Introduction
A number of the poor countries have their health care system being under the management of the government, a result of which most of them have been faced with problems of inefficiency and incompetence. Most of the health care services in a number of the poor countries such as African countries can not function effectively as a result of embezzlement of funds meant for the provision of health care and as a result, most of the African governments have to constantly depend on external aid to cater for the provision of health services. Most African states also depend on the western countries for drugs donation especially for the major killer diseases such as malaria, HIV and T.B (Maathai, 2009 p. 143).
Over the past few years health care has been normally provided by individual medical personnel mostly in the homes, but this has since changed over the years. The care is now provided in organized systems such as hospitals by teams of professionals using modern technology. As a result of this kind of progress, some issues have arisen in the provision of health care. These include an increase in the consumption of the medical services; the cost of some form of health care has tremendously risen making some of them unaffordable to many individuals. There is also the problem of limited health care resources which sometimes bar others from getting the crucial care (McIntyre and Mooney 2007, page 14). The healthcare system is quite complex and the cost of delivery also quite high; this makes it difficult to decide on what is good for an individual and the society as a whole. The healthcare system is also flawed and at times the care provider may be forced to go against the regulations in order to suit an individual. Such changes result in more flaws and may end up interfering with health care provision (Novick, Morrow and Mays, 2005, p. 76).
As a result of such variations, a set of principles have been formulated to be used as a guide to enhance ethical decision making in the provision and delivery of health care. The principles put focus on the delivery of the services which are meant to improve the cooperation of those involved for the benefit of the individuals and the society as a whole. These principles are meant to be used by the workers in the health care systems to guide decisions about the form of care to be given and the interactions with the patients. They are also to be used by the health care organizations to enable them fulfill their goals and missions according to their ethical requirements for the benefit of the society as a whole (Veatch, 2007 p. 196). Governments, employers and insurance organizations also need to use these principles in order to ensure that their policies are supportive and in line with the efficient running of the health care systems. Lastly, the public too need to have information on how the health care system functions so as to enable it to play a positive role towards the success of the care system (Geyman, 2004, p. 273). Coordination and cooperation of the various stakeholders involved in the delivery of the health care can give very positive results that could be beneficial to the society as a whole. Some of the ethical principles are; health is a human right, the care of the individual should be the top agenda of the health care system, though the care should be given in such a way that it does not interfere with the care provision to the whole society; the care system should endeavor to prevent illnesses and reduce disabilities, there needs to be cooperation amongst different stakeholders in the care provision. All the participants in the care provision should aim at improving the quality of care given (Green, 2007). Others include coming up with initiatives to prevent illnesses and injuries; putting up a system that promotes high level of hygiene, for instance reducing environmental hazards like pollution; and putting in place efficient immunization programs and encouraging healthy lifestyles. The general principles include encouraging people to put focus on the value of the care by providing information to the consumers of the health services to enable them make more rational choices. It also enables them to be responsible for the kind of care they get. Thirdly, analysis of under capacity and over capacity in terms of the physical equipments and the buildings, technology, labor supply, the demand and sustainable supply of the services is important. Others are monitoring the quality of the services such as the clinical practices, availability of information about the activities of the care providers and the use of monitoring systems and audits to assess the activities of the care providers (Monagle and Thomasma, 2005, p. 247)
The other principle is promotion of cost competitiveness by enhancing the productivity process and containing the cost of input into the care system. It is also important that the financing mechanism is looked at, for instance, the sources of financing and realigning the reimbursement procedures with the providers so as to enhance competitiveness. Lastly, there is need to be able to make the necessary implementations agreed upon which may involve imposing mandates, providing the necessary financial initiatives such as tax breaks and creating awareness about the recommendations made (Kilpatrick and Johnson 1999, p. 1086). Most of the health care policies are derived from theories. Utilitarian theory suggests that policies should be based on their consequences in that; it should bring about good for many and not just an individual. Kantian liberalism theory explains that people have the ability and capacity to make moral choices and therefore, a care system policy should prevent the state from being in control of health issues since that is meant to be an individual based decision. Lastly, there is communitarianism which is normally based on the belief of a desirable society that is guided by religion or a sociopolitical philosophy like Marxism or socialism. The health policy in such a case should therefore be focused on provision of universal care and disease prevention in an appropriate social framework like in USSR, Cuba and the Islamic Republic of Iran.
The Key Principles and Policies for Appropriate Health Care System in a Poor African Country
The health care system of most African countries is based on a number of principles which include initiatives to prevent illnesses, disabilities and injuries (Markle, Fisher & Smego,. 2007, p. 200). This is normally done through the immunizations against diseases such as polio which are likely to cause disabilities. They also do this by extensive programs aimed at preventing major killer diseases in the continent; this includes the provision of mosquito nets to prevent the spread of malaria and the provision of water treatment tablets to prevent the cases of typhoid and other water borne diseases. The African countries have also tried implementing principles that promote the general hygiene including the prevention of pollution. The African countries have also tried to reduce pollution by advocating for activities that prevent pollution of the environment. For instance, some of them have designed smoking zones within their cities and towns so as to prevent cases of passive smoking. Due to the high level of poverty and ignorance in most African countries, they have not been able to effectively control pollution of its water resources as well as the atmosphere since most of its people still depend on firewood for fuel, adding carbon dioxide to the atmosphere. As much as the African health care system may be based on the principle of capacity; it is normally faced with a lot of shortages. First, in terms of labor, most of the African countries lack enough health providers and have to depend on volunteers or NGO based organizations to meet their demands (People’s Health Movement, Medact, Global Equity Gauge Alliance & University of South Africa, 2005, p. 119). Most of these care systems are also faced with financial and technological shortages as well as the lack of physical facilities. This has made the health care services to be inefficient and substandard. The health care system in African states is generally in a sorry state since it is faced with a lot of challenges and it seems like nothing much is being done to change the scenario.
The African states medical system policy can be said to be partly utilitarian in that, it is consequence based and every thing is normally done for the common good of all. The health care system is run by the government and as a result, every decision concerning the heath care provision or delivery is normally done on a generalized basis. The government can not take care of all individual needs and specifications, making the individual have to contend with what has been offered by the government for the whole population. The health care system’s policies can also be said to be capitalistic in nature. This is so because most of the quality healthcare services in the African states are provided in by the private sector where there are divisions in terms of class. There are those that are quite expensive and are beyond the reach of the poor while there are others that are averagely cheap. There is also the government owned hospitals where the care is normally averagely cheaper though the quality is quite compromised, this makes most of people in the middle class income levels to opt for the substandard care provided by the private hospitals; they tend to believe that it is better than the government owned care system (Ashley, DeBlois, and O’Rourke 2006, p. 38).
Comparison between the Policies and principles that guide the Planning of health care system in Japan and in a Poor African state
The health care systems in countries like Japan are quite efficient and apart from sharing the same principles with the African health care system, they have also incorporated some other important principles into their care systems that have made it quite efficient. No wonder the Japanese have the highest life expectancy level. The way in which the care system is organized is dependent upon the values and the ideals of the society and the political recognition policy, which defines what healthcare should achieve for its people (Annesaki and Powell, 1990, p. 116.).The health care insurance cover is mandatory and those that can not pay are assisted by the government (Campbell and Naoki, 1998, p, 1). The Japanese health care systems, apart from having the above principles on its agenda also encourage the Japanese to practice healthy lifestyles. The Japanese always endeavor to eat healthy foods according to their body requirements. They also indulge in a lot of exercises in order to keep their bodies in good shape. Another principle is that, they place a lot of emphasis on the value of the services. Citizens are enlightened on the necessary information concerning care provision. This enables them to make the right decisions concerning the care choices they make. Labor, facility demand and sustainability of the care system are also modern and more efficient. Japan does not experience any shortages of any of the above like the African countries but they have been criticized for having an overcapacity of the MRI scanners. The Japanese health care system is putting a lot of focus on making health care affordable at the expense of the care providers; this is because the care providers earn peanuts due to the low cost of health care. This has also resulted in most of the hospitals experiencing financial difficulties.
The Japanese health care system policy is normally considered to be based on Kant’s theory of liberalism. This means that it allows the individuals to make decisions concerning the health care provision that they prefer. The patients are allowed to visit their care provider of choice and they need no gate keepers for referrals. It is also argued that the health care policies may be partly based on the capitalistic theory in that the care system is mainly provided by the private owned firms.
Conclusion
Policies and principles governing the provision of care are normally universal though there are a few differences in the level of success. These are brought about by the differences on the point of focus in the provision of care (Liu, 2003, p. 83). The best way to improve care provision internationally is to have countries borrow some of the principles used by those countries with efficient care systems. But as it has always been said, there is no care system that is perfect, each of the principles employed could be compromising the care provider, the patient or the care providing organization itself. It is therefore important that all the three issues are considered when formulating policies and principles to govern the health care systems. It is also important that the citizens are involved in the policy making (Petersen, 1982, p. 196).
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