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Ethical Concerns
As with many public services, management of public administration in healthcare holds the responsibility and objective to provide for the public good at the highest ethical standards. Healthcare is a service which is highly disparate in terms of populations based on socio-economic or racial factors, while it is critical for public administration to promote social equality. Two ethical concerns that are relevant to healthcare are fiscal responsibility and equitable distribution of public resources. Fiscal responsibility is crucial when working with community-owned public resources. Funds should be transparent and face regular audits to ensure observance of local and federal regulations.
Mismanagement of funds to support private gain can occur, particularly in healthcare where there are numerous private industry agents such as insurance companies, pharmaceutical corporations, and even private hospitals seeking public funding. Excess spending on healthcare in the United States results from too high prices and unnecessary administrative waste. Therefore, fiscal responsibility is vital to competently manage funds within budget constraints without negatively affecting public good (Tran, Zimmerman, & Fielding, 2017)
Health disparities are a significant public health policy concern, which is partially dependent on proper funding and distribution of health resources. Recent regulation under the Affordable Care Act has bridged some divides by offering insurance coverage to many of those who lacked it. However, community resources in areas of poorer socioeconomic status are often lacking with a larger amount of funding going to more affluent areas. Although disparities occur due to a complex mix of social, environmental, individual, and health system factors, public health administration has the responsibility to ensure equitable access to quality healthcare and funding (DeSalvo et al., 2017).
Organizational Structure
Organizational structure directly impacts organizational ethics because it inherently defines decision-making activities. Structure establishes leadership and levels of hierarchy, thus creating formal reporting relationships, a system of checks and balances, and coordination. Organizational structure creates departments according to the needs of the entity and defines communication channels and systems of integration. There are centralized and decentralized structures, which impact ethical behavior.
For example, centralized organizations have a concentration of power at the executive level which can potentially promote unethical behavior because there is little scope for accountability. Furthermore, there is little upward communication in such structure, therefore managers may not be aware of unethical behavior in low level employees. At the same time, decentralized structures may also promote unethical behavior. Due to individual responsibility and delegation of authority, individuals may be driven to make decisions that are self-benefiting or deviate from organizational values (Schminke, Arnaud, & Taylor, 2015).
A public agency that follows ethical principles is the Administration for Children and Families (ACF) which is a division of the Department of Health and Human Services. This organization focuses on economic and social growth of families and children, one of the largest divisions for human services at the federal level. It works with minority groups and those in impoverished living conditions, offering programs that focus on resolving social and public health issues in these communities.
It is a public organization with transparent funding and spending, as well as focusing on offering the disadvantaged communities equitable access to public health care and health education (Administration for Children & Families, n.d.). The American Cancer Society is a nonprofit whose structure and ethics seem to be for the benefit of the public good. It is one of the most well-known and respected nonprofit medical organizations in the United States which focuses on cancer research, treatment, and education.
It is highly transparent in its finances and although there are some concerns regarding fiscal responsibility in terms of administrative waste and management salaries, the organization acknowledges and seeks to correct its course. However, the organization is ethical in its cause and seeks to pursue its mission by providing cancer-related health services to all layers of society.
Personal Development and Strategies
I believe that I am most effective in terms of human skills, but struggle with conceptual skills, while having adequate technical skills for public administration management. I believe I excel in human skills due to my openness and ease of communication; it is easy for me to work with others both as co-workers and as a leader, enhancing teamwork. Technical skills are at an average level for me, I tend to learn well depending on what task I need to accomplish or if it is a new field.
As stated in the textbook, managers learn as they reach new levels of leadership or tasks, which is how I approach these types of skills. I often struggle with conceptual skills, as I am highly practical and the ability to think abstractly is difficult. However, I do tend to consider many elements of a task, team, or organization and think on how these can be used for the best.
I think in order to address the concern of ethical fiscal responsibility I would use my technical skills to follow proper accounting, auditing, and transparency for all public administration activities. Furthermore, though conceptualization of organizational structure, it may be viable to reorganize departmental or even the whole organization to achieve most efficiency and eliminate waste. Meanwhile, to achieve equitable distribution of resources, human skills of communication are necessary. Through research and communication with local populations, disparities can be identified and addressed through public policy and highly effective teamwork within public administration.
One strategy to become an effective public administrator is to be open to change. The change process is necessary to craft vision and be able to deal with challenges of a public crisis or economic shock. Public administrators must combine elements of flexibility and transformation to be forward-thinking and efficient (Kettl, 2015). Second, I will use my human skills to form good relationships with public and private stakeholders in order to drive the agenda. This includes identifying top talent within the organization as well in order to cultivate a workforce which is focused and effective in pursuing the public good.
References
Administration for Children and Families. (n.d.). About. Web.
DeSalvo, K. B., Wang, Y. C., Harris, A., Auerbach, J., Koo, D., & O’Carroll, P. (2017). Public health 3.0: A call to action for public health to meet the challenges of the 21st century. Preventing chronic disease, 14, E78. Web.
Kettl, D. F. (2015). The transformation of governance: Public administration for the twenty-first century. Baltimore, MD: JHU Press.
Schminke, M., Arnaud, A., & Taylor, R. (2014). Ethics, values, and organizational justice: Individuals, organizations, and beyond. Journal of Business Ethics, 130(3), 727-736. Web.
Tran, L. D., Zimmerman, F. J., & Fielding, J. E. (2017). Public health and the economy could be served by reallocating medical expenditures to social programs. SSM – Population Health, 3, 185-191. Web.
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