How can the Population Health Model be Effective?

Population health has been defined as the health outcomes of a group of individuals and includes distributions of such outcomes within the group. The group of individuals in health population is often populations of a geographic region such as a country or nation.

The approach of healthcare aims to achieve the optimal health of an entire human population. The health outcomes of the groups are crucial to policymakers in both the government and the private sector.

The concept of population health shifts the focus from the individual level which is the primary characteristic of mainstream medicine branches. It also contributes to the efforts of public health agencies by addressing a wide range of factors which make an impact on the health of different populations.

The recent boom in population growth has encouraged the involvement of the human role in population health. Epidemiologists have shown increased interest in the subject of economic inequality and its relation to the health of populations.

The Economics of Population Health

It is speculated that socioeconomic status and health have a very strong correlation under the population health model. For this reason, recent health reforms are trying to bring a change in the traditional hospital reimbursement models.

The trend of current reimbursement models has been shifting from quantity to value. The models use a value-based reimbursement approach such as pay for performance rather than focusing on volume. The approach provides financial incentives on patient outcomes and has completely transformed the way US hospitals used to conduct their business to remain financially viable.

A value-based reimbursement model encourages physicians and healthcare providers with financial incentives to keep their patients healthy and out of hospitals. Under this approach, health becomes a capital good where health capital is a part of human capital, as defined by the Grossman model. Owing to its nature, health can also be considered both as an investment good and a consumption good.

Efficient healthcare can be delivered to a limited sized community population in less time and cost-effective manner. There are fewer people to deal with, and the overall culture and health patterns are mostly similar among the group. But as the population grows there is the risk of an oversimplification of certain segments leaving many people out of the scope of quality care.

It will create strong political constituencies by overlooking socioeconomic and economic disparity and skew the resources to where there is a demand rather than where it is needed.

A highly controlled environment and profiling are required in order to ensure an effective population health model and optimal outcomes. The regulations and control tend to turn dominant and fierce as the population increases taking the path of bureaucracy. In my opinion, it can traverse to the extreme and take on the slippery course of autocratic decisions made by a few individuals who get to determine the treatment options of a patient. It is not in the interest of the individuals, nor serves any good for healthcare.

Population health care model will need micromanagement which will eventually be counterproductive to deliver it from cost and quality perspective effectively. There has been a historic debate from the inception of the population health approach about the relationship between economic growth and human health.

The Coming of Population Health

The Industrial Revolution brought disruption in population health in Britain and France and encouraged early epidemiological studies which contributed to the early preventive public health movement. This lead to a century-long process of political adjustments between the forces of liberal democracy and proprietary interests. With time population health gradually emerged as the chosen model fueled by increasing populations and expanding the economy.

During the 20th Century, the welfare states worked through complex political mechanisms for transforming economic growth to enhanced population health. In recent times we are seeing the growth of a ‘neo-liberal’ agenda disparaging the role of the government. This has once again highlighted the importance of population health approach and prevention to track and inform the health impacts of the new age of ‘global’ economic growth.

Population healthcare model is based on populist thinking and approach. It will require a pseudo-authoritarian approach at the least to be implemented on a large scale federal level. But is that what the American population wants?

People are becoming more independent and informed as individuals at this age. Poverty is on the decrease while minorities are being empowered. We have unlimited access to information which is readily available and given rise to higher expectations. Technologies have become far advanced to meet the needs of the citizens. Every industry is adapting to this trend and individual need, and this applies to healthcare as well. We have to provide individual liberty on health and healthcare which is becoming inevitable and must for bringing the genuine “healthcare for all.”

Extreme planning of population-based healthcare model will eventually lead to autocracy. Authoritarianism is the most effective tool of implementation that is required if central micromanagement is to be brought about on a large scale.

Countries which have achieved a reasonable level of democracy find it suitable to plant and nourish the population-based approach. This is because there is a significant uniformity in population attitudes, culture, non-consumer derived healthcare market and ethics devoid of the extreme autocratic system.

Any foreign or new addition to the society will be forced to participate and take up the path followed by the majority of the population. The growth of information technology and globalization of geographical borders will nudge the countries sooner or later with their version of healthcare reform and free personalized market. But the United States is and always has been a diverse society based on a consumer derived market.

The best of progressive healthcare is the one which encourages open market, accessibility, competition, and independence of every individual.

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