Career RelevancyIn your career in healthcare, you will often come across patients who can’t

Career Relevancy
In your career in healthcare, you will often come across patients who can’t afford medical care due to low income and the inability to afford insurance. In order to understand and connect with these patients, you’ll need to know how the market-oriented healthcare system can make it difficult for some people to have access to quality healthcare. This will help you to think more critically about the services healthcare organizations provide and which people benefit from them.
You will also need to be familiar with other types of healthcare systems like universal healthcare, single-payer, and open market. Being familiar with the different approaches to healthcare will help you understand and think critically about the healthcare market and how it affects your patients.

Background
Market-oriented, or market-based, healthcare refers to the idea that healthcare providers provide services to meet the needs of their patients. In this system, healthcare is transactional—people exchange money for the services they want or need. People are also able to shop around for those services. They’re not required to visit a specific doctor, so they can use available resources and information to make the best choices for themselves. People will often try to find the healthcare provider that can offer the best price for the highest quality.
This competition for patients helps keep prices lower—healthcare organizations will want to do what they can to get patients to visit their clinic instead of someone else’s (Capretta, 2018). They’ll also need to make sure they hire the best staff and have access to the latest in medical equipment. This is great for the patient, but it can be a little daunting for the healthcare organization to try to compete against everyone else.
Market-oriented healthcare also approaches health insurance in the same way—people have the ability to shop around for their insurance coverage. The drawback to this type of healthcare system is that people who live in low-income communities or are unable to access health insurance have a hard time paying for medical services and may skip treatment altogether. In rural communities, people might not have many options when it comes to healthcare and may have to travel a great distance to access healthcare options.
Healthcare System Approaches
Market-oriented healthcare is the current system in the United States. But a market-oriented system isn’t the only approach to healthcare. While market-oriented healthcare depends on a capitalist system, other approaches remove the idea of competition in an effort to make healthcare more accessible. The issue of healthcare is a hotly debated topic—let’s look at some of the other approaches to healthcare.
Universal healthcare means everyone has access to healthcare services without having to pay for it directly. They can see a doctor, have surgery, or go to an emergency room without paying out of pocket. It also means they don’t have to rely on their employer to get insurance as so many do now. However, people do pay for universal healthcare through taxes—usually payroll taxes or income taxes (Ng, 2018). The benefit of a universal healthcare system is that people can visit the doctor without fearing large medical bills. But the drawback is that healthier people end up paying for treatments other people use.
Single-payer healthcare relies on one source to provide healthcare—usually the government. In a single-payer system, a government program offers medical coverage to everybody. An example of a single-payer system is Medicare; it’s run and funded by the government. Because it is government-funded, single-payer systems often only offer limited services and people might need to purchase additional insurance to cover more rigorous treatments and medical expenses (Ng, 2018).
An open market, or free-market, gives people total freedom to choose healthcare services at an agreed-upon price. This type of healthcare system is entirely unregulated, meaning people pay out of pocket for all medical expenses and don’t use insurance (because insurance often comes with regulations) (Ladd, 2017). A completely open market is unrealistic because most people can’t afford to pay their entire medical bills out of pocket and will need some sort of insurance to help with the cost.
A Healthcare System That Helps
The most important goal of a healthcare system is to help the most people. For much of the population, there are many barriers to seeking healthcare and it’s the responsibility of medical professionals to help them overcome those barriers.
The biggest barrier is the cost – not just the cost in money, but also the cost in time and resources. Like we discussed in Discussion 1 this week, the cost of seeing the doctor isn’t just the amount the patient is billed for; it also includes travel time, time off from work, and often childcare. For many, these obstacles might be so big that they don’t bother seeking medical care unless it’s life or death. And for many others, even just the cost of the visit is enough to stop them in their tracks. People living in poverty are unlikely to seek medical care or have health insurance (Norman, 2020). The cost of healthcare is the issue most often cited when people argue for universal or single-payer healthcare over a market-oriented or open market.
Another barrier to seeking medical care is a general lack of understanding. Many people only go to the doctor when they feel sick. They might not know that preventative visits, like a yearly checkup, go a long way toward keeping them healthy and catching any problems early (Norman, 2020). Healthcare organizations would attract more patients by educating the general public about the importance of regular checkups.
For people who don’t already have a doctor, finding one can be difficult too. In a market-oriented healthcare system, people have many options available to them. Sometimes, too many. This can make it hard to pick the right one. They might be worried that they won’t click with the one they pick, and they’ll have wasted their time and money. On the other hand, people in rural communities might not have a choice – there might only be one or two doctors available to them (Norman, 2020).
Fear is another barrier that stops people from seeking medical care. Some people may not want to know that there’s something wrong with them while others might just feel a general sense of anxiety surrounding medical settings. Appointments can be awkward, and tests can be uncomfortable (Norman, 2020). It’s important for healthcare professionals to try to put their patients’ minds at ease by creating an inviting environment, explaining tests and procedures beforehand, actively listening to patients’ concerns, and answering any questions.
References
Capretta, J. (2018, September 20). Two visions for market-based health-care reform. Real Clear Policy. Retrieved on August 12, 2020. https://www.realclearpolicy.com/articles/2018/09/20/two_visions_for_market-based_health_care_reform_110806.html
Ladd, C. (2017, March 7). There is never a ‘free market’ in health care. Forbes. Retrieved on August 12, 2020. https://www.forbes.com/sites/chrisladd/2017/03/07/there-is-never-a-free-market-in-health-care/#2ac2eed31147
Ng, D. (2018, July 2). Universal healthcare vs single payer healthcare. Pfizer. Retrieved on August 12, 2020. https://www.pfizer.com/news/featured_stories/featured_stories_detail/universal_healthcare_vs_single_payer_healthcare
Prompt
Which system approach do you prefer from an administrative perspective, market-oriented, single-payer, open market, or universal healthcare? Explain your reasoning. How does your administrative view differ from your patient perspective?