Key Stakeholders in Health Insurance Company
In the healthcare context, stakeholders refer to all the bodies actively involved in the healthcare system and are directly affected by reforms or policy changes. Patients, doctors, employers, insurance providers, pharmaceutical firms, and government are the key stakeholders of the healthcare system. Insurance firms offer healthcare plans to individuals directly or indirectly through employers or state facilitators. Pharmaceuticals manufacture and then sell drugs that physicians recommend for treating patients. Often, pharmaceutical firms get payments through insurance companies or governments through various federal plans and programs.
Most companies provide health care benefits for their workers, with various co-payments and deductibles. The practitioners are medical treatment providers; the patients are the receivers. The government, on the other hand, is subsidizing health care for the elderly, the handicapped, and the disadvantaged. All involved stakeholders have different roles and obligations.
Apparently, the interrelatedness in the healthcare system between the stakeholders is growing complex. Two of the critical stakeholders, insurance firms, and pharmaceuticals are publicly listed corporations. As a result, their primary obligations shift to making profits for the shareholders. Similarly, firms’ primary aim is to earn a profit; however, their coverage of health insurance is a privilege, not a source of income. In comparison to other actors, practitioners have direct prudential responsibilities and obligations regarding the patients. Even though they get remuneration for their services, the relationship between a practitioner and a patient is a noble act that supersedes monetary concerns. Patients as well have duties, responsibilities, and rights. Lastly, representative government has obligations and responsibilities toward its people, but the manner in which they are described in terms of healthcare provision is a developing American narrative.
Evaluation of strategies used to develop Relationships with Internal and External Stakeholders
Insurance Industry.
Growing rates and stringent conditions currently prevent most people from getting healthcare insurance. Although the nature of insurance companies in healthcare dictates that the companies should not focus on revenue generation, this is far from reality. Owing to financial difficulty, obtaining affordable healthcare is getting harder.
For insurance firms, their obligations to shareholders and customers must be appropriately balanced. Financial reports for shareholders push corporations to rely more on profitability than on affordability. This focus on profit leads to stringent regulatory criteria for insurance providers such that only healthier people are chosen for healthcare coverage. These patients are not likely to use expensive treatments as much as chronically ill individuals. Nevertheless, insurance firms may not be ethical as it reduces health coverage to a profitable market and keeps those in need from health coverage.
Patients
Patients do have a moral obligation to their health, welfare, and cost-control. Although a policy that will compel people to lead healthy lives cannot be enforced in the foreseeable future, it is rational to assume that better lifestyle choices would result in lower healthcare costs. Many businesses, including Wal-Mart, have avoided hiring people who smoke to reduce the expense of medical care. Doctors are often accused of over-administering diagnostic tests, but that may be because of patients who ask for multiple tests while some of them are unnecessary.
Conclusion
With the advancement in technology, patients are asking for the latest, most innovative, and most costly procedures that their healthcare insurance can cover, and physicians sometimes yield to their demands. The most costly procedures aren’t always the best, and the patient has a responsibility to make fair and cost-effective decisions with the practitioner.