How does a health care system assess and assure quality health care services?

The litmus test for the efficiency and effectiveness of any public health system is its performance in a crisis situation.  Civil societies have come to expect basic protections at the time of these crises.  Such emergencies also test a government’s true ability to act under pressure.  In other words, “they define a state’s capacity to protect its population while exposing its vulnerabilities to political upheaval in the aftermath of poorly managed crises” (Gorin, 2002). In the context of economic globalization at the turn of the new millennium, more than ever before, the general public demand transparency and accountability in global public health systems during medical and natural disasters.  To gauge the robustness of public health systems in this new globalization paradigm, we need to study recent cases of acute public health emergencies.  In this context Hurricane Katrina is particularly relevant to this analysis.  It was a reflection of the inadequacy of the American healthcare system that it “accepted bilateral and multilateral relief aid, a rare event in modern times”. (Burkle, 2006)

Recognizing the present quality issues with the healthcare system in America, the World Health Organization report suggests a comprehensive array of changes to give Americans world class health care. These recommendations could have the widest impact on patients, families, and communities, including treatment of people with substance abuse and more aggressive management of obesity.

“The report focuses many of its recommendations on improving care for patients with chronic health conditions. Other areas include evidence based cancer screening; preventing complications from the frailty associated with old age, such as falls and bedsores; and treatment of hypertension, immunization, and depression. A further eight areas are reducing medical errors; preventing  infections; pain management; prevention of stroke; treatment of severe mental illness, diabetes, and asthma; and the prevention of risk factors for conditions such as coronary heart disease.” (Wakefield 262)

Such recommendations were concurred by the Institute of Medicine, which advises the US Congress on medical issues.  There is strong proof that shows that carrying out these proposals to the word will bring the healthcare industry’s performance on par with advances in medical technology. So, while the US healthcare system is more advanced in terms of technology, optimal use of the same is not being made as of now. (Coghlan).

Furthermore, quality of healthcare is undermined due to the American government’s impotency to negate the influence of vested interests. Recently, the US government dismissed a connection between junk food and obesity in a confidential letter to the director general of the World Health Organization. This is not a good sign for the health and well-being of the American people. This episode is one more to the long list of events where private business interests have superseded all others, especially quality concerns. (Wakefield 266).  Continuing in the same vein, the U.S. Food and Drug Administration (FDA) decision in May 2004 not to allow over-the-counter sales of the morning-after pill, Plan B, is but one troubling example of the increasing impact of politics and ideology on science and health policy. The agency’s ruling, contrary to recommendations from an external advisory panel and its own scientific staff, is indicative of the growing gap between common sense and U.S. policies affecting the well-being of women and girls (Bodenheimer 799).  What are needed at this juncture is progressive developments such as the Wakefield Act, which was successfully ratified by the Senate Committee on Health, Education, Labor, and Pensions. This legislation keeps alive efforts to continually improve emergency care for children. It focuses on reaching out, caring and providing solace for children engulfed by pain and suffering (Wakefield 266).


Burkle, F. M. (2006). Globalization and Disasters: Issues of Public Health, State Capacity and Political Action. Journal of International Affairs, 59(2), 241+.

Bodenheimer, Thomas. “Innovations in primary care in the United States. (Primary Care in the United States).” British Medical Journal 326.7393 (April 12, 2003): 796(4).

Coghlan, Andy. “A health fad that’s hard to swallow: dietary supplements are more popular than ever. But we don’t know if they do us more harm than good.” New Scientist 182.2442 (April 10, 2004): 6(2).