This paper aims to discuss the current issue on responsibility on health and its effect on the New Zealand healthcare policy as well as in the international scale. This paper will also highlight on some types of international policy solutions used to deal with the question on who is more responsible for the health of the individuals.
One of the biggest modern issues in healthcare today is the question on whose responsibility is the individual’s health. This issue is still being debated over at present time especially because almost all first-world countries provide universal health care or free healthcare provision for all citizens and this is thought to have negative effects on a person’s responsibility to look after his/her health.
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People are divided when it comes to their opinion on this. Some say that it is more reasonable to put the whole weight of the health responsibility on the individual’s shoulder since most of the contributing factors to the diseases that plagued the world are related to the individual’s lifestyle. However, this idea met a lot of oppositions, mostly stating that health does not only depend on the lifestyle factor, but also on genetic and environmental factors. That is where the society’s responsibility comes in. This conflict of ideas greatly affects the national and international healthcare policy making.
In line with this, globally accepted policy interventions on education, tax benefits, respite care, business regulations and financial support are prepared to address this modern-day issue in healthcare. These solutions are implemented worldwide in different orders in terms of importance.
- The impact of the issue on health responsibility on national and international healthcare policies
The World Health organization defines health policy as the decisions, plans and actions undertaken to achieve specific health care goals within a society. In addition, it can further achieve these things: define a vision for the future, build consensus, inform people and outline priorities and the expected roles of different groups (World Health Organization). As it is still uncertain who holds the responsibility for the individual’s health, health planning and decision-making are affected too.
However, because the society can greatly benefit from a generally healthy community, the WHO set a priority objective called Universal Health Coverage or UHC, which has also been a major goal for most countries for their health reform projects. UHC works by ensuring that all people have access to needed promotive, preventive, curative and rehabilitative health services, of sufficient quality to be effective, while also ensuring that people do not suffer financial hardship when paying for these services (World Health Organization).
This shows that although health is highly dependent on individual choices on lifestyle and beliefs, the society somehow still has a role to play in the health of its members. However, the question does not end there. There are still issues on cost effective strategic planning and health spending.
Cliché as it may sound, but prevention has always been better than cure, as it lessens the possibility of unnecessary pain and burden on the family and the person affected. That is why health advocates and experts are currently shifting their attention to health promotion such as sanitation, pollution control, food and drug safety, health education, disease surveillance, urban planning and occupational health. These measures help prevent diseases and promote a person’s ultimate well-being, at the same time giving a person a choice between promotive or destructive health habits. For example, if the government increases awareness on proper sanitation by education and other activities, the people will know which habits promote and improve health but they still have the liberty to choose to adhere to poor sanitary practices. However, it will be much of their loss as individuals.
These actions also encourage individuals to make informed choices about their lifestyles. That way, their health also becomes their responsibility and they can achieve freedom in their decision-making. Therefore, a balance of the societal and individual responsibility will impact the healthcare policy making, in the national or international level, as it can easily outline the expected roles of different groups and individuals in the healthcare system. It should be clear which are the responsibilities or the individual and that of the society so that relevant and sound health policies can be made within New Zealand and internationally.
Here in New Zealand, the benefit culture is prevalent in the Maori population as most of them are unable to pay for health care cost. Some taxpayers are against being willing funders of healthcare for the Maori (and other Pakeha) as they believe in individualism as being responsible for one’s self and his/her dependants. However, the Treaty of Waitangi’s intention was to protect and maintain the well-being of all citizens, and its health implications relating to processes of good government and notions of participation and equity. Therefore, it is the government’s responsibility to look after the health of the Maori populace.
The dilemma is that no matter how much effort the government puts into health promotion, the Maori people still have health habits and traditions that are unique to them and some will not understand. In this sense, health is still an individual’s own choice and responsibility.
- International policy intervention solutions to address the contemporary health issue highlighted in the case study
b.1. Education and Training
Aside from promoting access to healthcare, it is a very important societal role to promote health through education and training. Many health-related trainings and courses are made available worldwide due to the increased awareness of its importance. This kind of health promotion strategy is very cost-effective and will surely minimise the need for access to healthcare because if people are more knowledgeable about lifestyle and habits that promote well-being or total health, they will be more keen on avoiding diseases than treating diseases.
An example of this is the effort of New Zealand Red Cross to train adults, teens and even kids on first aid. This programme enables people of all ages to know how to handle emergency situations like making an emergency call and performing cardiopulmonary resuscitation. Knowing how to act in these situations lessens the panic and the mistakes committed in panic, therefore, saving the life of a person. This project of Red Cross is known all over the world.
There are also some other non-government organisations all over the world, like GHETS (Global Health through Education, Training and Service) who believe that well trained and supported doctors, nurses and allied health workers are key to sustainable change. That is why they support developing countries by innovations in education and service. Their aim is to train people about primary health and treatment of diseases common in their area (Global Health Workforce Alliance).
There is a hunger for health awareness all over the world that needs to be fed necessary information on health promotion like family planning, maternal health, vaccination, child development, sex education, occupational health and disease prevention. Government agencies and other organisations are working hand-in-hand to combat ignorance on health, therefore, prolonging and saving lives.
Other education and training programs that add quality to life and benefit the health of the people in the community are sanitation programs, clean air movement and food and drug safety. These programs are not only beneficial for one individual or a group but for all of the citizens. This is the reason why experts find these means more cost effective as it costs less but the paybacks are felt by the society as a whole.
In New Zealand, the Ministry of Health thought of a way to bridge the gap between Maori and non-Maori health and that is to have MÄori health providers that tend to deliver health and disability services to predominantly MÄori clients. To attract Maoris to study health and disability related courses, the Ministry of Health spearheaded the programme Hauora MÄori Scholarships that provide financial assistance to students who are undertaking or completing a course in health and disability studies that has been accredited by the New Zealand Qualifications Authority (Ministry of Health).
b.2. Tax benefits and payments to caregivers
Caregivers play a great role in improving and maintaining the health of individuals because as mentioned in the Journal of Medical Ethics, many of the other strategies address problems that are beyond the ability of individuals to deal with. Even though people have basic knowledge on taking care of themselves when they are well, most of them will have difficulty looking after themselves when they have illnesses. Leaving it to the professionals is a good idea.
Therefore, caregivers are very important to give help and protection to the compromised ones and it is only fair that they get benefits and enough payment for their services. Caregiving itself is a very expensive service, in part because of strong adverse selection phenomenon – the only people willing to pay for private sector caregiving services tend to be those families facing the most daunting care requirements for their family member. Caregivers continue to be the primary source of long-term caring for elders and other compromised people worldwide and as such, their unpaid work makes a valuable contribution to society and the economy, and touches a huge segment of the population.
New Zealand also has their way of attracting people to render caregiving services. Caregivers can file for income tax return too if their annual income from caregiving is over $17,500. On top of that, they also get benefits from the ACC (Accident Compensation Corporation) if they meet accidents at the workplace.
b.3. Respite Care
Respite care is the provision of short-term, temporary relief to those who are caring for family members who might otherwise require permanent placement in a facility outside the home. In New Zealand, these services are funded by the Ministry of Health to give family caregivers a break, and ensure that the person they are caring for gets the care and support they need in the meantime.
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This clearly shows a balance of individual/familial and societal responsibility when it comes to the health of the people. The responsibility of the family and individual is encouraged as the client is not permanently put in a facility to have someone else take care of all his/her needs, but they are also assured that the government also has a role to play to support the client and the family/caregivers.
It would also be unhealthy for family members to be constantly exposed to the stress of taking care of a sick/unwell family member when they were not trained or skilled enough to. Respite care is one way of minimising stress and fatigue on the part of the family and fulfilment of society’s obligation to take care of its members.
When the client is also on respite care, there will be better access to emergency services, laboratory and diagnostics and health teachings from professionals. Ensuring access to these is also an important social responsibility and the Ministry of Health paying for it is showing a sense of responsibility over the members of the society. This is also a good way to spend a portion of the national health budget as this is also very important.
Respite is also popular in all parts of the world as universal health provision is promoted in first-world countries
b.4. Business regulations combining work and care giving
Business regulations are provided by the government to take care of the business side of institutions and at the same time protecting the rights of the consumers and workers. All over the globe, businesses should be profitable while giving the service or product they promised to the consumers. This is also the same in the healthcare industry. While hospital, rest homes and respite care centers are mainly businesses, they are mandated by a government body to render safe and effective healthcare services and provide occupational health and safety guidelines for the workers.
The workplace is not always a safe place as simple mishaps can cause injuries and pose threats to the employees. In the healthcare setting, simple injuries like back pain and stress can incur a loss to the business and to the well-being of an employee. That is why regulatory bodies, like the Ministry of Business Innovation and Employment (New Zealand), emphasized the importance of occupational health and safety. This includes activities like identification and elimination of workplace hazards like needle-stick injuries, back injuries and infection.
It is also a requirement of the MBIE for business to provide contingency plan for emergencies like fire, earthquake, other forces of nature and technological failure. Aside from that, businesses are required to comply with building safety and access of the place by people with disabilities.
Caregiving is also an industry that not only requires physical safety, but it is also a requirement to provide culturally safe healthcare services, especially in places in the world where indigents are present and need as much care. Here in New Zealand, the Maoris have special health needs that are met only by knowing them and their culture. It is also essential to know their concepts of health and illness so that caregivers will know how to introduce treatment and health promotion to these people.
Another important thing that regulatory bodies are monitoring is the fact that caregivers should be free from contagious diseases or those that will affect their performance of the job and that they are really fit to do the job. For this purpose, health screens, as well as police checks are done prior to employment. Knowingly hiring someone who do not have the qualifications for the job is a violation of the consumer’s rights.
b.5. Financial support and provision of pension credits for caregiving
Taking care of the caregivers is also like taking care of the individuals in the society. That is why international health care policies have provisions on care giving benefits like financial support and pension credits.
Financial support is offered to care givers mostly as reimbursement for the expenses incurred by the care giver while servicing clients. They are also automatically enrolled in a pension plan that will help them settle upon retirement.
These entitlements are causing a shift to the employment status of a lot of health care professionals. With these benefits, they feel valued and appreciated for all their hard work as helpers and protectors of the compromised ones. That way they also feel that help will come if they need it and that they, too, will be protected.
Health, although it is an individual experience and responsibility, is likewise society’s greatest asset. Just as parenthood is a shared responsibility of both mother and father, health should also be a collaborative effort between the individual and the society with the goal of achieving the highest possible level of wellness for all. Just like in a family, if all members are well and healthy, the family will most likely be functional and successful, as opposed to a sick one.
The basic unit in a society is the family and the basic unit in a family is the individual. Therefore, an individual’s health is the health of the whole society. Individual health should be as important as other social matters. If one person is sick, it will create a ripple effect in the community as the family members are burdened by the illness and the community is somehow paying for the healthcare services. As each individual plays a role in the family and in the society, it is important to look after ourselves and for the government and other groups in the society to promote health and wellness.
Health is not only influenced by personal preferences and lifestyles alone, but also by the environmental and genetic factors, where the society can extend their help with. Health promotion activities like sanitation, pollution control, food and drug safety, health, disease surveillance, urban planning and occupational health will help lessen the threats to public health without having to spend on healthcare access.
As much as it is the individual’s responsibility to practice good habits and lifestyle to acquire optimum health, it is also the society’s task to set health goals and priorities for the community. Although healthcare access is very important and would most probably take a good share of the budget, other health promotion methods like research and education should also be given attention and funding. The caregiving industry should also be given a part of the budget allocation for health as care givers are very important people in restoring and maintaining health among the members of the community.
On the whole, health is a society’s business as much as it is a personal responsibility. Working hand-in-hand with the community, it should be achieved by all members and the whole nation will benefit from it. Families, organisations and societies will function better with healthy and health-conscious people.
Global Health Workforce Alliance. (n.d.). Global Health Workforce Alliance: Members and Partners. Retrieved from Global Health Education Training & Service (GHETS), USA: http://www.who.int/workforcealliance/members_partners/member_list/ghets/en/
Ministry of Health. (n.d.). Ministry of Health. Retrieved from Maori Health: http://www.health.govt.nz/our-work/populations/maori-health
World Health Organization. (n.d.). World Health Organization. Retrieved from Health Topics: Health Policy: http://www.who.int/topics/health_policy/en/
World Health Organzation. (n.d.). World Health Organization: Health Systems. Retrieved from Universal Health Coverage: http://www.who.int/healthsystems/universal_health_coverage/en/
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