The Objective of For-Profit (NP) Entities

Response to Question One 

There is a notion that the objective of for-profit (NP) entities is to provide a return on the investments made while the not-for-profit (NFP) is to focus on the provision of excellent care for the patients. The premise is that government-funded health facilities should only ensure that patients and the populace receive quality care. In essence, the concern is not profitability, and for-profit institutions do not highly regard quality, as long as they remain profitable (Phillips et al., 2014). As the healthcare system progresses to one that values quality over quantity, there should be a shift towards measuring the precise results and not merely the financial markup. In terms of quality of care, the film  Code Black  underpins the concept that if an individual admitted at a public health facility is well enough, then he or she gets turned away if his or her condition does not amount to health-threatening. Public hospitals appear to attract patients who have low incomes.  

             The film insinuates that in terms of quality, NFP facilities tend to perform better compared to FP facilities. The FP facilities tend to have a lower level of staff members in comparison. The lower numbers mean higher profitability levels since they spend less on staff salaries and remuneration. In retrospect, a higher level of staffing is associated with higher quality care and, subsequently, lower mortality rates. NFP facilities prioritize quality and provide support for residents’ payment of their expenses. Closely related to that is the fact that the financial aspect also has a bearing on the quality of care. The FP facilities have the edge over the NFP in terms of financing because they have additional resources such as funds from stakeholders and various other entities (Phillips et al., 2014). The funds are advantageous in certain aspects. Nevertheless, the fact that FPs mainly concentrate on profitability negatively affects quality. Therefore, most residents found in FP facilities tend to focus on marketing campaigns rather than the quality of care.  

            The fact that the FP facilities have access to a larger pool of capital than the NFP facilities does not mean that they have an edge in terms of quality in different dimensions. As a result, the FP facilities have a higher quality of care when measured in terms of the distribution of medicine, efficient staff levels, which supersede the additional resources that define the FP facilities. The sheer number of staff numbers at NFP means that the workload is evenly distributed, and the residents are not overburdened, meaning that they can stay longer in comparison.  

Response to Question Two 

            I rushed to the ED, and the physicians are reluctant to provide prompt care. I would certainly understand because the circumstances in the government facilities are not favorable to the care providers, as depicted in the film,  Code Black . The system, which is the county hospital, is seemingly overwhelmed during an occurrence of a heart attack. In essence, the documentary is an accurate depiction that the American healthcare system is in limbo to the point that even the advent of socialized medicine serves very little to ease the misery found therein.  

            The problems, as shown by the movie, include paperwork and funding. The cost of medical care in the United States is exceedingly high to the point that the onset of a severe illness or the occurrence of a major injury can drive a family to bankruptcy. The problem is made worse by the fact that people refuse to subscribe to the idea that collective payment of health care is helpful (Nic Carthaigh et al., 2015). One doctor in the film explains that people may resist the idea of collective payment of health care services even though they are already practicing it in the US. He further explains that when someone from a working-class or poor person goes for medical treatment, taxpayers foot the bill. Therefore, the issue should relate to the efficiency and sensibility of how to invest best or sue the contributed money.  

             Apart from the financial issues that present serious challenges to the residents, the paperwork is also a serious issue. The movie stipulates that emergency medicine was discovered at C-Booth, which was a ward in LA County General in a battlefield tent. Because C-Booth was in a tent, there was no much paperwork at the time due to the minimal administrative requirements. At the time, the doctors and nurses mainly worried about treating patients and not filing paperwork. Nevertheless, when C-Booth moved to a new location and facility in 2008, the health care providers currently spend a lot of time filling paperwork instead of concentrating on their duty, which mainly entails caring for the patients or treating ailments (Hughes, 2008). As a result, many patients have to wait for hours and, in most cases, days to see a physician.  

Response to Question Three 

            Code Black  highlights the various barriers to care, which entail the high cost of health care that patients from poor backgrounds and those from relatively lower-income, for instance, the diabetic patient, undergo in their quest for quality care. It is evident from the film that low-income individuals experience poor care, lack of trust in the care system, and financial obstacles when in need of care. The Affordable Care Act is currently responsible for increased access to care for families that cannot afford it (McGinnis et al., 2013). The act requires the meeting of care demands of low-income earners through tax credits on health care insurance and cost sharing.  

            Cost sharing, which requires the citizens to pool resources as a way of offsetting medical emergencies, is perhaps the most viable option that would help low-income earner to deal with the problem of accessibility of care. As mentioned earlier, a doctor in the film explains that people may resist the idea of collective payment of health care services even though they are already practicing it in the US. He further explains that when someone from a working-class or poor person goes for medical treatment, the taxpayers foot the bill. It proves that for the government to improve access to care for people who cannot afford it, then it has to come up with and implement a system that is reminiscent of the one proposed by the Affordable Care Act. The system requires the government to pool resources and use them to offset medical bills for low-income individuals.  

            Most low-income individuals agree that the fact that doctors and medical practitioners do not inform them of their possible bill or expense in time, which further exacerbates their problems. Helping people who can barely afford care would involve informing them of the possible or estimated cost early enough so that they get their finances in order or solicit for funds in the best way they understand to access care. For example, when a patient, for instance, one who has diabetes, is informed that the insurance may cover the entire cost but later finds out that not all the services were sufficiently covered may feel financially disoriented. A doctor should educate the patient early enough of any impending costs and tests. Additional tests without the knowledge of the patient tend to cost money, and the patient may not afford care beyond his or her insurance cover. Therefore, advising the patient to seek alternative care is also an option, especially in NFP facilities may help in such situations.  

References 

Hughes, R. (Ed.). (2008).  Patient safety and quality: An evidence-based handbook for nurses  (Vol. 3). Rockville, MD: Agency for Healthcare Research and Quality. 

McGinnis, J. M., Stuckhardt, L., Saunders, R., & Smith, M. (Eds.). (2013).  Best care at lower cost: the path to continuously learning health care in America . National Academies Press. 

Nic Carthaigh, N., De Gryse, B., Esmati, A. S., Nizar, B., Van Overloop, C., Fricke, R., & Philips, M. (2015). Patients struggle to access effective health care due to ongoing violence, distance, costs and health service performance in Afghanistan.  International health ,  7 (3), 169-175. 

Phillips, R. L., Han, M., Petterson, S. M., Makaroff, L. A., & Liaw, W. R. (2014). Cost, utilization, and quality of care: an evaluation of Illinois’ Medicaid primary care case management program.  The Annals of Family Medicine ,  12 (5), 408-417.