Prerequisites and reasons for the problem
Various circles of American power initiated health care reforms, in part with the goal of curbing the rising cost of health care services. It was the rising costs that were the main “contributor” to the rate of inflation in the economy as a whole (Bodea, et al., 2020). At the same time, the allocation of state subsidies ensured the continuous generation of profits in the medical sector of the economy. In contrast to other civilized countries, the U.S. is characterized by the absence of a single universal health insurance system in which resources are concentrated to ensure universal access to it for the population (Hall and Roussel, 2020). A third party, the health insurance system – public and private – acts as a guarantor of the provision of health care.
Unsuccessful attempts to solve the problem
With the introduction of the largest public health insurance programs, Medicare and Medicaid, the focus shifted from the distribution of health services to their financing mechanism. The role of the state expanded considerably in the social sphere in general, including, in particular, in the area of health care. There is a fundamental difference between Medicare and Medicaid: Medicare is part of the social insurance system, for which Americans pay the appropriate tax (Bodea, Torres-Lima and Cuevas, 2020). Medicare was enacted by an amendment to the Social Security Act and went into effect July 30, 1965. It originally covered Americans age 65 and over, and in 1972 was expanded to include the sick and infirm in certain categories.
The program automatically applies to every U.S. citizen age 65 or older who is eligible for the General Federal Program, which is the main Social Security program. Medicare benefits go to patients with chronic kidney disease and those in nursing homes and residential care for the sick and infirm who have less than six months to live. The program pays for immunosuppressant drugs for 12 months after an organ transplant (Kumar, 2019). Americans with insufficient seniority to qualify for Social Security FPL may be insured on a voluntary basis by making monthly payments (Kiyimba, Lester and O’Relly, 2018). Medicare is a testament to the American government’s social responsibility to its citizens.
Medicaid, the nation’s second-largest public health program, is a major source of health care coverage for the poor and disadvantaged in the United States. The beneficiaries under the program were not insured themselves (Milner, 2018). Second, the program was legally and administratively administered by state governments, although jointly funded by the federal and state governments (Milner, 2018). Medicaid, as an objectively necessary complement to Medicare, has played and continues to play a critical role in providing health care services to America’s poor and poorest (Waitzkin, Perez and Anderson, 2020). Acknowledging achievements at this juncture, American researchers convincingly show an expanding role for the federal government in health care (Hall and Roussel, 2020). But critics point to the lack of a clear statement of national goals, which hindered the reasonable allocation of health care resources.
Shortcomings of the reforms
It is necessary to note that the sphere of social assistance in health care in the United States is experiencing difficulties and faces unresolved issues. All efforts have failed because of Americans’ mistrust of government, the diversity of their professed values (Saunders et al., 2019). Its essence was that the government, according to supporters of such a viewpoint, has limited capacity and in principle is not able to solve social and other problems – this is on the one hand (Clegg, Skyttermoen and Vaagaasar, 2020). On the other hand, American society and people expressed a commitment to individual freedoms that gave them strength and an optimistic view of the future (Jarman and Lambert, 2018). Given all the above-mentioned features of American society, it is necessary to propose the creation of a new social assistance project.
Suggested Models for Change and Improvement
This project should take into account the shortcomings of previous policies in this area. The idea does not involve building, buying, or setting aside separate areas. The savings lies in the fact that either unnecessary facilities or parts of existing hospitals can be used. This will not disperse the spectrum of those in need throughout an established system, but will enable it to be used as a separate, independent system (Fernez-Walch, 2018). It is necessary to explain why the percentage should be static. Individual responsibility has been established, requiring all Americans who can afford insurance coverage to purchase it or pay a penalty (Gibbon, Hurst and Nurse, 2019). This policy needs to continue, but it needs to be adapted to current realities, because only minor adjustments have been made since 2014.
It should be noted that the concept of quality of medical care at the moment is extremely vague. Therefore, for the appropriate implementation of the project it is necessary to edit this aspect, highlighting some clear criteria. It is suggested to focus on the number of specialists per capita, as well as the statistics of patient confidence. It will help to control and timely prevent undesirable tendencies that appear in the work of the system (Hansen and Metzl, 2019). Project management is a synthetic discipline that combines both specialized and professional knowledge (Bodea, Torres-Lima and Cuevas, 2020). Special knowledge reflects the peculiarities of the field of activity to which the projects belong.
In order to identify and establish the responsibility of the leader, it is necessary to identify the criteria of the project manager. An important condition is that in a large-scale project the leader should be understood as a group of specialists, not as a single person. The essence is to take into account and control all financial and scientific components of the project, thus avoiding complications of such projects (Hansen and Metzl, 2019). Another alternative can be called the administrative theory, which includes management by specialties. In other words, this theory uses imperative methods of influencing each of the elements of the project, combining them into a single mechanism (Piraquive et al., 2020). Project management methodology is completely different from the purely technical methodology that is often associated with most projects.
Bodea, C. N., Torres-Lima, P., and Cuevas, R. (Ed.). (2020). Research on Project, Programme and Portfolio Management. Integrating Sustainability Into Project Management. New York: Springer International Publishing.
Clegg, S. R., Skyttermoen, T., and Vaagaasar, A. L. (2020). Project Management: A Value Creation Approach. Thousand Oaks: SAGE Publications.
Fernez-Walch, S. (2018). The Multiple Facets of Innovation Project Management. New Jersey: Wiley.
Gibbon, H. M. F., Hurst, C. E., and Nurse, A. M. (2019). Social inequality. Forms, causes, and consequences. Oxfordshire: Taylor & Francis.
Hall, H. R., and Roussel, L. A. (2020). Evidence-based practice: an integrative approach to research, administration, and practice. Burlington: Jones & Barlett Learning, LLC.
Hansen, H., and Metzl, J. M. (Ed.). (2019). Structural Competency in Mental Health and Medicine. New York: Springer International Publishing
Jarman, J., and Lambert, P. (2018). Exploring social inequality in the 21st century. New approaches, new tools, and policy opportunities. Oxfordshire: Taylor & Francis.
Kiyimba, N., and Lester, J. N., and O’Relly, M. (2018). Using naturally occurring data in qualitative health research. A practical guide. New York: Springer International Publishing.
Kumar, R. (2019). Nursing research & statistics. New Delhi: Jaypee Brothers Medical Publishers Pvt. Limited.
Milner, D. (Ed.). (2018). Global Health and Patology, An Issue of the Clinics in Laboratory Medicine. Amsterdam: Elsevier Health Sciences.
Piraquive, F. N. D., Diez-Silva, M., Monsalve. N. A. M., and Uribe, R. I. P. (Ed). (2020). Handbook of Research on Project Management Strategies and Tools for Organizational Success. Hershey: IGI Global.
Saunders, B. F., Oberlander, J., Churchill, L.R., Buchbinder, M., King, N. M., Walker, R. L., Strauss, R. P., and Estroff, S. E. (Ed.). (2019). The Social Medicine Reader. Duke: Duke University Press.
Waitzkin, H., Perez, A., and Anderson, M. (2020). Social Medicine and the Coming Transformation. Oxfordshire Taylor & Francis.