Discuss about the Measuring Health System Performance.
New Zealand was a pioneer for being the first to implement a public health system country. New Zealanders invest large amounts of money on social and health services and are one of the countries with excellent health indicators. Furthermore, this country has a single accident insurance in the world Accident Compensation Commission (Accident Compensation) which provides free or subsidized health care for those who have accidents. Also compensation for loss of income and collaboration with the rehabilitation plan it is received (Gardner, Sibthorpe, and Longstaff, 2008). The paper will provide an in - depth analysis of the role of the government and NG0S as well as analysis and critics the political, social and economic scope of the health system. The performance of the country is further analyzed.
History of your New Zealand health care system
New Zealand is a large country situated in the Pacific Ocean on an Island. The country is the home of an estimated 4.49 million persons. The population in New Zealand is diverse in the form of 9% of Asians, 7% of Pacific Island, 15% of MÄori and finally the predominant group of New Zealand European ethnicity taking up the rest of 68%. 13% of the population is aged 65 years and above while 0 to 14 years old of the population is approximately 20%. Due to the global economic recession that is currently experienced, New Zealand has experienced a downfall in their economy since 2008 because they heavily rely on the foreign trade. Christchurch is the second largest city in New Zealand. The city was hit by two subsequent earthquakes in 2011 and 2010 which adversely affected the entire economy (New Zealand health system review, 2014). After every three years, the New Zealand people elect a democratic parliament through a representative system under a Mixed Member Proportion. The current coalition government is led by the National Party. A large number of local and regional authorities make up the local government (Frenk, 2010). On the International front, New Zealanders are among the elite regarding quality health status. According to New Zealand 2009 census’ data, men expectancy rate is 78 years while that of women stands at 82 years. Non-communicable diseases are the primary cause mortality and morbidity. New Zealanders of European ethnicity have a higher health status than the Pacific Islands and MÄori peoples; health status. The responsibility of the health policy is the central government of New Zealand. Universal coverage is provided by the health system through service provision between a variety of voluntary, private and public agencies.
Role of government in Health System Delivery, Organization, and Efficiency
The government provides free medical care to those who qualify through the public health system. Public health care or subsidized by the government includes hospital treatment, emergency clinics 24 hours, prescriptions, most vaccines, ambulatory care, and medical care for people with chronic diseases or elderly. However, some routine tests, such as a visit to the doctor or dentist, they have to be paid either partially or totally. The government provides free medical care to those who qualify through the public health system (Flood and Hardcastle, n.d.). Public health care or subsidized by the government includes hospital treatment, emergency clinics 24 hours, prescriptions, most vaccines, ambulatory care, and medical care for people with chronic diseases or elderly (Whiteford, Harris and Diminic, 2013). However, some routine tests, such as a visit to the doctor or dentist, they have to be paid either partially or totally.
If you qualify for public assistance, this is what you can expect from national public health system:
Free hospital treatment
Free treatment in clinics for accidents and emergencies 24-hours
Tariffs subsidies for visits to general practitioners (GPs). You must register with a primary health organization (PHO) to get the best discounts.
Discounted rates for specialists such as physical therapists, chiropractors, and osteopaths if a general practitioner refers you because of the accident.
Free or subsidized medical assistance for those suffering from chronic or acute medical conditions.
Most laboratory and radiographic examinations are free, except in private clinics.
Free medical care during pregnancy and childbirth, unless you attend you in a clinic or private sector specialist.
Hospital treatment free when you refer to or derived from a general practitioner.
Subsidies for children under six years of doctor visits and prescriptions. Most doctor visits and prescriptions for young children are free.
Diagnostic tests for breast cancer free for women between 45 and 69 years old.
To be eligible for these support services in the public health system in New Zealand, you must meet one of the following requirements:
be a New Zealand citizen
be a permanent resident in New Zealand
Hold a visa two years or be a refugee for resettlement fee. Those who are not residents must pay for some hospital services although they will not be denied emergency medical care if you cannot afford to pay.
Role of Non-Government Organizations (NGOs) in Health System Delivery, Organization, and Efficiency
Not all non-profit entity is an NGO, but NGOs must be non-profit entities.The concept nonprofit has several connotations. The main thing is that the organization is not constituted for individual benefit and therefore their economic surplus and property, never be distributed among the partners, even in the case of dissolution. Non-profit does not mean that the entity is profit-loss (Nishtar, 2010). In the past, the welfare and paternalistic model identified as something wrong and unethical, the destination of part of the economic surplus, the capital strengthening of the organization; hence, a certain image of insecurity and destitution they had in society. The new concepts of sustainability, social enterprise, and institutional strengthening have rethought this concept.
This reality marks the coexistence and simultaneity of NGOs family under these three approaches which in turn interpret eight conceptions of what should be families (Eckermann, Sheridan, and Ivers, 2015).
In the preamble of the declaration of principles of non-governmental organizations (NGOs) of Colombia reads:
"NGOs are private entities, non-profit, with clear objectives of social and community benefit, whose activities are aimed at: Build the public good. Eradicating poverty, seek equity and achieve healthy living. Promote the defense of fundamental rights and contribute to the construction of decent standards of living for Colombians.
Promoting ethical values.
Promote the defense and increase of goods and values that constitute social capital.
Promote the formation of the genuine civil society that will lead to achieving full democracy, the exercise of citizen participation and the application of control means governance in all its stages.
Contribute to the social development and social advancement of Colombians, especially those belonging to the lower classes.
The experience of NGOs calls shows that the problems of privatization of the public are not matters that relate exclusively to State (The New Zealand health and disability system, n.d.). It is abundantly documented that many non-governmental organizations, including grassroots, can not only bureaucratized, but also start organizing your activity resourcing and provision of services regarding priority auto referents. Self-righteousness, survival, growth payment of staff and the organization itself, becomes, in these cases, the objective fundamentally oriented action (Eckermann, 2014).
Financial viability and questioning what to do institutional became priority issues. Sustainability was threatened by the disappearance of official aid. Competition for resources via public procurement; the decrease in private donations by the economic crisis of enterprises; the lower yields of equity for those organizations had achieved in the past and capitalize create a surplus and the delay in learning to formulate, present and negotiate projects with cooperation agencies.
An Evaluation of the Performance of New Zealand Health System
The health system is predominantly funded by the government. Between 2009 and 2010, Organization for Economic Co-operation and Development reported NZ$ 19 870 million as the entire expenditure of the country with 83.2% of it publicly funded via taxation. Health budget is the main vehicle of supplying the public funds. In New Zealand, all citizens, residents and people with work permit with a visa at least two years have access to medical care. You, your partner and your children under age 19 qualify for public assistance (System of Ethical review of health and disability research in New Zealand, 2003).
If you meet the requirements to receive health care in the public health system in New Zealand, you can expect the following from that system: free care at a public hospital. free care in the 24-hour accident and emergency departments of public hospitals. Discounts on the cost of prescriptions.
Discount rates of visits to family physicians (GP for its acronym in English). To get the most advantageous discounts, you must be registered in a health center.
Discount rates of visits to specialists such as physical therapists, chiropractors, and osteopaths, when they have been referred by a doctor in case of the accident.
free or discounted costs for health care services if the patient has a serious or chronic medical condition.
Laboratory tests and X-rays are usually free, except when offered by private clinics. However, it should be noted that the public service does not cover the costs incurred in laboratory tests and x-rays as part of the medical examinations required for employment or training (Cashin, Chi, and Smith, n.d.).
Healthcare services during pregnancy and childbirth are free unless they are offered by the private medical sector. Apart from the initial price of the consultation, there is no additional cost for the flyer issued by the doctor for care in public hospitals.
Doctor visits and prescriptions are free or subsidized for children under six years. Most doctor visits and prescriptions for young children are free.Screening programs free breast cancer for women between 45 and 69 years old. Screening programs for cervical cancer free when appropriate.
An Analysis and Critique of Health System Policy and Initiatives Focusing on Key Institutional, Social, Cultural, Economic and Political Influencing Factors
Therefore proposes that the deinstitutionalization process is characterized by three aspects:
The construction of a new mental health policy from below and from within institutional structures, through mobilization and participation of all stakeholders.
The centralization of therapeutic work to enrich the global existence of patients, in a way, that they, more or less affected, are active subjects and not objects about the institutions (Berhouma, 2013). The key word is: from the madhouse, zero level of social exchanges, the extreme-de multiplicity of social relations.
The construction of external structures that are complete substitutes internment in the asylum. This is precisely because they arise from inside, and its decomposition. in this perspective Trieste work has led to these services have a responsibility to respond to all the mental health needs of a population; 2) change the ways of managing resources for Mental Health, and multiplies and becomes more complex the professionalism of workers.
Higher and technical education of health professionals have also been and is still undergoing major changes in this period of sectoral reforms. The old problem of inadequate training meet the population needs, and services (derived from the term of a biomedical, recuperative educational model focused on the disease and aimed at a specialized practice) is still the most important. The model that is refractory to both curriculum changes and initiatives teacher-care integration, and that translates, among other situations, in a divorce-and not always good relations-between schools and services. In this "quasi-structural" condition other issues have been added or novel manifestations of old issues arising from new educational visions, new health system needs and new positions of the actors, especially the state (Ologunde, 2013).
Changes in care models have not found an adequate and timely response in the formation of human resources. The reasons have to do with what was stated in the previous paragraph, but also with the resistance of professional corporations, limited incentives and weakness or absence of health policies that clearly and effectively define and develop a certain care model. There are exceptions, and perhaps the most recent, comprehensive and notorious in New Zealand and its policy of strengthening the basic level of care and the expansion of the program strategy of family health. In this case, the impact on human resources training has been very significant. In other countries can be found systemic or institutional policies (in Social Security, for example) change in the models of care without having been a consistent response of the former system.
Sectoral reforms have also driven major changes in the management of services, under and promotion of decentralization processes (Barnett et al., 2009). These changes include the economic-financial, human resources and the organization and delivery of services, impacting personnel management, labor markets and development of own staff. However, in organizational or service networks dimension, the progressive introduction of practices of "managed care" in many countries, not only in private services, tends to change the orientation, conditions of practice and results from the attention that the staff gives the population (Rata and Zubaran, 2016). It is difficult to find in educational programs content and experiences that have to do with these important changes in services. An Analysis of Past and Future Health System Reforms; Including in Response to Emerging Issues Identified within the Region
The government has carried out a program focused on three areas: accident prevention, injury rehabilitation, and compensation for losses. Also, to supporting educational programs related to daily life, work or taught driver education.
Health Insurance for College Students - Students who wish to complete their training in New Zealand must take out travel insurance to cover the entire period of stay in the country and private health insurance (Ashton, Cumming, and McLean, 2004). If you do not possess a visa will not be issued (in cases where required). Usually, schools are the bodies responsible for their students to have a safe and usually offer coverage. The price of insurance for a foreign student is 225 euros for a full course. If we suffer an accident during the stay, we will be attended by the Accident Compensation Commission (ACC), but this is not an alternative to medical insurance or travel. ACC did not cover illnesses, or we reimburse treatment costs in our country. Another important fact we need to know is that there needs to be vaccinated to prevent disease.
Reforms and Human Resources Sector Health - The complex and nothing harmonious relationship between sector reforms and development of HHR is full of paradoxes. One of them concerns that despite the absence of matters of health personnel in the agendas and political speeches of reforms, these have produced important changes with significant impacts on the whole field of human resources, as can be seen below (Ologunde, 2013). In other words, sectoral reforms have been, de facto, deep reforms of current labor order and the sector in the region. To analyze the impact of sectoral reforms on workers and their performance a framework that goes beyond the institutions of the health sector is needed. So, become important reforms of the state and public administration, thus reducing personnel (downsizing) that took place in many countries, such as regulatory changes that pave the way, among other possibilities, flexible modes of employment (public and private). It is also important to consider changes in the situation and the employment policies of national economies, shaped by labor reforms calls; as well as reforms of education systems, especially those affecting the secondary and tertiary levels (Ashton, 2015). Formal to informal, in recent years the informal labor has increased in almost all countries of the region, in some of them to constitute 85% of overall employment. Of every ten new jobs created in the last 20 years, eight have belonged to the informal sector of the economy. From goods to services: eighty percent of new jobs were created in the services sector, which is the least affected by foreign competition. Although the expansion of public employment in the health field has stopped in most countries, the state remains an important source of employment in Latin America.
Besides public hospitals, New Zealand has a system of private hospitals for those who want to get quicker treatment for conditions other than emergency and public hospitals in waiting lists can be very long. A network of hospitals and private clinics offer a variety of services included recovery, voluntary procedures, and general surgical procedures for specialized procedures such as cardiothoracic surgery. There are also clinical laboratories and private radiology clinics. In New Zealand all citizens, residents and people with work permit with a visa at least two years have access to medical care. You, your partner and your children under age 19 qualify for public assistance. The health system in New Zealand can be considered divided into two areas: primary health care and secondary care (Paterson, 2002). The first includes the GP or family, specialists (who also work in hospitals), dentists, pharmacists, physical therapists, podiatrists, and counseling and therapy. Secondary health care is provided in public and private hospitals. It has a system of private hospitals for those who want to get quicker treatment for conditions other than emergency and public hospitals in waiting lists can be very long. A network of hospitals and private clinics offer a variety of services included recovery, voluntary procedures, and general surgical procedures for specialized procedures such as cardiothoracic surgery (Appleby, 2011). There are also clinical laboratories and private radiology clinics. Many of the health care services in New Zealand are free or subsidized.
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