Clinical Issues within Managed Care Paradigm

Clinical Issues within Managed Care Paradigm
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Clinical Issues within Managed Care Paradigm
Managed care is one of the representations and characteristics of health care delivery in the United States. Managed care refers to activities ostensibly required to lower the cost of healthcare provision while at the same provide quality care. In the past, the delivery of clinical care and the practice of medicine were under different management paradigm. Managed care paradigm has some clinical issues that result from the management of health care. The clinical issues under this context revolve around the operations directed at medicine and the delivery of care (Kasper et al., 2015). These issues include patient diagnosis, patient treatment and drug administration.
The cost of managed care has become a major problem and especially when dealing with diagnostics. Over 70% of all Americans have insurance covers paid for by the employer. The premium is often paid fully by the employer although some expenses are taken care of by employee. This exception is particularly evident when it comes to diagnostic procedures. The cost of the diagnostics depends on the diagnosis of the patient. From this, the managed care does not cover the most expensive part of medical care provision (Kasper et al., 2015). It goes against logic for managed care to have its obligation as the provision of affordable care while the employer specifically wants out for the particular procedure.

When it comes to patient treatment, the same is seen to take place. There is a limit to the amount of money that the employer is willing to spend on the health of the employee. There is a continuation of rationing by harassment of the employer by the employee. The strategy is called rationing by harassment. There has also been an issue about the restrictions on clinical services under managed care. Laboratory services and drug administration are being restricted and this, in turn, lowers the quality of healthcare provision (Kasper et al., 2015).

References
Kasper, D., Fauci, A., Hauser, S., Longo, D., Jameson, J., & Loscalzo, J. (2015). Harrison’s principles of internal medicine (19th ed.). New York: McGraw-Hill Education.