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Q – Define free market
Free markets refers to where clients or patients and providers or sellers are independent and the clients are able to pick services from any provider. In a free market rates for services are determined by the Demand-Supply factor and not by the provider or any external force. US healthcare market is mostly in private hands, but partially controlled by free market system. Hence the US healthcare system is called quasi market or imperfect market as it is not singularly based on delivery and consumption (Shi and Singh, 2017).
Free healthcare markets would have unrestricted competition among the suppliers built on price and quality of services. Contrary to that in the current scenario, as the purchasing power lies with the private health plans the suppliers are compelled to form associations and integrated delivery system for the supply front (Shi and Singh, 2017).
A free market needs the patients to have all the information pertaining to their services based on their requirements, but currently it is challenging to obtain the information due to the technology driven medical care. Knowledge regarding medical procedures, diagnostic tests and newer drugs is more of a professional physician domain than a patient. Having a primary care provider in the chain would help reduce the information gap to a better extent. Internet and medical advertising have been a powerful resource for medical information in the recent years (Shi and Singh, 2017).
Another trait of free market is where patients have to bear the cost of the services received. Insurance is primarily to protect oneself from the risk of unseen catastrophic events. Unlike other insurances such as home insurance, health insurance covers the basic and routine healthcare services which further weakens the principle of insurance. Hence health insurance prevents the patient from full cost of healthcare and creates a moral hazard (Shi and Singh, 2017).
In current healthcare patient’s ability to make decision is limited because the utilization of healthcare is need based rather than price based demand and delivery of healthcare is driven by demand creation. This (demand creation) occurs when the providers advocate the medical care beyond necessary, such as extra follow ups, excessive tests or unrequired surgeries (Santerre and Neun, 1996).
Q – How is public health different from clinical medicine?
Public health has various meanings among the masses from health care services to everyone to welfare system, however none of it aptly states what public health is (Shi and Singh, 2017). In simple words, according to Krishnan, Kapoor and Pandav (2014), “public health is a combination of sciences, skills and beliefs directed towards the maintenance and improvement of the health of all people through collective or social action” (p. 99). Due to the wide range, public health is largely administered by government organizations, for instance Centers for Disease Control and Prevention (CDC) in United States (Shi and Singh, 2017).
Public health approach in handling a health issue consists of – identifying the health issue, determining the risk factors associated with the problem, develop and analyze the intervention for the problem, implement the intervention and monitor the efficiency of the intervention, an approach similar to clinical medicine (Krishnan et al., 2014) Yet public health significantly differs from clinical medicine.
Following are the differences between public health and clinical medicine:
- Clinical medicine concentrates on an individual patient- diagnosis, treatment and restoring normal function, whereas public health emphasis on the masses (Shi and Johnson, 2014).
- Medicine focuses on the biological causes of the health conditions and developing new treatments and therapies, while public health centers on environmental, social and behavioral causes along with possible risks that may harm people’s health and wellbeing, and administers mass interventions to reduce the risks (Peters, Dabrant, Elster, Tierney and Hatcher 2001).
- Medicine is more inclined towards the cures and betterment of health but public health works for preventing disease and stopping threats to people’s health (Shi and Singh, 2017).
- Public health activities have a broad spectrum from educating the masses for proper nutrition to passing laws regarding automobile safety. One of the primary task of public health includes educating masses and health professionals regarding health issues, especially the ones associated the harmful communicable diseases. On the other hand medicine only deals with treating an individual with a health condition (Shi and Singh, 2017).
- Medical field includes physicians, nurses, social workers, nutritionists, dentists, therapists, pharmacists, lab technicians, health service administrators and so on, while public health not only includes the above mentioned but more, such as epidemiologists, statisticians, industrial hygienists, food and drug inspectors, toxicologists, environmental health specialists, sanitarians and economists (Lasker, 1997).
- Krishnan, A., Kapoor, S. K., & Pandav, C. S. (2014). Clinical medicine and public health: Rivals or partners. Natl Med J India, 27, 99-101.
- Lasker, R. D. (1999). Medicine and Public Health: the Power of Collaboration (New York: New York Academy of Medicine, 1997).
- Peters, K., Drabant, E., Elster, A., Tierney, M., & Hatcher, B. (2001). Cooperative actions for health programs: Lessons learned in medicine and public health collaboration. Chicago IL and Washington DC: American Medical Association and American Public Health Association.
- Santerre, R. E., & Neun, S. P. (2010). Health economics: Theory, insights, and industry studies. Mason, OH: Southern -Western Cengage Learning.
- Shi, L., & Singh, D. A. (2017). Delivering health care in America (7th ed).Burlington, MA: Jones & Bartlett Learning.
- Shi, L., and J. Johnson, eds. 2014. Public health administration: Principles for population-based management. 3rd ed. Burlington, MA: Jones & Bartlett Learning.
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