The health care system is not about physicians and patients, it is a very vast system that comprises a lot of individuals and different stakeholders that make up this industry.
What are stakeholders in healthcare system? Well, stakeholders are considered as the backbone of the healthcare system, and they are actually involved in almost every aspect of the healthcare system and have a say in final reforms also.
To understand the responsibilities, duties, nature, and kind of stakeholders involved in a healthcare system we will be defining them in detail in this article. To find out more, read along!
What are stakeholders in healthcare systems?
Stakeholders in the healthcare system are those separate bodies that are involved in the healthcare system and affect the system’s rules. The main stakeholders of a healthcare system are physicians, patients, insurance companies, employers, government, and pharmaceutical companies.
Insurance companies are known to be one of the major stakeholders as they are the ones who sell medical coverage plans to patients and governmental intermediaries.
Pharmaceutical firms are the ones that are responsible for developing the medicines and further transporting them to the markets from where they are picked up by the patients as per the prescriptions of the doctors.
The pharmaceutical firms are said to receive remuneration through the government’s drug-benefit plans and their insurance. A lot of employers also offer health insurance that helps the patient in co-payment of their medical bills as well as other medical services.
The physicians are the main providers of all kinds of medical assistance and care while the patients are the direct recipients. The government bodies subsidize the healthcare services for the poor, the disabled, and senior citizens. All of the above-mentioned stakeholders of the healthcare systems have their own responsibilities and duties.
The interrelationship between the stakeholders of the healthcare system
The interrelationship among the stakeholders of the healthcare system is very complex. Two of the main stakeholders namely the insurance companies and the pharmaceutical companies are both publicly listed companies on the stock exchanges.
The main responsibility of these two stakeholders is to maximize the wealth of the stockholders.
Similarly, the main goal of the employers attached to the health industry is to maximize the profit margin by generating money. However, the provision of health insurance is mainly to provide benefits to its employees and that does not count in profit.
The other stakeholders like physicians have direct responsibilities and duties towards the people who are their patients. Although they do receive a heavy remuneration for the services they provide, the patient-physician relationship is considered a sacred one that is very trustworthy and is above all monetary rewards.
Patients are known to have responsibilities and duties but above all, they have rights as they are mainly on the receiving end. They do have certain responsibilities of their own but usually, they are overlooked as the other stakeholders have a larger role to play when it comes to keeping the healthcare system working.
Finally, the democratic government has responsibilities and duties towards all of its citizens regarding the provision of the healthcare system and its evolution with the passage of time.
Let’s have a detailed look at the job description of every stakeholder separately.
1. Insurance companies
The majority of people across the United States of America opt for health insurance to attain premier medical healthcare services in these inflation-stricken times.
Insurance companies are always driven by profit but their services are not necessarily focused on profit.
As the world is struggling to get back to normalcy after the coronavirus pandemic, more and more people are opting for healthcare insurance.
The insurance companies are looking to find the perfect balance between their responsibilities toward other stakeholders and the patients.
The quarterly reports of the stockholders determined that the insurance companies are focusing more on profits at the moment compared to affordability because of the financial hardships.
This has caused the insurance companies to derive stricter rules and regulations as compared to the past so that the healthiest people who are really in need of insurance can select their plans.
A lot of patients do not utilize the very expensive procedures unless and until they are suffering from chronic disease. Therefore, it is unethical for the insurance companies to stop people from obtaining medical insurance by coming up with strict requirements and conditions. As it also reduces the profit margin of the healthcare industry.
2. Pharmaceutical firms
A lot of pharmaceutical companies including GSK, Novartis, and Sanofi Aventis are compelled to increase their prices because of their extensive research programs and materials required for medicine development.
Pharmaceutical companies are direct stakeholders in the healthcare sector as they are responsible for developing medicines, vaccines, and other related treatments for patients for the betterment of the patients.
However, it is believed that it is the responsibility of pharmaceutical companies to reduce the prices of life-saving drugs and make them available and affordable for everyone.
Physicians can also be counted as the direct stakeholders in the healthcare industry around the world as they play a key role in making healthcare services available to patients.
They need to find a balance between the insurance companies and the patients so that the healthcare industry keeps on moving and doesn’t halt because of the irregularities among the stakeholders.
The gatekeeper role is given to the physicians who are in a position to lower medical and healthcare costs with the help of referring fewer tests than usual. However, this might not be possible entirely as the whole practice needs to go under a re-evaluation but still, a physician can work it out on his own personal level for his dedicated patients.
Primary care physicians can increase the number of patients they can check in a day in order to compensate for the decreasing revenue so that they increase the diagnostic testing. This way they can assist the growing costs and reduce the risks associated with the healthcare industry.
These actions can be spread across the healthcare system by placing the physician in two different roles. One is to check and assist the patients and the other is to play the role of a gatekeeper between the patients and the insurance companies.
Ethically, it is a job to assist the patient morally but nowadays the insurance companies give heavy incentives to physicians so that they can work according to the model presented to them by the insurance companies.
It is the obligation of the physician to work for the benefit of the patient and not run after monetary benefits presented to him by different stakeholders in the healthcare system.
The ethical responsibility of patients is to look after their own health and control their growing medical bills. This would be very much possible if people would adopt a healthy lifestyle as a healthy lifestyle would mean fewer medical bills.
A lot of companies like Walmart have taken the initiative to adopt healthier means of lifestyle in their corporation by hiring employees who are strictly non-smokers.
Doctors are often accused of writing prescriptions that consist of huge diagnostic tests which are most of the time not needed but it has been seen that for their own satisfaction, certain patients ask for multiple tests to be conducted even if they are unnecessary.
A patient should realize that it is not necessary that the most expensive treatment will also be the best, a patient should find a physician who is cost-effective and reasonable, and also sincere with his profession.
It is the responsibility of the government to emphasize equality, a free market, and resources for all. The government can prevent clashes between different ideologies by keeping the healthcare system policies uniform for everybody residing in the United States of America.
The pharmaceutical companies might try to influence the government with their monetary funds but it is the moral responsibility of the government to provide the best healthcare system to its citizens regardless of what financial tier they belong to.
Healthcare reforms were formulated so that the healthcare system can assist and help every citizen of the United States of America. As the economy of the country is still struggling after Covid-19 ended, it is getting more and more difficult for the stakeholders to keep on working in the medical healthcare system on the same terms as they were in pre-Covid-19 days.
New reforms should be formulated so that the stakeholders can define new responsibilities and duties for themselves and make the medical healthcare system helpful like it was in the old days. All the stakeholders need to work together to bring back the glorious days of the medical healthcare system.