Public health care can be defined as a science and an art in particular designed for prevention of diseases, prolonged life and promotion of health through the well organized efforts and informed choices of the society in the larger perspective. It also entails public and private sectors, communities, individuals and organizations as well. Public health deals with the threats that are directed to the overall health of a community and in specific details, the population health analysis. Since public health is directed to the whole community, it cannot be effective unless its structure is well organized. Following this point, the health care is divided into different branches aimed at making the health care provision effective. So to speak, there exists the epidemiology department, biostatistics and health service in the larger perception.
In line with this, there are major characteristics that mark the public health. They comprise of the prevention of diseases rather than the curative aspect of the public health. From a broad point of view, it can be said that the public health care deals with the health of the public rather than the individual health. In order to attain this goal, the public health care makes use of programs that are aimed at addressing the health of the community in order to prevent diseases and provide treatment for such diseases (Crichton, 1997). Accordingly, it is the one responsible for vaccination, surveillance of cases, prevention of infectious diseases and promotion of health behaviors. Following this point, the issue of public health care as social economic institution, can be brought into view.
A social economic institution can be described as one that has one sole aim and mission of meeting the social needs of the population. In particular, a social economic organization or institution has its main mission as to offer services to the members and the community leaving out the aspect of making profits as the main goal. Equally, the governance of such organization is usually independent of the government along with the fact that the decisions made are all autonomous (Maurer & Smith, 2005). This is for the workers and/or users ensuring that the people are the main agenda of the organization compared to the capital. At the same time, the social economic organizations or institutions work by means of participation, collective and individual responsibility and empowerment as well.
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Public health care as a social economy institution
Following the definition provided in the introduction, a social economy institution, deals with the sole and the major aim of providing services to the members and the community. In this case, public health care can be classified as one of the social economy organization or establishment. This is for the reason that the public health care as defined has one mission that is so crucial and this is to ensure the health aspect of the population it serves is well. The public health care is not profit-oriented but rather its motivating factor is to see the outcome of the efforts made, a health population (Crichton, 1997). Thus, in most cases, it has been the role and the service of the public health care to ensure the availability of vaccination programs and prevention measures being taken in order to prevent diseases and cure them as well.
Public health care seeks to prevent anything that would endanger or rather threaten the wellbeing of the population. The profit gained in such as case is the outcome of having a health population with healthy behaviors prevailing. The main agenda of a public health care is to ensure that the process of decision making is democratic. That is to mean that the interests of both the users and the workers are important when it comes to making of decisions. Equally, the users are not only looked at as the beneficiaries of the services provided but they are viewed as important participants in what becomes of the efficiency and effectiveness of the services given.
General overview of the governance of public health care
The control or the management of any public health care is given in the hands of both the care providers and the target population. So to speak, the governance and control of public health care can only be well measured by means of looking at the difference between the inputs and outputs. In actual sense, this is equivalent to the control or the management of the health care system. In such a case, when both the care providers and the patients are satisfied, it is clear that the management or rather the organizational structure of the health care is an excellent one. It is therefore important to note the components of a public health care and the stakeholders of the same are essential. In line with this, the components of a public health care system comprise of the population that is in need of the care services, the people responsible for delivering the care services and the systematic arrangement that make it possible for the delivery of the care services (Maurer & Smith, 2005).
Generally, the public health care constitutes of the health care consumers, the professionals and practitioners responsible for care giving and both the public and the private sector liable for the organization, planning, regulation, financing and coordination of care services. In addition, there are institutions and organizations of a public health care. In specific details they include the hospitals, home health agencies, insurance companies, the clinics, programs that pay for the services, the schools that provide professional training, education towards the career of medicine and human health as whole. Accordingly there are those agencies and associations as well that are responsible for doing research and monitoring the quality of care given to the public together with the official approval providers and those companies that provide for medical technology which is essential for providing care services.
Having brought into view the components that make up a public health care system, it is important to note that it incorporates a wide range of participants that may otherwise prove hard to manage if the organizational structure is not well taken care of. An organization or an institution can only be said to have been making profits if only the management is good. If poorly managed or rather governed, the outcome would automatically be negative since the poor management and control would translate to decreased competence in delivering the services (Novick, 2005).
A well managed public health care can well be described as the one in which both the care providers and the patients or rather the consumers are satisfied. Therefore, the management should be satisfied and the consumers satisfied. Nevertheless, the management only offers the control but the employees and the patients remains to be the only means through which the governance can be measured. The quality of services that is offered by the employees in a public health care is a clear indication of the governance that is carried out. Also, the relationship as well as the behavior developed by the consumers also indicates the level of satisfaction the consumers or rather the population has gotten from the health care.
When it comes to the organization, planning, regulation and financing of a public health care, many problems arise. They involve issues like the mismanagement of the finances, poor planning, the poor kind of leadership, strikes organized by the employees due to their dissatisfaction with the kind of salaries they are paid and lack of motivation. The governance of a public health care should be like any other bureaucratic management. This is for the reasons that in a public health care the doctors, all professionals and practitioners cannot be the managers of their own work but instead they are accountable to a selected higher authority. This becomes important in the sense that the care providers will not perform their duties based on their private interests but they will instead do it with the knowledge that they are accountable to a higher authority (Scutchfield & Keck, 2003).
With this in mind, the doctors, the physicians, nurses and the whole practitioners will ensure that the delivery of services to the population is a good one as in case of anything that backfires; they will be accountable. If it happens that there is a mess that has been done by the health care providers, they are both answerable to the law and the board that governs the heath care (Novick, 2005). Therefore, it is prerequisite to state that in a public health care, the care providers and professionals are not their own managers or rather they are not their own governors. Instead, they are entitled to answer to their governors and to the board that governs them. So to say, even the public has a right to voice out their dissatisfaction and can even imprison them if they are found guilty.
Services offered by Public Health Care
On the other hand, there a several services that are given by the public health care. It is the duty of the public health care to monitor the health status and ensure that it identifies the community health problems in order to be well acquainted in administering health assistance to them. In connection to this, there should be a provision for information, education and empowering of the population as it regards the health issues (Crichton, 1997). . Accordingly, the public health care should be able to mobilize the community concerning the existing health problems as well as offer the solution to them. Furthermore, there should be a diagnosis as well as the investigation of the health problems and hazards in the target population.
Development of policies and plans that are supportive to the individual and the community health efforts are important. In order to ensure safety and protect health, public service offer room for enforcement of laws and regulation that account for this. At the same time, the public health care ensures that it has provided room to link the population with required health care services together with ensuring that they assure the provision of health care even when it is unavailable. It is also the public health care to assure the public of competence in health and personal health care workers (Crichton, 1997).
Public health care in the broader point of view brings about the evaluation of the whole work and the performance of the health care as whole. In this sense, the effectiveness, quality, efficiency, accessibility and the qualitative analysis of the personal and health of the population is considered (Scutchfield & Keck, 2003). Finally and not the least on the services provided by the public health care, is the scientific research carried out with the sole aim of finding new discoveries and innovations that is essential in solving health related problems.
Analysis of an Effective Governance of Public Health Care as a social economy institution
An ideal public health care is the one that is well structured ensuring delivery of care services in a manner that both the patients and the care providers are satisfied. In such a case, the health care can be termed as a well managed care. As earlier on highlighted, public health care is a social economy institution or rather establishment that is a non profit. It has a mission to offer services to its members and the community it serves. In line with this, it serves the population by ensuring them of a good health, and dealing with any diseases that threaten the health of the community. Focusing on the public health care services that it offers to the community, its structure and management may be seen as to be complex (Wolper, 2004).
However, the structure would and must have several departments that are managed under a board of governors. Therefore a public health care can be divided into departments that deal with different aspects of the healthcare. They involve the community and population health department that deals or rather provides leadership in the area of promoting health, prevention and disease control (Scutchfield & Keck, 2003). Also it provides the services of the wellness strategy development, health surveillance and the environmental health as well. In the same line of thought, it is the one responsible for the facilitation of the well organized approaches that are directed to the improvement of the health of the public through developing the health policy.
From this point, this division makes works uncomplicated and delivery of services easy. Following the community and population health, there is the corporate support department. This one has the duty of leading and running the public health system. As a matter of fact, it is responsible for giving informed advises to the department of law and legislative issues (Huber, 2006). Accordingly, it also does the same to the development and assessment of risk methodology. Additionally, it gives the corporate based services dispensation, acquiescence assurance and claims services.
The structure of the public health care does not ignore the department of financial accountability. This division ensures that there is an effective and corrupt free leadership offered to the internal and external allocations of funds. Likewise, it gives the financial accountability, the cost of the health care services and the general planning of the fiscal planning. Together with the General Auditor, the division gives the analysis of studies and works on fiscal reporting matters (Wolper, 2004).
Furthermore, the management of the ministry finances and resources altogether with the capital planning is given to the financial accountability department. More to the public health care the department is given the responsibility to maintain health policy and service standards. This is to mean that this is a division that is responsible for the guidance and development of the health system by means of a strategic planning and the development of the policy. They involve areas like the leading the continued care, health system research and data access and in addition the pharmaceutical programs. The services cover the province wide services planning and it ensures that there is planning, quality, access and performance as well.
Moreover, there is the department of Health system performance and information management. This is the ones that deal with the leadership and setting of the province’s directions that are strategic for the benefit of the Electronic health record and the provincial information management policy direction. Further, it provides security standards as well as the development and the support of the all information systems that addresses the business and the needs of the ministry. It also plans about business, development and the implementation of the information management policies. This is in terms of the collection of the information, the accessibility of it, use of the same and disclosure of the information of which it should meet the requirements of the law and the legislature (Huber, 2006).
Finally in the area of the divisions of a good public health care, there can be no completion without having tackled the area of the health workforce which is so crucial in providing the health care. It constitutes of the physicians, professional colleges and all the other partners of the health workforce division. It promotes the health and innovative strategies and approaches to a balanced workforce that addresses with effectiveness the health needs in the so called economically sustainable manner (Wolper, 2004). Accordingly, it is the one that takes the responsibility of the health workers and physicians together with their compensation negotiations. Besides, the alternate physician arrangements of remunerations and the general health workforce policy and planning are left in the hands of this department.
Limitations of a public health care as a social economy institution
Since the main aim of a public health care is to offer health services to the members and the community and it’s a non profits establishment, delivery of services to the population and raising a health population is the motivating factor. Therefore, a public health care can be measured in terms of the delivery of the services and the health of the population. As the structure and governance suggests, there is the complexity of the issue as whole. This is for the reason that there are several factors that can limit a Public health care to serve as a social economy establishment aimed at serving the common interests of all (Huber, 2006). This is to mean that population health can be defined as the health of the entire population. This can be well translated as an approach that aims at reducing health inequality among the population group.
In order to fulfill its mission as a social economy institution, public health care looks into those factors and conditions that determine health from a broader point of view. So to articulate, the challenges that face the public health care are some issues like poor governance (Noya et al., 2007). This is to mean that although a public health care may be directed to serve as a social economy institution, it can be limited by the type of governance it has. For a poor governance and control, a public health care cannot be able to meet the health requirements of the population. Focusing on the structure of organization that defines public health care, every department should be in a position to carry out its duties of which failure may translate to poor delivery of services to the public.
Corruption in a public health care can be a limiting and a detrimental factor in social economy institution. This is for the reason that corruption is a means that seeks for self interest rather than the common interest of all. Moreover, it is a way that looks for profits and yet a public health care is a non profits institution. In relation to this, there can be other limitations to a public health care evident in the distribution and access of health services to the public. Access of health care to the public entails a lot of factors that needs to be addressed. These factors are things like the poverty which can limit the population from accessing the health care (Koford & Miller, 1991).
Socioeconomic classes in this sense vary greatly. This is to mean that people vary in their levels of the income they get and the standards of living they adapt. These may be a challenge to the public health care which has to fulfill its mission ad meet all health aspects of a population. From this point, a public health care may be willing to provide its services but the population may not be willing to receive it and therefore this may make the mission to fail. Also, the public health care may be limited in terms of the lack of knowledge of the health care services by the population as these calls for education to be given to the population concerning the health care (Noya et al., 2007).
Culture may also stand as a limitation to public health care as some cultures dictate that the population should not take medicine but rather depend on the natural and traditional medicine. Religion may also limit the public health care delivery to the public. These are some of the challenges that limit a social economy institution like a public health care among others. However, good governance of such an establishment together with involvement, empowerment, individual and collective responsibility can make such a social economy institution to work by ensuring accessibility, quality and performance.
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