Health Care System and Managed care approach




Health Care System

The health care system in the country has drastically changed over the years. Various factors contribute to this change. The health care sector is now one of the highest consumers of federal government budgeting. Health care spending has risen to an all time high level compared to GDP. Consumers, health care providers, insurance companies and health care workers must change their roles and habits in order to keep track with these radical changes in the health care system. For instance, consumers must adopt new ways to cope up with the spiraling health care costs in the country.

Managed care approach

The country’s health care system has a different approach from what it used to be. During the past years, the health care system had a managed care approach. This approach significantly reduced health care costs to the patients. There was emphasis on the prevention of common diseases. Physicians encouraged adopting healthy living ways in order to prevent some diseases. For instance, this approach emphasized healthy eating habits to curb obesity and related diseases such as high blood pressure and heart failure. As a result, this prevented huge costs incurred in treating such diseases. The cost of health care to the consumers was affordable to the low costs of running this system.

The managed care approach also reduced unnecessary services in the health sector. Some services are expensive and hugely contribute to the high costs incurred by the consumers. These services may include radiotherapy and chemotherapy sessions for cancer patients. The managed care approach minimized overutilization of such expensive services by the patients, thereby decreasing the cost. This approach, allowed the use of such services only when necessary. In addition, the managed care approach controlled the quality of service offered by service providers. There were set traditional fees levied for different type of services offered to the consumers. This effectively prevented the medical costs from spiraling out of proportion. The managed care approach therefore ensured that majority of the citizens afforded health care as opposed to the current situation.

The evolution of the health care system has also affected families. Most families have adopted cost containment approach in an attempt to avoid high medical cost. Families avoid staying in the hospitals but prefer home care and out-patient surgeries. They utilize more ambulatory services to reach the hospitals while undergoing treatment at home. To avoid unnecessary medical costs, families have adopted healthy behaviors and habits. Many consumers avoid coverage by insurance companies with very high premiums and other payments to cut down on insurance cost.


The health care system faces other myriad challenges that not elucidated above. However, health care workers can help solve some of the health care problems. Although the challenges in the health care system are enormous, clinicians can play a mercurial role in ensuring that health care is affordable and patients receive quality care. Couger’s problem solving model will play a crucial role in solving these problems. My desire aims to help in preventing some of the health care problems after completing my nursing course. Generating new ideas to prevent the numerous challenges in the health sector will be important in curbing the present problems. At the moment am developing a comprehensive problem statement of our health care system.


With the rising costs, more families cannot afford admissions and staying at the hospitals. Symphonic thinking requires the ability to look at problems in a different perspective in order to establish fresh ideas to curb the problem. In this regard, upon my graduation, I will provide home care attention to the increasing number of patients who requires home care services. There clinicians should divert their attention to home care. I aim to mobilize health workers become more flexible to perform surgical procedures and other services to the millions of patients who cannot afford admissions to the hospitals. Mobilization for more funding to allow doctors attend to home patients is mandatory. Ambulance services should begin to ferry physicians and medical equipment from the hospitals to homes as opposed to the current scenarios where ambulance services carry injured patients to the hospitals. This is a breakthrough from the past and an indication of symphonic thinking in solving the problem of numerous patients in need of home care.

Promotion of healthy habits will help to prevent many diseases and in the long run, help avert the rising medical expenditures by the federal and state governments. Creative ways to eliminate unhealthy practices is necessary. Policies regarding healthy eating habits help tremendously in preventing obesity and obesity related diseases. Forceful measures are not effective in encouraging healthy eating habits. I will establish weight loss reward programs which will reward patients who were initially obese but lose many kilograms. This program will require people suffering from obesity to register and begin counseling and treatment sessions for a given period of time. At the end of the program, patients with high weight loss receive monetary and other possible rewards. This will encourage weight loss thus significantly reduce obesity cases and other related diseases. Consequently, the country will save the billions of dollars used to treat obesity related diseases, reducing the country’s health care cost. Encouraging healthy eating will also be useful in preventing the high medical expenditures in the country. Reducing the cost producing healthy foods will ensure that their prices are affordable. On the other hand, taxing the unhealthy foods will cause an increase in price of these foods and hence; discourage their consumption.


The health sector is a large sector whose problems cannot effectively eradicated by physicians and other health care workers. To ensure an effective health care system, every stakeholder must play a part. Leaders for instance, must ensure that implementation of policies that will ensure access to affordable health care for all. Policies providing health care to the uninsured group like the elderly and children. Patients must also be assertive when dealing with the health care insurance companies in order to get the best coverage. Flexibility of health care workers to suit patients requiring home care services, guarantees a successful solution to the millions of citizens who cannot afford the exorbitant medical costs of hospital admissions. Providing incentives for weight loss is a short gap measure to fight obesity. In this regard, the high medical cost incurred in the treatment of obesity reduces tremendously.


Examining the health care sector has made me learn the numerous challenges the sector faces. The medical costs in this sector have increased more than increase in the economy. This is unacceptable and a major challenge to our country and the future generations. The rapidly aging population worsens the scenario because many elderly people are without medical coverage and rely on the Medicare programs. Symphonic thinking as well as Cougar’s problem solving steps are very necessary to ensure prevention of these problems. The problems in the medical sector have made me to look at things in different perspectives in order to establish concrete solutions.