Question

Managed care models and tools can be seen in health care systems around the globe. Today, U.S. private insurers and managed care organizations are partnering with local entities in other nations; however, this partnership has not come without its share of challenges. In your opinion, can U.S. managed care approaches be successfully implemented internationally? What are some of the challenges that have led to difficulties with those ventures? How are these challenges being dealt with? Use an example to support your opinion.

Answer 1

In my opinion U.S. managed care approaches cannot be successfully implemented internationally. This is because there are several challenges in case of implementing U.S. managed care approaches internationally and these challenges act as a roadblock or a constraint for the successful implementation of the managed care approach. First of all international implementation has failed because players in the U.S. managed care system operate with a strong US corporate ideology and the focus is less on helping to better or improve the system and more on making profits. Secondly the system of American healthcare is highly unique to America and the American environment. This environment is not replicated anywhere else and hence this becomes an impediment.

These challenges are being dealt with by trying to adapt to the diversity of the world health system. Hence the American HMOs are now not merely replicating their home model overseas but are trying to change their system as per the requirements of the country in which the model is being implemented.

An example that supports my opinion is the failure of Tenet Healthcare in Australia in 1997 and then again in 2010. The company operated in Australia and tried to reap large amounts of profit by gaming Medicare in Australia. Its practices, even though not illegal, were clearly inappropriate.