Prepare A Written Answer To This Situation And Support Your

Prepare A Written Answer To This Situation And Support Your Answer Wit

Prepare a written answer to this situation and support your answer with sound reasoning. Your answer should include at a minimum the answers to the 10 questions stated below. Your answer should be in a word document of no more than 10-12 pages in length. A Country Case Study on the Partnership between Abu Dhabi and the Cleveland Clinic in the United States Abu Dhabi is the capital of the United Arab Emirates, an oil- and gas-rich federation of seven Emirates. All UAE nationals have a government-funded, mandatory health insurance provided by a public or private option.

Many of the acute care services in Abu Dhabi are oversubscribed and historically have had long waits. Many Emiratis travel overseas to obtain access to world-class to health care; each year the government spends 25% of their health budget sending patients to other countries to obtain medical care. To stem the flow of patients abroad, one of the government’s global targets is to create health care services that meet and exceed international standards. The Mubadala Development Company PJSC (Mubadala) was established and is owned by the Government. It partners with “best-of breed” international organizations, attracting world class experts to help diversify the economy in several business units including health care.

It has formed alliances with leading international health care organizations including Cleveland Clinic and Johns Hopkins Medicine International of the United States and Imperial College London. In 2012 construction will be completed on Cleveland Clinic Abu Dhabi (CCAD), a state-of-the-art 364-bed multi-specialty hospital. CCAD will attempt to replicate the culture and best practices of the Cleveland Clinic. The organizational model will be Cleveland’s physician-led multi-specialty approach with a shared vision of achieving "outstanding patient experiences," “superior clinical outcomes," and "improved quality of life for the people." A Country Case Study on Canada's High Quality, Low Cost Hernia Hospital Shouldice hospital in Ontario, Canada, is an 89 bed hospital with five operating theatres that focuses on the surgical repair of simple inguinal hernias.

Shouldice is not only efficient but offers high quality care and attracts many medical tourists. Whereas a general surgeon may perform 50 hernia repairs a year, each Shouldice surgeon performs over 600 per year. What makes the clinical work challenging and rewarding for a Shouldice surgeon is repairing a hernia that another surgeon was unable to repair. Shouldice is also a well-designed service proposition that has clinical value for a specific group of patients. The care process includes a stay in a pleasant and relaxed environment, continuity of relationships, low prices, and high quality.

The physician-patient interaction differs from most surgical encounters; when patients are admitted, the first person they see is their surgeon who confirms their diagnosis, explains the procedure, and describes what to expect. Once selected for Shouldice, patients are educated to become partners and co-producers in every aspect of the care process, which builds both trust and self-confidence. Every patient, physician, nurse, and employee at Shouldice is an alumnus. Patients, providers, and staff are fully engaged, understand their roles and responsibilities, and share an attitude and a mindset. Through mutual interaction, learning and understanding, they are committed to the mission and goals of the clinical care process and adopt a Shouldice identity.

Value is created for patients, value is created for clinicians, and value is created for the organization. A Country Case Study on Ethiopia’s Flooding and Retention Strategy Ethiopia suffers from an acute shortage of health workers at every level, and rural areas have been particularly chronically under-served. It is estimated that 60% to 80% of the country’s health problems are due to largely preventable communicable diseases such as malaria, pneumonia, TB, and increasingly, HIV/AIDS. Among the government’s health initiatives are the Health Extension Program (HEP) and the Ethiopia Public Health Training Initiative (EPHTI). The HEP aims to improve primary health services in rural areas through an innovative community-based approach that focuses on prevention, healthy living, and basic curative care.

It introduced a new cadre of health worker, Health Extension Workers (HEWs), and defined a package of essential interventions for them to deliver from village health posts. Female high school graduates are recruited and trained for one year (candidates must have completed grade 10 in school, need to be from the local community, and speak the local language). The program aims to train 30,000 new HEWs to work at local health posts. The EPHTI is a partnership between the Ethiopian government ministries of Health and Education, The Carter Center, seven Ethiopian universities, and other nongovernmental organizations, that aims to improve the quality of pre-service training to health science professionals within Ethiopia and to build a team of qualified health care workers across the country, especially in under-served rural populations.

The program aims to train 5,000 health officers (the leaders of the community-based health centers’ professional staff) by 2010. A Country Case Study on Cuba’s Internationalist Principle and the Latin American Medical School Program The devastation caused in Central America and the Caribbean by hurricanes George and Mitch led the Cuban government to offer medical assistance, to seek to strengthen local health systems, and to open a medical school in Cuba offering 10,000 scholarships to students from those countries. This became the Comprehensive Health Program (CHP). The program’s underlying mission to train doctors to serve local communities by combining population-based public health principles and prevention with clinical medicine.

The focus of the training is bio-psycho-social; individual, family and community. This prepares students well for working in resource poor settings where the close association between poverty and ill-health means that health professionals must have a good understanding to the economic, social, cultural and environmental determinants of health in order to be effective. Health professionals must believe in health as a human right and must be prepared to make sacrifices to deliver on this right. As well as this large scale training of doctors, Cuba also trained auxiliary personnel, such as nursing auxiliaries and health technicians, to serve in the rural areas and to meet the changing needs of the health system.

Cuba now has one of the best doctor to population ratios in the world and has better health indicators than countries that have substantially higher per capita spending on health. Make a convincing set of arguments in favor of the hypothesis that the world of health care is flattening. What are the counter arguments? Why are most medical travelers from nearly every continent choosing Asia for their health care? Under what conditions would you consider going to another country to receive health care?

Should governments take a position against the exploitation of organ donors, in particular, taking organs from prisoners or paid living donors? What international agency regulates unproven and/or experimental treatments? Who will ensure that evidence-based methods are used and comparative effectiveness studies are being conducted? Finally, do these providers who serve medical tourists have an institutional review board that oversees its medical ethics? Debate the following proposition—“DRGS are the most significant contribution to global health care management since World War II.†What explains the global price differential among hospitals? Why would countries like the U.S. have 10x the charges for procedures like hip replacements? Cleveland Clinic's goal is to bring world class medical care to the people of the world wherever possible. Will it work? Will they attract medical tourists? 8. Are some professionals over-trained for the work that they do? Can we afford to continue training health professionals for periods of 5-10 years or is this now a luxury we can no longer afford? With increasingly sophisticated technological and medical diagnostic aids, how important is the human element in the process? 9. Why is there an insufficient supply of health professionals to meet current service demands? Should higher income countries follow Ethiopia and adopt shorter training, more specialized training, and task shifting to allied health professionals? 10. Are some professionals over-trained for the work that they do? Can we afford to continue training health professionals for periods of 5-10 years or is this now a luxury we can no longer afford? With increasingly sophisticated technological and medical diagnostic aids, how important is the human element in the process?

Paper For Above instruction

The landscape of global health care is rapidly evolving, influenced by advancements in medicine, international collaborations, and the shifting dynamics of supply and demand. Analyzing this complex environment reveals patterns of innovation, disparities, and potential future directions. This paper addresses ten critical questions that probe into the factors shaping modern global health care, using examples from Abu Dhabi’s partnership with Cleveland Clinic, Canada’s Shouldice Hospital, Ethiopia’s health worker programs, and Cuba’s international health initiatives, among others.

1. Is the world of health care flattening?

There is strong evidence suggesting that healthcare is becoming more uniform across countries, a concept often referred to as "flattening." Globalization facilitates the spread of best practices, clinical protocols, and technological innovations. For instance, Abu Dhabi's partnership with Cleveland Clinic aims to emulate American standards of care, adopting similar clinical practices and organizational models. Similarly, the rapid dissemination of telemedicine and digital health platforms bridges geographical divides, making high-quality healthcare more accessible worldwide. The adoption of evidence-based medicine and internationally recognized quality metrics further contribute to this flattening effect (Frenk et al., 2010).

Counterarguments challenge this view, pointing out persistent disparities driven by economic, infrastructural, and social factors. Wealthier nations often have more advanced health technology, better-trained professionals, and comprehensive healthcare systems. Developing countries still grapple with shortages of skilled health workers, inadequate infrastructure, and regulatory inconsistencies, which hinder true uniformity (World Health Organization, 2016). Moreover, cultural differences and varying health priorities prevent a complete flattening of health services globally.

Most medical travelers are choosing Asia, particularly countries like India, Thailand, and Malaysia, due to cost advantages, high-quality care, and shorter waiting times. These countries have invested in medical tourism infrastructure, skilled healthcare staff, and internationally accredited hospitals, making them attractive for patients seeking affordable yet high-standard care (Connell, 2013). Additionally, many Asian countries have streamlined visa and travel procedures to facilitate medical tourism, further boosting their appeal.

Personally, I would consider going abroad for health care if the local options are unavailable, significantly more expensive, or if specialized procedures not accessible domestically are needed. Conditions such as complex surgeries, experimental treatments, or access to cutting-edge technologies available elsewhere might justify international travel.

2. Ethical considerations in organ transplantation

Governments must oppose the exploitation of organ donors, particularly the unethical practices involving prisoners or paid donors. Such practices raise serious ethical concerns about coercion, informed consent, and human rights violations. International agencies such as the World Health Organization (WHO) monitor organ trafficking and promote frameworks to ensure ethical standards (WHO, 2010).

Organizations like the Transplantation Society and national regulatory bodies oversee transplantation ethics, prohibit organ trade, and establish guidelines for lawful donation. Additionally, international conventions aim to prevent unscrupulous practices, emphasizing voluntary, non-remunerated donation models aligned with human rights principles (Ghods & Motallebi, 2014).

Unproven and experimental treatments are regulated by national health agencies, such as the FDA in the United States. The International Society for Stem Cell Research (ISSCR) and similar bodies advocate for evidence-based practice and conduct oversight to prevent exploitation of vulnerable patients. These organizations are responsible for ensuring research adheres to ethical standards, including rigorous clinical trials and peer-reviewed evidence.

Providers serving medical tourists should have institutional review boards (IRBs) or ethics committees overseeing their practices, especially when dealing with experimental treatments. Transparency, ethical oversight, and adherence to international standards are critical to maintaining credibility and patient safety (Sueur et al., 2014).

3. Significance of DRGs in global health management and hospital price variations

Diagnosis-Related Groups (DRGs) revolutionized hospital reimbursement systems post-World War II by incentivizing efficiency and standardization. They foster transparency, cost control, and quality measurement—making them arguably among the most significant advancements in health care management (Fetter et al., 1980). Globally, DRGs facilitate benchmarking and performance assessment, enabling health systems to manage resources more effectively.

However, the global price differential among hospitals is influenced by multiple factors. In the United States, high charges for procedures such as hip replacements stem from administrative costs, high litigation expenses, malpractice insurance, and integration of advanced technology and pharmaceuticals (Cohen et al., 2014). Countries with lower healthcare costs often have government-funded systems, lower administrative overhead, and less litigation, leading to reduced prices.

Cleveland Clinic’s goal of providing world-class care aims to attract international patients through quality standards, cutting-edge technology, and comprehensive services. Success depends on balancing costs, quality, and accessibility, which varies with local economic factors and health system maturity (Thomas et al., 2016).

4. Over-training health professionals and the human element’s importance

Some argue that certain health professionals, such as specialists, may be over-trained relative to their typical scope of work, especially when technological tools allow for less invasive or simplified procedures. While this specialization enhances outcomes, it raises questions about resource allocation and educational costs.

The lengthy training periods—often 5-10 years—are increasingly scrutinized given the financial and workforce sustainability challenges. Technological advancements provide tools that reduce reliance on solely human judgment, but the human element remains crucial for patient-centered care, empathy, and complex decision-making (Bachireddy et al., 2018). It is unlikely that technological reliance will eliminate the need for trained professionals, but optimizing education and task-shifting can improve efficiency.

5. Insufficient supply of health professionals and possible reforms

The global shortage of health workers results from aging populations, migration of trained professionals to higher-income countries, and inadequate training capacity in many regions (WHO, 2016). Countries like Ethiopia exemplify shortages, especially in rural regions, which hinder service delivery.

Higher-income countries could adopt shorter, more specialized training programs, emphasizing task-shifting to allied health professionals. Ethiopia’s approach—training Health Extension Workers—illustrates how community-based, task-shifted models can mitigate shortages and extend primary care access (Assefa et al., 2017). These models emphasize community engagement, preventive care, and efficient use of skilled personnel.

6. Over-training professionals and the role of technology

The concern about over-training is linked to the rapid pace of medical innovation. With sophisticated diagnostics and minimally invasive procedures, the essential human element—empathy, ethical judgment, and complex decision-making—remains vital. While some tasks can be delegated or simplified, holistic patient care necessitates highly trained professionals (Verghese et al., 2018). Balancing education costs with workforce needs depends on aligning training length with technological advancements and health system demands.

7. Addressing the shortage of health professionals and potential strategies

The deficiency stems from resource limitations, migration, and aging health workforces. Shorter, focused training, task-shifting, and leveraging technology can help meet current demands. Countries like Ethiopia demonstrate how community health worker models efficiently extend primary care, which could inform strategies in other countries facing similar shortages. However, quality assurance and ethical standards must guide any reform.

8. Over-trained professionals and the importance of the human element amidst technological progress

Overtraining can be inefficient when technology replaces tasks traditionally performed by humans. Still, the human element—empathy, trust, and contextual understanding—remains essential. The integration of AI and diagnostics shifts but does not eliminate the need for well-trained, compassionate health professionals who can interpret complex data and communicate effectively (Sinsky et al., 2017).

9. Ethical and regulatory aspects of medical tourism and innovation

Medical tourism presents ethical challenges, such as exploitation and variable standards. International governance, through WHO guidelines and national regulations, must ensure ethical practices. Agencies like WHO and national bodies regulate unproven treatments, requiring transparency and evidence of safety and efficacy. Ethical oversight, including IRBs, is critical in maintaining standards and patient safety.

10. The future of health care management and global disparities

DRGs significantly impacted healthcare management by promoting efficiency and standardized payments. Their influence underscores that innovative reimbursement models can improve quality and control costs. Price disparities across countries arise from economic, systemic, and policy differences, with higher charges often linked to advanced technology and legal environments. Cleveland Clinic’s efforts to globalize high-quality care hinge on balancing quality, accessibility, and affordability, and whether they can attract medical tourists depends on delivering consistently superior outcomes and patient experiences.

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