Free «Budgetary Priorities: Washington» Essay Sample

Budgetary Priorities and the Quality of Medical Services in Washington

Over the past three years, the budget of Washington has been slashed by roughly $6 billion; this has brought about a negative effect in development in lines of public schools and Basic Health, it has also led to low-income children losing quality health care. In Washington DC, public schools receive premier disbursements, for instance, in the year 2009, public schools received 43%. Public heath came second at 28% while higher education, retirement benefits and corrections received 9%, 5.9%, and 5.1% respectively.  The remainder 9% was directed towards general government expenditure (Konigsberg, 2007).

Health Care has faced a big challenge in its effort to providing citizens with health services. This problem has majorly been contributed by inadequate funding by the budgetary allocations (Kosoy, 1997). Inadequate health services pose a great threat to the lives of our most vulnerable citizens. Some of the major challenges that the health care providers often come across are discussed below.

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Shortages of funds; for smooth operations to take place in any organization, there must be enough and continuous cash flow. Some of the areas where large proportions of cash is directed include; purchase of equipment and medicines, payment of salary to staff, as well as extensional services which include emergencies and ambulances. Shortage of fund in this sector contributes poor services dispensed at public health centers. Comparing the quality of services offered by public health centers to the ones offered by the private centers, the services offered by the latter are of better quality. The cost incurred in providing quality care services in public hospitals is practically unaffordable due to the low amount of funding they receive from the government.

Price distortions; the payment systems for individual services and products may not be accurate. This leads to unduly disadvantaging some providers and unintentionally rewarding others, for example under the physician fees schedule, fees are very low for primary care and very high for specialty care and procedure. This makes the physicians feel that they receive better deals on specialty and procedures and therefore, they tend to provide more volume. As a result these signals could influence the supply of providers, resulting to oversupply of specialized services and shortage in number of primary care providers. For instance, the number of undergraduate taking primary care programmes in U.S has dropped drastically over the last decade (Schick & LoStracco, 2000).

Lack of accountability; due to in dissatisfaction resulting from underpayment, the providers are not strictly held accountable for the value of care they provide. In addition, providers are not answerable for the full spectrum of care a recipient may use, even when they make the recommendation that determine resource use. For instance, hospital discharge planners or physicians ordering tests recommending for post acute care do not consider the financial effects or quality outcomes of care that the other providers may furnish. This puts the quality and efficiency of care at risk.

Lack of coordination; on being less accountable, there is very narrow chances that the health care provider will be coordinative. Each care provider may treat one aspect of the patient’s problem without paying regard to what the previous providers had done. The main concern to them is on the procedure and services but not on the recipient’s total benefits. This becomes a particular predicament for the recipient with several chronic conditions and for the patients transitioning between a numbers of care providers.  Poor coordination amongst care providers could result to the patient overtreatment, confusion, higher spending, duplicative services and lower quality of care.

In conclusion, the process of reform should begin as soon as possible. Reform is known to take lengthy periods; further delay will induce a greater deterioration in the financial stability of Washington. The deterioration can be partially traced to the dysfunction delivery system that the current payment system has helped to create. Those payments must be primarily improved, and the recommendations outlined above in this essay should be put to practice.


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