ANDERSON’S CONCEPT OF THE “UNEASY EQUILIBRIUM” BETWEEN THE PRIVATE AND PUBLIC HEALTHCARE SECTORS
Health and human development form integral component of overall socio-economic development of any nation. The organizations and financing of healthcare in different countries are different. In each country, the design of health services and the means by which these services are financed depend on the country’s political culture, history, and wealth. Several frameworks and models have been developed by analysts to explain these systems and to help compare healthcare systems in a meaningful manner. The work of Odin Anderson and Milton Roemer is most notable among them. Anderson developed the concept of the “uneasy equilibrium” between the private and public healthcare sectors, and he organized health systems on a continuum based on the level of government involvement in the financing and organization of health services. In his market-minimized/market-maximized continuum Anderson explains that the degree to which a state centralizes financing and planning and the relative size of its public sector determine its position in the continuum, and as well the extent to which it influences the procedures of the economy itself. (Dollard, 89-92)
The market-maximized end of the continuum focuses on the concept of change through the private market with limited government involvement. According to Anderson, Such transformation may be speedy or sluggish, but it is natural to the system and its speed is also normal. It is incremental, not revolutionary. Anderson has positioned the United Kingdom at the far end of the market-maximized end of the spectrum. The market- minimized end of the spectrum, on the other hand, focuses on the socialistic strategy of planned economies and government programs for distributive justice and aims to modify with deliberate speed and at a scheduled pace. The United Kingdom health care system has moved its position on Anderson’s market-minimized/market maximized continuum. This oscillation has affected Socio-economic, Demographic, Health status, Political areas in United Kingdom. As a result it is extremely important to analyse and evaluate the basic formulation of the issue and its effects on the society and national economy. (Berkowitz, 189)
2. Literature Review
Practically every person in the United Kingdom used to face the risk of failing to receive needed care regardless of race, gender, income or insurance status. Studies have proved that some disparities in health care exist in United Kingdom. Americans receive just half of recommended care no matter where they live. People in all socio-demographic groups experience deficits in receiving needed care, but the relative performance varies by the aspect of care examined. The quality-of-care problem in this country is profound and systemic. According to the study, which assessed preventive services and care for 30 acute and chronic conditions that constitute the leading causes of death and disability. Participants received about 55 percent of recommended care. (Lamb, 243-245)This is despite the fact that recommended care for these conditions is widely known and accepted. Each year, several children used to die from the effects of disease and inadequate nutrition. Infection, particularly frequent or persistent diseases like diarrhoea, pneumonia, measles, or malaria, undermines nutritional status. Poor feeding practices including inadequate breastfeeding, offering the wrong foods, giving food in insufficient quantities, and not ensuring that a child eats his or her share contribute to malnutrition. For these and other reasons malnourished children’s vulnerability to diseases increased in United Kingdom. (Border, 227-228)
Infant mortality is linked to several predictive correlates, including the factors like economic conditions, ethnicity and culture, low birth weight often resulting from premature birth, maternal age, maternal education, etc. Previously cases of Infant mortality were registered in United Kingdom. With the improvement in the United Kingdom health care system better medical facilities are provided to people. Various measures were taken to make living condition of people better and hygienic. Measures have been taken to reduce environmental pollution. Efforts were made to provide complete safety to people in every aspect of life. The United Kingdom health care system paid attention on proper nutrition of children. These steps taken by the United Kingdom health care system reduced mortality rate. Though targets have been achieved in controlling population growth, but the reduction in mortality rate resulted in growth of population. Increase in longevity resulted in growth of adult population. (Deb, 323)
The ministry is responsible for implementing programs of national importance like The overall healthcare achievement of the United Kingdom health care system was ranked 15th by the World Health Organization. The United Kingdom expends far more than any other nation in healthcare, measured in terms of both per capita spending and percentage of GDP. This expenditure had not related with provision of high ranking facilities in public health metrics. The average salary of a physician in the U.K. is the highest in the world. Unlike some other Western countries, the U.K. healthcare system is not fully publicly-funded, instead relying on a mix of public and private funding. The shortcomings in health care system in United Kingdom gave rise to public dissatisfaction. Due to this reason and other reasons government was loosing public confidence. (Dev, 78-81)
With the new developments in the United Kingdom health care system better medical facilities are provided to people. Various measures were taken to make living condition of people better and hygienic. This helped in re-establishing people’s confidence in the government. People have started relying on the governmental policies and supporting the enforcement of the policies. Thus the United Kingdom health care system has greatly influenced the political structure of United Kingdom. (King, 126)
In conclusion it can be mentioned that the change in the position of the U.S. health care system on Anderson’s market- minimized/market maximized continuum has brought about commendable changes in Socio-economic, Demographic, Health status, Political areas. Thus it can be concluded that the improvement in the United Kingdom health care system has resulted in overall development in United Kingdom. (Dos, 441-442) Furthermore, texts like Tones’ Health Education: Effectiveness, Efficiency and Equity along with Unwin, Leeson and Pless-Mulloli’s 1997 work called An Introductory guide to public health and epidemiology would also be very helpful. Wright’s Health needs assessment in practice would also be relevant for the study.
Similarly there are few more books that would provide enough data and illustrations on the topic. Hunter’s Public Health Policy and Jones’ Ethics and Social Responsibility in Healthcare would be two very important books for the study as they provide a wide range of data on the topic. Kernick’s Getting Health Economics into Practice, Moon’s Reflection in Learning and Professional Development, Peckham’s Primary Care in the UK: Policy, Organisation and Management and Watterson’s Public Health in Practice are all recent books that would provide a wide range of arguments on the topic.
3. Aim and Research Questions
Analyzing and evaluating effect of the oscillation on Health status of United Kingdom in context of “uneasy equilibrium” between the private and public healthcare sectors and the effect of the oscillation on Socio-economic structure of United Kingdom are the fundamental questions and aim of the research.
Health systems in each and every country in the world, regardless of their wealth or level of economic development, are struggling to deal with multiple demands and pressures. With modernization and industrialization the developed countries like United Kingdom are experiencing epidemiologic Transition.
This term refers to a change in the type of diseases and sickness experienced within a society. Changes in mortality structure are the principle result indicator by which the epidemiological transition is evaluated. People in industrial area have to live with industrial waste and polluted water and air. Slums arose in industrial cities and became central points for poverty and the spread of disease. Epidemics of smallpox, typhus, diphtheria, measles, and yellow fever were well-documented. Tuberculosis and respiratory diseases such as pneumonia and bronchitis were even more serious problems, and they were exacerbated by harsh working situations and crowded living conditions.
The United Kingdom health care system has taken several steps to educate people about health issues, provide uncontaminated food and water, safer and better living conditions. As a result, now in United Kingdom, major sources of morbidity and mortality result from chronic and non communicable diseases. Many of these diseases are related to lifestyle, such as increased lung cancer due to smoking or high rates of cardiovascular disease that result from obesity and lack of exercise. Common diseases among wealthy, developed nations include arthritis, cancer, cardiovascular disease, diabetes, and hypertension. These diseases do not result from malnutrition or lack of access to health services. Instead these are results of excesses in personal lifestyle or simply be due to increased longevity, which causes the body to become more susceptible to such conditions. Consequently, in United Kingdom populations generally suffer with considerable chronic diseases and, thus, continual healthcare is needed.
Economic development seems to be the primary factor involved. However, economic development also brings modern determinants of health, which arise mainly from changes in lifestyle and from the hazards of contemporary and imperfectly understood technology. In United Kingdom people have become more civilized, living in a very high life style. But this development has also introduced both positive and negative influences such as use of tobacco, use of alcohol, etc which are injurious to health. Several psychological factors have an impact on suicidal tendencies, including social isolation, crises, depression, and alcoholism. Due to steady Industrialization and accelerating competition in market gives rise to an environment of tough competition. Competition along with more complex production and distribution environments requires identifying and reducing necessary costs, such as costs associated with development, manufacturing, distribution and service.
Thus the Working conditions in the industries become very hazardous. In developed countries like United Kingdom, however, levels of activity have been on a steady decline due to conveniences such as automobiles and many other labour-saving devices. Thus deficit of physical activity as is seen in these nations. The main sources of pollution vary among nations, but in general they result from motor vehicles, power plants, industry, and residential heating and cooking devices. Pollution given off from these sources can damage the lungs and other organs. Such pollution likely also contributes to chronic diseases of the lungs, such as asthma. (Kar, 145)
In order to eradicate negative effects of development the United Kingdom health care system has taken several measures such as antismoking and anti alcohol campaigns, restrictions were placed on advertising of alcohols and tobacco products, declining the percentage of tar used in cigarettes, and educate people about health issues. The United Kingdom health care system educated people about proper diet and nutrition. To maintain physical activity organizations were directed to provide recess to the employees for physical exercise. Many measures were taken to reduce air pollution. Provisions were made for safe and healthy working conditions in organizations. These resulted in growth of incentive and dedication among the employees. This again resulted in economic growth and increase in per capita income of people. Thus with the efforts of the United Kingdom health care system Socio economic structure of the nation has improved. (Fletcher, 188)
4. Approach to Research
In order to isolate the results for this particular study, only a survey questionnaire done from various areas would have been utilized. These questionnaires were delivered to general population, merchants, financial institutions, social and financial professors and administrators. The results were divided into these same categories to ensure validity and reliability. General information in regard to identifiers was utilized in order to ensure that there would be no bias.
Data gained from a specific area for ease of accessibility and for targeted accuracy lending reliability and validity to the research process. The variables involved would include age groups, amount of education, and understanding of financial responsibility. Other variables may be inclusive of the economic standings of the subject along with the same standings for the vicinity of the subject interviewed. A third series of variables includes the types of studies that are managed and the cultural background of the subjects at each of these areas. Each question had either a yes or a no answer or followed positive or negative reactions to certain questions. The process to deliver and collect these questionnaires spanned approximately two weeks.
Reliability for the researcher was achieved in the assurance that only a specified group of men and women were utilized in regard to the research. This gave the research a more focused view of the research goal. The validity was managed as a result of this focus and emphasized in the considerations involved in the data collection, variables, and sampling methods. Privacy and confidentiality methods included assigning numeric and alphabetic coding to each responding questionnaire. This ensured anonymity in regard to the researcher and the subjects of the research process.
All these variables are considered as very relevant and important features of the statistical method and it is to be seen if these aspects are fundamentally acceptable in practical world and it could well be mentioned that service are a very relevant manifestation of the social dimensions. As a result if the test is carried out in a proper manner with proper calculations of the population involved then there is no reason that the results would be both logical and true at the end consideration.
In accordance to the basic test selected it could be stated that it could be possible that the outcome would be relatively logical in the sense that it would ultimately follow the trends of social facilitation theory in marketing and thus it would be agreeable with the statistical method and thus a well formulated marketing strategy can be constructed in relation to the study. However, it should be stated that there would be few independent variables in the context of the test that could not be explained by the statistical method statements. Here the ethical consideration of the potential customers or the ethnic background of the potential customers may not be a very relevant factor. Thus there could be some flaws to the collection of the population but if these aspects are kept in mind then the shortcomings would easily be negotiated during the ultimate computations. As a result the test would appear to be a full proofed measure that would be able to define and prove the fundamental aspects and statistical method applied.
A Qualitative method of study differs from the usual quantitative methods (used in the study of pure sciences) in the sense that it tends to be far more subjective. This is in sharp contrast to the methods used in pure sciences which are exclusively objective. The research methods for marketing are a combination of both quantitative and qualitative methods. Being open to qualitative methods of study also allows social scientists to incorporate non-quantitative data (i.e. non-numerical data, such as words, images, gestures, impressions etc.) in their study. Since human beings tend to operate in terms of such data and not in terms of the terminology used in ordinary sciences this broader outlook is far more applicable in the study of social sciences. In keeping with the methodology employed in marketing researches the theories too are formulated and used keeping in mind that they aren’t necessarily applicable to all conditions. Be it psychology, history, political science or economics human events are most likely to influence the rules which define the basic theories of a marketing subject. Success in the field of marketing researches can therefore be achieved if and only if it is understood that the subject has no space or opportunity for water-tight methodologies or theories.
It can always be stated that Qualitative research is a process that includes interpretative paradigm under the measures of theoretical assumptions and the entire approach is based on sustainability that is depended on people’s experience in terms of communication. It can also be mentioned that the total approach is based on the fact that reality is created on the social formulations. It can also be mentioned that the basic target of qualitative research is instrumented towards social context under normal circumstances where it would be possible to interpret, decode and describe the significances of a phenomenon. The entire process is operational under the parameter of interpretative paradigm that can minimize illusion and share subjectivity under contextualization, authenticity and complexity of the investigation.
The basic advantages of qualitative measures are multi fold. Firstly, it presents a completely realistic approach that the statistical analysis and numerical data used in research based on quantitative research cannot provide. Another advantage of qualitative measures is that it is more flexible in nature in terms of collected information interpretation, subsequent analysis and data collection. It also presents a holistic point of view of the investigation. Furthermore this approach of research allows the subjects to be comfortable thus be more accurate as research is carried on in accordance to the subject’s own terms.
The best statistical method would be to interview long well formulated day to day working procedure at a specific and well selected location. Throughout the procedure, it should be noticed whether there are specific variables within the testable population or not. These variables would be extremely important while evaluating the basic data in the final stages where the adjustments would be made to the formulated data in accordance to the observations. However, it is important to completely take into account the aspects of fundamental variables of an individual such as ethnicity, religious belief or positive support from the sales structure of the management and individual.
However it could be stated that the most basic distinction is between a quantitative or qualitative evaluation. In a quantitative evaluation, the purpose is to come up with some objective metric of human performance that can be used to compare interaction phenomena. This can be contrasted with a qualitative evaluation, in which the purpose is to derive deeper understanding of the human interaction experience. A typical example of a quantitative evaluation is the empirical user study, a controlled experiment in which some hypothesis about interaction is tested through direct measurement. A typical example of a qualitative evaluation is an open-ended interview with relevant users. As a result this method would be used widely.
As descriptions of statistical methods that will be used it could be stated that in order to isolate the results for this particular study, only a survey questionnaire done would have been utilized. These questionnaires would be delivered to potential customers and retailers along with the administrators of different companies. The results were divided into these same categories to ensure validity and reliability. General information in regard to identifiers was utilized in order to ensure that there would be no bias and this is extremely vital for the study.
It is necessary to design a new experiment that test the statistical method. For the purpose it is necessary to collect a complete data of the site that would include different religion, ethnicity or gender. An open meeting with potential subjects in relation to the study would be very relevant in this context but only the upper income limits should be taken into account in the initial stages. This is because only upper sections are the groups that are most likely to be truly instrumental in developing the buying habits among children. However, a good portion of the subjects would be from the middle level section of income too. The mixed gender of male and female could well be excluded as that would complicate matters in the context of gender variable juxtaposed with other pre mentioned variables but considering other dependable factors sustaining it would yield to be fruitful in the long run. Data would be collected in relation to the gender, colour, and religion of the population in respect to the composition of the management under the same parameters. Furthermore, the favourable conditions in the context of experienced customer response would also be accounted.
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