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The article by Sein Et al demonstrates that there is a rise in the expenditure in healthcare especially in the developed countries.  This may be due to several reasons including a rise in the mortality and morbidity rates, the development of several public health problems such as HIV/AIDS and SARS, and a development of new technology that maybe costly to use, initially.

In such a situation, the policy makers should be clearly aware of the areas in which money is obtained and the areas in which it should be spent.

The article speaks of the use of a National Health Accounts (NHA) scheme that would ensure that the spending on the field of healthcare is well recorded and that transactions can be made across several barriers.  Through this scheme, the internal and external resources for funding the health and related services and products can closely be monitored and evaluated.

The NHA scheme is concerned with a macro-economy and the use in a macro-social environment.  According to the national health requirements, the expenditure to be spent is calculated.  The flow of the funds and money into the system is being calculated on the other side.  The expenditures and the income are classified into various types depending on the sources and the purposes (Sein, 2003).

The NHA is a more systematic way of maintaining a policy on healthcare financing.  The manner in which the resources are mobilized, raised or organized for the healthcare products and the services can be determined.

All the portions of the expenditures (such as human resources, logistics, support systems, equipment, etc) are incorporated in the NHA.  An increase in the expenditure may develop during the course of the financial year.

The manner in which the expenditure is distributed in the healthcare areas should be closely monitored and if necessary reforms should be introduced.  As far as possible the budget and financing should be decentralized.  It is very important to measure the ways in which the expenditure is spend in various sectors including inpatient services, emergency services, communicable diseases, mental health and cardiovascular diseases.

These could help to form appropriate indicators which can suggest future priorities of the heath policy.  The health policy to suit the health expenditure should suit several of the distributional dimensions such as social structure, income, geographical distribution, etc.

The NHA gives a great amount of importance to the concept of ‘flow of financing’ in the healthcare system.  It gives a lot of importance to single and multiple payers, private and public healthcare providers and any transitions required.

In order to ensure that the budget is spent efficiently, the NHA should take into consideration several non-financial data such as health indictors, population indicators, epidemiological studies, surveys, research findings, etc.  The user and the beneficiaries of the NHA should be able to follow a common classification for the health expenditure (Sein, 2003).

However, the NHA requires a structure framework and appropriate instruments to be followed.  All the interrelationships and interactions with other components that are present between the source and the end user should be recorded.  The NHA concept was utilized by several developed countries during the 1960’s.  Several of the developing countries have introduced this concept since the 1970’s and the 1980’s.

The sources of the income for the healthcare resources, such as the party who is supposed to pay, the amount that is supposed to being paid and the reason for which it is going to be paid, is determined.  It is also essential that the funds for the NHA system are organized in a punctual manner.  Any delays would be detrimental to the effectiveness of the system and could have serious impact on patient care (Sein, 2003).

In the Baptist hospital, the concept of NHA can be utilized for financing healthcare services and products.  It is essential that appropriate changes be made to the NHA concept to ensure that it suits the micro-economy and the micro-social environment.

The Baptist hospital began in the year 1979, and at present it is a 700 bedded tertiary medical care hospital.  More than 27, 000 patients are admitted to the hospital and about 54, 000 are admitted to the trauma care center of the hospital.

The hospital trauma care center is opened 24 hours a day, 7 days a week.  More than 800 child patients are seen every month.  A 19-bedded child care unit is also present in the hospital.  More than 120, 000 outpatients visit the hospital every year.

Baptist hospital is one of the top-rated hospitals in the US, especially in the area of orthopedic care (Baptist Memorial Health Care Corporation, 2007).

The hospital can ensure that the patients seeking healthcare services from the hospital paid for their treatment if they are uninsured.  The people having Medicare, Medicaid and Mediclaim would be covered for their medical treatment.  However, the uninsured and the people who cannot afford to pay require consideration.

A scheme similar to the NHA should be utilized to compensate for such patients.  The hospital would be receiving several funds which could be utilized as expenditure from sources including public funds, private funds, profits, donations and funds received from charitable trusts.

The hospital would be receiving some amount of funds from the government and the local bodies towards maintenance of certain healthcare services.  All the sources of expenditure are to be calculated.

Efforts should be on to determine the sectors of healthcare which require additional funds.  If possible, reforms should be introduced to increase the funds generated towards that particular sector or decrease the expenditure on that particular sector.

The hospital should come up with certain packages that would help the needy to receive the healthcare services at a subsidize rate (Baptist Memorial Health Care Corporation, 2007).  All the interactions present between the source of the funding and the point of expenditure should be noted and modified appropriately.

The hospital should make efforts to avoid the uninsured from paying high charges, which include any excessive amounts (Hutchinson, J. 2007).

The budget and the financing should be decentralized, but in order to introduce cost-effective measure and efficient strategies, a unified interdepartmental approach would be necessary (Bazzoli, 1999).  The government should also ensure that the hospitals that are providing with charity services are given tax reforms and regulatory amendments (Copeland, 2007).

IT is essential that the funds are released on time to ensure that the people need receive timely treatment.  Any delay in the fund could seriously impact patient care.  An account of the source of the funds and the way in which money is spent could be kept in great detail.

This should be analyzed frequently to ensure that unwanted expenditure is reduced, and areas requiring more funds are given greater attention.  These changes may have to be incorporated immediately or in the next budget.  Efforts should be made to increase the resources to help such patients,as it would be beneficial to the hospital.


Baptist Memorial Hospital-Memphis (2007), About Medicare, Insurance and Charity Care, Retrieved on July 7, 2007, from BMH Website:

Baptist Memorial Hospital-Memphis (2007), Facilities, Retrieved on July 7, 2007, from BMH Website:

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