Since the 1900s, the health care system in the United States has experienced a significant transition from the community institution to the corporation. Although this transformation aimed at increased quality of services for a decreased price, drug costs remain very high for a population, and not everyone can afford them. At the same time, hospital executive boards try to motivate working specialists and face all the challenges an organization faces to provide employees with necessary conditions to work with patients. However, there are some recommendations that boards need to apply in their future work.
The Evolution of the Health Care in the US
Over the past century, the health care system in the USA has undergone significant transformations. According to Burns and Pauly (2018), the health care system of the United States has experienced several transitions since the early 1900s. There is a view that the USA’s hospital has undergone the transition “from a community institution focused on health (especially for lower income populations) to a corporation increasingly focused on wealth” (Burns & Pauly, 2018, p. 61). Therefore, to understand why the health care system in the USA today looks the way it does, one should consider this transition in detail.
The health care system experiences a transformation from a community institution to a corporation, allowing entrepreneurs and private firms to provide medical services to the population. Firstly, in 1910-1920, there was a wide closure of many medical schools and the rise of medical specialties accompanied by the decrease in national income, and in 1930-1940, private insurance was introduced to the USA’s citizens (Burns & Pauly, 2018). Then, in 1960-1970, followed by elaboration of for-profit hospital chains, various federal and state regulatory efforts were undertaken to prevent costs on medicals and healthcare services from rising (Burns & Pauly, 2018). Finally, in the 1980s, the competitive market tried to create some solutions concerning the prices of healthcare services, which resulted in the establishment of hospital systems and medical homes in the 2010s (Burns & Pauly, 2018). However, the transformation did not result in higher quality at a lower price because the costs of drugs still increase faster than the GDP.
Evaluation of Hospital Executive Board
There can be defined six components of the effective non-profit boards in the USA, including the hospital ones. These characteristics are contextual (organization norms), educational (informing workers about their roles), interpersonal (development of employees as a community), analytical (addressing challenges), political (maintenance of healthy relationships among crucial stakeholders), and strategic dimensions (shaping organization’s future) (Mannion et al., 2017). Moreover, Mannion et al. (2017) claim that boards “may be able to impact on important staff perceptions” (p. 278). However, hospital boards are recommended to broaden their work to “include organizational performance measured by financial data, clinical data, team member engagement, stakeholder engagement, and behavioral integration” (Creek, 2021, p. 29). In other words, applying listed above components, the hospital executive board can influence the motivation of employees and improve the outcomes of an organization itself by the regulation of in-group relationships and conflicts. Overall, executive boards shape the hospitals, making them easier to function and provide patients with the health services, but are recommended to include the analysis of financial, clinical and other data in their work.
In the context of the health care in the USA transformed to a corporation, involving private organizations to provide population with drugs and services, the hospital board executive can be adopted for a future training and research. At least, future work is needed to uncover the influence of boards on the hospitals’ outcomes. Moreover, executive boards are recommended to consider financial and clinical data, team member and stakeholder engagement, and behavioral integration in their work.
Burns, L. R., & Pauly, M. V. (2018). Transformation of the health care industry: curb your enthusiasm?. The Milbank Quarterly, 96(1), 57-109.
Creek, G. (2021). Exploring The Emergence Of An Inaugural Hospital Executive Team (Doctoral dissertation).
Mannion, R., Davies, H. T. O., Jacobs, R., Kasteridis, P., Millar, R., & Freeman, T. (2017). Do Hospital Boards matter for better, safer, patient care?. Social Science & Medicine, 177, 278-287.