Case Study: Business Feels the Consequences of the Uninsured Problem Essay

BUSINESS FEELS THE CONSEQUENCES OF THE UNINSURED PROBLEM Vanessa Flores November 5, 2012 Ashford University Describe the issue based on the topic/content area/change in your own words (2-3 sentences) (the uninsured issue is the case study in this chapter): Uninsured employees choose to stay sick or self-medicate instead of going to see a doctor. This affects the stakeholders because it leads to lower employee morale and productivity due to their health issues that are not being addressed. Lower productivity leads to a lower profit margin and fiscal losses in the end.

From the table on page 274 of the text, explain what is the healthcare industry perspective on this issue over the next 3 years? Look at the topic, individually, from a cost, quality, and access point of view and then summarize the overall industry perspective in four to five sentences below. COST: Overall cost will increase and overhead will increase. QUALITY: Quality will decrease. ACCESS: Access will decrease. Overall industry perspective (integrate cost, quality, and access perspectives): Overall the industry will suffer losses in the coming 3 years. Cost will increase and make running the healthcare industry more expensive.

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Quality of care will decrease leading to customer dissatisfaction and profit losses. Access to healthcare will also decrease, which will make it more difficult for patients to receive healthcare. There is a huge issue in American society today regarding uninsured Americans. It is especially difficult for people who are working a full time job and are still not offered insurance by their companies, or simply cannot afford the insurance that is offered. From the stakeholder’s perspective, this issue weighs greatly on the organization’s productivity and revenue.

Stakeholders must take cost, quality, and access into consideration when they review this issue. The cost of running an organization is impacted greatly when uninsured employees become ill. An employee who has no insurance will more likely go to work sick and not be productive or stay home until they feel better. They are much less likely to seek care because they cannot afford the out-of-pocket expense. This lowers company productivity because a sick employee will come into work sick, but not be able to perform at the same level as a healthy worker, and in turn, this raises overhead costs.

There was a Gallup poll taken in October of 2011 that determined that unhealthy workers’ absenteeism in America lead to $153 billion in costs. 1 There are reasons sick workers cost companies that amount of money. When a healthcare worker is sick, management must seek a temp to replace that employee or pay a different worker overtime in order to cover the shift. Also, if the sick employee decides to go to work while sick, there is a risk of exposure to other workers. This ends up costing the business even more money. According to a survey done in 2008, a company can experience cost in three ways when it comes to employee absenteeism. Absences have three areas of financial impact: Direct costs for the benefits or wages paid to employees while absent. Indirect costs for lost productivity or the replacement worker expenses to “cover” absences and minimize loss of productivity. Administrative expenses, whether due to internal staffing and overhead, or to vendor services. ”2 The quality of care that a stakeholder’s organization provides can suffer when uninsured employees are ill. Having sick employees come into work can cost an organization because they are not working as productively as they usually do.

What this means is that the employees are not as productive when they are sick compared to when they are well. They are not treating the patient with the same level of quality as they would if they were healthy. Not as much gets done during the day as it normally does. If the employee is more focused on staying healthy enough to perform his or her job, he or she is not fully focused on caring for the patient. When quality of care goes down, not only does patient satisfaction suffer, but, more importantly, patient health takes a hit.

An article written in 2007 about the effect of nurse staffing on quality of care states that “higher registered nurse staffing was associated with less hospital-related mortality, failure to rescue, cardiac arrest, hospital acquired pneumonia, and other adverse events. The effect of increased registered nurse staffing on patient safety was strong and consistent in intensive care units and in surgical patients. ”3 Better patient outcomes is an essential element for the success of an organization. The quality of care that an organization provides is essential for an increased profit margin.

Patients go to hospitals and other healthcare facilities because they provide positive results. This often occurs through word-of-mouth. If the quality of care is unsatisfactory to patients, they tend not to return. An organization’s profits decrease when patients become less satisfied with their experience there. Employees who are uninsured and ill increase the chance for bad quality of care and unsatisfied patients. Access to healthcare decreases when uninsured employees are ill. Illness decreases the number of healthcare providers available and creates an increase in cost and a decrease in profits.

When a company experiences a budget crisis, it affects the amount of workers it can employ. A decrease in available employees leads to a decrease in access. 4 “The service survival results are consistent with the theoretical prediction that hospitals are more likely to maintain unprofitable services when facing softer budget constraints. ”5 This demonstrates the issues organizations are faced with when uninsured and ill employees cause costs to rise and therefore access to decrease. Another issue when speaking of reduced access is third-party payers.

Usually patients have a certain kind of insurance that only allows them to go to certain facilities. If the facility that their insurance covers is not equipped to care for them, it forces them to seek other providers. However, if their insurance does not cover any other providers, then the patient has no choice but to either wait until the covered facility is available or stay sick. Employees’ illnesses also decreases access to healthcare simply because they are healthcare providers and when they are sick, they are less capable and not available to care for their patients.

When an organization is short-staffed due to illness, it creates turmoil in the employee’s entire department. When there are fewer providers on staff due to illness, patients are likely to get short-changed when it comes to their care. The wait time in an emergency department, for example, can be longer due to employee absenteeism. A non-critical patient may choose to seek care at a different hospital if he or she feels they waited too long. The stakeholder has a lot to consider when it comes to uninsured employees. When it comes to profit margin, it makes no sense to not insure an organization’s employees.

The cost, quality of care, and access of care each suffer greatly when an employee is sick and uninsured.

References: 1. Agrawa, S. and Witters, D. October 17, 2011. Unhealthy U. S. Workers’ Absenteeism Costs $153 Billion. Retrieved November 4, 2012. http://www. gallup. com/poll/150026/unhealthy-workers-absenteeism-costs-153-billion. aspx 2. Carpenter, G. and Wyman, O. October 2008. The Total Financial Impact of Employee Absences – Survey Highlights. Retrieved November 5, 2012. www. kronos. com/absenceanonymous/media/mercer-survey-highlights. pdf 3. Kane, RL. Shamlyian, T. , Mueller, C. , Duvall, S. , & Wilt, TJ. (March 2007). Nurse staffing and quality of patient care. Evidence Report/ Technology Assessment (151). 1-115. 4. Will, J. (2010). Diagnosing American Health Care: Economic Stakeholders and Bioethical Considerations. Mississippi College of Law Review. (Vol. 313). 5. Shen, Y. , & Eggleston, K. (2009). The effect of soft budget constraints on access and quality in hospital care. International Journal of Health Care Finance and Economics, 9(2), 211-32. doi: http://dx. doi. org/10. 1007/s10754-009-9066-2