All competition is good even in healthcare delivery. Or is it? From a Public Health Perspective

The Business Dictionary defines competition from an economics point of view as: rivalry in which every seller tries to get what other sellers are seeking at the same time: sales, profit, and market share by offering the best practicable combination of price, quality, and service. Where the market information flows freely, competition plays a regulatory function in balancing demand and supply.

The Merriam-Webster's Learner's Dictionary gives what it calls a simple Definition of competition: the act or process of trying to get or win something (such as a prize or a higher level of success) that someone else is also trying to get or win : the act or process of competing; actions that are done by people, companies, etc., that are competing against each other. The competition: a person or group that you are trying to succeed against : a person or group that you are competing with.

I would use the terms access, quality and price more instead of competition as far as public health and medicine go. Why? Because public health and medicine as services are different for  each individual. Public health is a science of protecting and improving the health of families and communities through promotion of healthy lifestyles, research for disease and injury prevention and detection and control of infectious diseases. Overall, public health is concerned with protecting the health of entire populations. According to CDC. Public health is about protecting the safety and improving the health of communities through education, policy making and research for disease and injury prevention.

fee-for-service.Source: Wikimedia

References:

Competition. Retrieved from: http://www.businessdictionary.com/definition/competition.html. Retrieved on July 9th 2016.

Simple Definition of competition. Retrieved from: http://www.merriam-webster.com/dictionary/competition. Retrieved on July 9th 2016. 

What is public health. Retrieved from: http://www.cdcfoundation.org/. Retrieved on July 9th 2016.

Barriers or quality assurance? From a Public Health Perspective

Technology, the patents surrounding breakthrough inventions and computer platforms that facilitate exchange of information have helped in the organization of healthcare delivery. The HIPAA Privacy Rule establishes national standards to protect individuals' medical records and other personal health information and applies to health plans, healthcare clearinghouses, and those health care providers that conduct certain health care transactions electronically.

The HIPAA Security Rule establishes national standards to protect individuals’ electronic personal health information that is created, received, used, or maintained by a covered entity. The Security Rule requires appropriate administrative, physical and technical safeguards to ensure the confidentiality, integrity, and security of electronic protected health information. key elements of the Security Rule including who is covered, what information is protected, and what safeguards must be in place to ensure appropriate protection of electronic protected health information. 

The Security Rule, provides room for interfacing providers to negotiate measures that separate tradecraft  secrets from providing quality care to a given patient.

EMR/EHR. Source: Wikimedia

References:

Summary of the HIPAA Security Rule. Retrieved from: http://www.hhs.gov/hipaa/for-professionals/security/laws-regulations/. Retrieved on July 9th 2016.

The Security Rule. Retrieved from: http://www.hhs.gov/hipaa/for-professionals/security/index.html. Retrieved on July 2016. 

Access, Care, Costs, Quality outcome-focused performance measures promote accountability; From a Public Health Perspective

I was tasked to reconcile the heavy load of health mobilization and promotion that I engage in with an inventory that can be used to measure performance. I want to see the clients I help go to hospitals smile again or I want to hear them talk about a plan to continue seeking professional health care.

The U.S. health care system today seeks to address broad themes such as: access, quality and affordability. Approximately 46 million Americans are uninsured, many who are insured face rapid increases in premiums and out-of-pocket costs. Congress and the Obama administration are seeking ways to invest new funds to reduce the number of Americans without insurance coverage. 

However, with price discrimination there is need to simultaneously address shortfalls in the quality and efficiency of care that lead to higher costs and to poor health outcomes. To do otherwise casts doubt on the feasibility and sustainability of coverage expansions and also ensures that our current health care system will continue to have large gaps — even for those with access to insurance coverage. 

Preventive care is underutilized, resulting in higher spending on complex, advanced diseases. Patients with chronic diseases such as hypertension, heart disease, and diabetes all too often do not receive proven and effective treatments such as drug therapies or self-management services to help them more effectively manage their conditions. There are variations in hospital inpatient lengths of stay, visits to specialists, procedures and testing, and costs — not only by different geographic areas of the United States, but also from hospital to hospital in the same town. Many patients often do not receive medically necessary care, others receive care that may be unnecessary, or even harmful. 

Encouraging efforts at the state and regional levels to enable public and private payers, including Medicaid and Medicare, to participate in private-public initiatives is aimed at using better, outcome-focused performance measures to support payment and benefit reforms that promote accountability for greater value.

patient care. Source: Wikimedia

Access to Health Services. Retrieved from: https://www.healthypeople.gov/2020/topics-objectives/topic/Access-to-Health-Services. Retrieved on July 9th 2016.

Drug Registration and Listing System (DRLS & eDRLS). Retrieved from: http://www.fda.gov/Drugs/GuidanceComplianceRegulatoryInformation/DrugRegistrationandListing/ucm2007058.htm. Retrieved on July 9th 2016. 

Jonathan Blum. 2011. Improving Quality, Lowering Costs: The Role of Health Care Delivery System; Committee on Homeland Health, Education, Labor and Pensions United States Senate. Retrieved from: http://www.hhs.gov/asl/testify/2011/11/t20111110a.html. Retrieved on July 9th 2016. 

Measuring Health Care Quality:An Overview of Quality Measures. 2014. Retrieved from: http://familiesusa.org/sites/default/files/product_documents/HSI%20Quality%20Measurement_Brief_final_web.pdf. Retrieved on July 9th 2016.

Niall Brennan, Nicole Cafarella, S. Lawrence Kocot, Aaron McKethan, Marisa Morrison, Nadia Nguyen, Mark Shepard & Reginald D. Williams II. 2009. Improving Quality and Value in the U.S. Health Care System. Retrieved from: http://www.brookings.edu/research/reports/2009/08/21-bpc-qualityreport. Retrieved on: July 9th 2016.

Living With HIV/AIDS: Myths and Facts

You Can't Get Lifesaving Drugs Without Insurance

Myth. There are government programs, nonprofit groups, and some pharmaceutical companies that may help cover of the cost of HIV/AIDS drugs. But be aware: These drug "cocktails" can cost $20,000 a year or more. Talk to your local HIV/AIDS service organization to learn about financial help.

Lifesaving Drugs. Source: WebMD/Getty

Living With HIV/AIDS: Myths and Facts

You Can’t Avoid Other HIV-Related Infections

Myth. Due to weakened immune systems, people with HIV can be vulnerable to infections like pneumocystis pneumonia, tuberculosis, candidiasis, cytomegalovirus, and toxoplasmosis. The best way to reduce the risk is to take your HIV medications. Some infections can be prevented with drugs. You can lessen exposure to some germs by avoiding undercooked meat, litter boxes, and water that may be contaminated.

Children at play. Source: WebMD/Getty

Living With HIV/AIDS: Myths and Facts

You Can Have a Baby if You Are HIV-Positive

Fact. Infected mothers can indeed pass HIV to their babies during pregnancy or delivery. However, you can lower the risk by working with your doctor and getting the appropriate care and medication. Pregnant women with HIV can take medications to treat their infection and to help protect their babies against the virus.

Mother and child. Source: WebMD/Getty

Living With HIV/AIDS: Myths and Facts

Sex Is Safe When Both Partners Have HIV

Myth. Just because you and your partner both have HIV, doesn't mean you should forget about protection when having sex. Using a condom or other latex barrier can help protect you from other sexually transmitted diseases as well as other strains of HIV, which may be resistant to anti-HIV medication. Even if you are being treated and feel well you can still infect others.

A condom. Source: WebMD/Getty