system since the income would be lower (Prentice, 2016). Despard (2017) explains that nonprofit organizations are extremely important to the social safety net of Americans.

The bible states in Colossians 3:12, “Therefore, as God’s chosen people, holy and dearly loved, clothe yourselves with compassion, kindness, humility, gentleness and patience”. While I would like to believe that the health care system should be profitable to providers and insurance companies while affordable to patients and consumers, I know that we are not there yet. As a health care professional, I will continue to do my best to provide quality care to those who are in need. Through utilizing our skills and remembering to be compassionate to those in need, I believe we are in the perfect position to provide quality care to all patients.

References

Despard, M. (2017). Can Nonprofit Capacity Be Measured? Nonprofit and Voluntary Sector Quarterly, 46(3), 607–626. Doi:10.1177/0899764016661425

Harrington, M. (2016). Health care finance and the mechanics of insurance and reimbursement. Burlington, MA: Jones & Bartlett Learning.

Herrera, C., Rada, G., Kuhn-Barrientos, L., & Barrios, X. (2014). Does ownership matter? An overview of systematic reviews of the performance of private for-profit, private not-for-profit and public healthcare providers. PLoS ONE, 9(12). doi:10.1371/journal.pone.0093456

Prentice, C. (2016). Understanding nonprofit financial health: Exploring the effects of organizational and environmental variables. Nonprofit and Voluntary Sector Quarterly, 45(5), 888–909. doi:10.1177/0899764015601243

Wendt, C., Frisina, L., & Rothgang, H. (2009). Healthcare System Types. Social Policy & Administration, 43(1), 70-90. doi:10.1111/j.1467-9515.2008.00647.x

CLASSMATE #2- rePLY IN atleast 450 words in current APA format with atleast 2 scholarly sources and 1 biblical referenece (correct grammar etc a must)

There are two major differences between for-profit and not-for-profit healthcare systems. One major difference is taxes. For-profit healthcare systems have to pay property and income taxes; not-for profit healthcare systems don’t pay either. The other major difference is that for-profit hospitals have access to capital funds that not-for-profit hospitals don’t have. This critically comes into play when a hospital needs to upgrade or build new facilities. Other small differences include how not-for-profit healthcare systems provide more benefits to the local communities’ because they have to prove their worth to stay exempt from paying taxes. “A for-profit company can be held privately or publicly with regards to ownership” (Harrington, 2016, p. 11).

For-profit healthcare systems try to make as much money as they can for their investors, while non-profit healthcare systems put the profits back into the healthcare system. Both types of systems both face the same difficulties of maintaining their existence. It is their mission statements, locations, size, and ability to acquire a share of the population in their communities that allows them to survive. Adelino, Lewellen, & Sundaram (2015) stated “understanding investment decisions of a non-profit hospital is challenging because standard finance theories and most empirical research deal primarily with shareholder owned corporations, and their insights are not necessarily applicable to nonprofits” (p. 1584).

It shouldn’t matter whether a healthcare system is for-profit or not-for-profit when it comes to patient care, but unfortunately it does have some ethical issues. A for-profit healthcare system may make decisions on patient care based on the ability of someone to pay for their services because their end goal is to make money for their investors. Not-for profit systems will treat regardless of the ability to pay and are more likely to meet the patients in the community because of their inability to make it to a facility to receive care. Some hospital systems have community healthcare providers that will go into communities’ and provide basic care and tests, at no charge, to keep patients healthier. Most not-for-profit systems are patient driven, while for-profit systems are business-driven. Patients have better access to overall healthcare in a not-for-profit system when they are poor or financially strapped. I have seen patients at not-for-profits get sponsorships from the hospital because they are unable to pay and the hospital wants the communities’ overall health and well-being to be increased.

Healthcare professionals do need to remember which kind of healthcare system they work for because the shareholders will have differing opinions on extent of care and unnecessary testing. For-profit systems might make healthcare professionals feel that someone is peering over them to ensure they are treating but not over treating patients because that will take profits from the investors. “Higher net patient revenue and lower operating expenses result in higher operating and total margins, thus improving a hospital’s profitability and allowing it to build equity capital” (Singh & Wheeler, 2012, p. 326). Not-for-profit healthcare professionals have more avenues to allow them to meet the needs of the community. These professionals may have a higher job satisfaction because they are doing good for the community instead of worrying about the bottom line every shift. “A joyful heart is good medicine, but a crushed spirit dries up the bones” (Proverbs 17:22, English Standard Version).

Insurance companies have a stranglehold on both for-profit and not-for-profit healthcare systems, but do they make as much money as most people think. Insurance company CEOs don’t make as much money as other avenues in the healthcare industry. A significant portion of the United States of America citizens do have insurance because they have to or get fined according to the Affordable Care Act. “Regardless of how much revenue carriers collect in premiums, they’re required to spend most of it on medical claims and healthcare quality improvements” (Norris, 2018, para. 7). Medical loss ratio (MLR) rules tell insurance companies that they have to spend at least 80 percent on claims and quality improvements for their respective members (Norris, 2018). Insurance companies are required to pay what their contracts are written as for each patient. The difference between a for-profit and not-for-profit doesn’t have as much to do with insurance companies, although, for-profit companies may be more apt in trying to get the companies to pay out quicker.

Word Count = 709

References

Adelino, M., Lewellen, K., & Sundaram, A. (2015). Investment decisions of nonprofit firms: evidence from hospitals. The Journal of Finance, 70(4), p. 1583-1628. Retrieved from https://onlinelibrary-wiley-com.ezproxy.liberty.ed…

Harrington, M. (2016). Health care finance and the mechanics of insurance and reimbursement. Burlington, MA: Jones & Bartlett, 2016. ISBN: 9781284026122.

Norris, L. (2018). Are health insurance companies making unreasonable profits? Health Insurance. Retrieved from https://www.verywellhealth.com/health-insurance-co…

Singh, S.R., & Wheeler, J. (2012). Hospital financial management: what is the link between revenue cycle management, profitability, and not-for-profit hospitals’ ability to grow equity? Journal of Healthcare Management, 57(5), p. 325-341. Retrieved fromhttp://go.galegroup.com.ezproxy.liberty.edu/ps/i.do?p=HRCA&u=vic_liberty&id=GALE%7CA305082263&v=2.1&it=r&sid=summon