Charity Care Programs

Protection Motivation Theory

In 1975 Rogers wrote the Protection Motivation Theory to give clarity to understanding fear appeals. An evaluation of a health threat and coping responses can result in the performance of a response, or lead to a wrong response. The wrong response could lead to a situation where an individual health is put at risk. This can lead to an individual making a bad choice (e.g. smoking) or not participating in a health screening program.

The combination of threat appraisal and coping appraisal leads to protection motivation. Threat appraisal is a calculated guess on the chances of catching a serious disease. Coping appraisal is ones belief in being able to carry out successful and recommended courses of action successfully. Protection motivation is a mediating variable whose function is to arouse, sustain and direct protective health behavior (Boer, 1996).

Theory of Planned Behavior/ Reasoned Action

TRA was formulated in 1980 by Ajzen and Fishbein. They were trying to estimate discrepancies between attitude and voluntary behavior.

The best predictor of behavior is intention. Intention is the cognitive representation of a person's readiness to perform a given behavior, and it is considered to be the immediate antecedent of behavior. In addition to measuring attitudes toward the behavior, we also need to measure people’s subjective norms – their beliefs about how people they care about will view the behavior in question. To predict someone’s intentions, knowing these beliefs can be as important as knowing the person’s attitudes.

Charity Care Programs

Free (or charity) care refers to “free or discounted health services provided to persons who meet a [health care] organization’s criteria for financial assistance and are thereby deemed unable to pay for all or a portion of services.” Because health care is an essential service, all hospitals are expected to offer some level of free or discounted care to patients who are faced with unaffordable medical bills. Moreover, many hospitals receive public funds that indirectly subsidize a significant portion of their uncompensated care. Non-profit hospitals have a special responsibility in this area because, as charitable institutions, they receive valuable federal, state and local tax exemptions. In exchange for these exemptions, they are expected to provide community benefits, including free or discounted care to people in need. The provision of charity care is a core part of non-profit hospitals’ charitable missions (Pryor et al., 2010).

Health Financing for the Poor

The World Health Organization (2014) defines universal health coverage as the goal of “assuring that all people will have the health services they need without suffering financial hardship when paying for them.” It needs a well-managed health system that responds to people’s priority health needs, a financial system that helps eradicating financial hardship of people availing health services, access to essential diagnostic and treatment medicines and facilities, and skilled health workers.

Universal health coverage pertains to two aspects of health system performance: health service and financial protection (World Health Organization, 2014). Health service includes health promotion and prevention; and treatment, rehabilitation and palliation. Financial protection includes assistance in times of catastrophic health spending and prevention of impoverishment due to health spending. Health spending is catastrophic when household out-of-pocket health spending is greater than or equal to capacity to pay (Xu, 2005).

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