Organizational Impact of Rationing Healthcare

 

The passage and implementation of the PPACA expanded health insurance coverage to many who did not previously have health coverage, and mandated that health services organizations promote the uptake of strategies to foster health and well-being that is accessible, affordable, and effective for all who carry health insurance coverage. However, while the main goal and mission of a health services organization is to deliver effective health services, it, too, must operate as a business and perform competitively within the healthcare delivery system. To that end, it may come as no surprise that some limitations and caps are placed on certain procedures, treatments, or health services depending on health insurance coverage type or subscription. In essence, such “rationing” of healthcare is commonplace and may present an ethical dilemma for the healthcare administration leader.
As a current or future healthcare administration leader, how might you rationalize the aims of promoting effective healthcare delivery for all who now have coverage extended due to the mandates of PPACA, while minimizing increased costs to deliver services to all and still remaining competitive in the healthcare delivery system? Identify a current strategy that the government uses to ration healthcare. Then, describe how this policy may influence your health services organization and explain how this policy impacts healthcare cost and access.

 

Sample Solution

If The Wind in The Willows was a book intended for adults, then possibly the definitive childhood character from The Golden Age of Children’s Writing’ is Peter Pan. Again, there is a conflict arising from the adult perception of what it means to be a child, or if the subtext of the story is one intended for children as readers. Here, a wilful and spirited boy replaces the image of Pan as a horned, half man, half goat god. Fairies and mermaids replace the Nymphs of mythology, and the shepherds who worshipped Pan are now a tribe of lost boys.

Peter Pan is first introduced when ‘Mrs. Darling is tidying up her children’s minds’ as Barrie describes’ a child’s’ mind, which is not only confused, … it keeps going round all the time’ (Location 84 of 2074, Peter Pan and Wendy, Kindle edition.) Which suggests the author ultimately regards the minds of children and the state of childhood as a separate and unordered state, in need of organisation. Like Mr. Darling, Barrie feels compelled to reinstate order.

We learn Peter Pan comes from Neverland, a place where each child has their version of Neverland, seen in the moments before they go to sleep. Peter lives with the fairies and ‘when Children died he went part of the way with them so that they would not be frightened.’ Within the story, there are fights to the death, and a reference to Peter Pan thinning out the lost boys, though we do not know how this is achieved. The story suggests Peter kills for fun. If a literal interpretation, then he is cruel and controlling. One can also read Peter Pan is a representation of the fleeting dreams children have before deep sleep, imaginings fed by pocket magazines of the day, playing out pirates and Indians? An illustration, At Home in The Nursery, By George Cruickshank, from 1835, depicts children at play with a range of battle inspired toys. War and death are trivialised by play. Even before the story is established, the author makes the distinction that ‘Children have the strangest adventures without being troubled by them’.

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