Executive Extra: Healthcare reform in 2013: Enduring and universal challenges
Sean P. Clarke PhD, RN, FAAN

$7.95
Nursing Management
March 2013 
Volume 44  Number 3
Pages 45 - 47
 
  PDF Version Available!

ABSTRACT
Healthcare leaders are still looking for a sense of what's to come in healthcare reform and for guidance about how to prepare for specific aspects of implementation. However, I'd venture that although there's a lot to know about and follow in the coming years, the lessons for managers and executives from the current wave of healthcare reform are actually broader. What isn't part of the legislation and court cases is as important to pay attention to as what's at the heart of the reforms. The real challenges on the healthcare landscape aren't specific to the legislation; in fact, they're probably not even specific to the United States.Many looking from the outside at the U.S. healthcare system are struck by what they see as ample resources, exceptional leadership, and innovation in the health sciences, alongside a huge separation between the wealthy and poor in terms of healthcare access. Looking at their own countries, they often find the U.S. government's roles in ensuring healthcare access are less than straightforward and are struck by how much the notion of healthcare as market goods is accepted by Americans. Of course, seen in true international perspective, the truth is considerably more complicated. Extensive government involvement is actually a prominent feature of American healthcare. Likewise, there are extensive private, as well as for-profit, interests in every healthcare system in the world, and the United States is far from the only country in which significant responsibilities for health expenses fall on individuals and their families outside government subsidy or control.Beyond the United States, citizens and even health professionals and managers have an idealized view of their own healthcare systems. Sometimes there's blindness to crumbling infrastructure, serious quality problems, and out-of-control costs. But even when shortcomings are acknowledged, in the end, deep commitment to their systems as reflecting national values blocks real discussion on

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