University of Chicago
Type of paper: Thesis/Dissertation Chapter
United States Health care system
United States Health care system
The healthcare system is one of the most important departments that require total commitment from all the stakeholders in order to deliver quality services to all citizens irrespective of their socioeconomic status. The delivery of health care system in united states involves various stakeholders such as researchers, educational, insurers, payers, governments, states, private sectors among many others. However, the healthcare system is faulted due to lack of coordination between the stakeholders that result in inefficiencies and complexity during service delivery (Shi, & Singh, 2009). The fragmentation of the healthcare system has raised financing problems. Consequently, the country lacks a national health care system and citizens are left to make their decision of the type of the health care that is appropriate to them. The financing of the healthcare system is done through insurance cover that are provided through private or public system. Lack of universal healthcare system in the country has hindered poor people from accessing quality healthcare. In addition, employees lack freedom of making medical cover decisions as the current policies leave employers to make such decisions. The country has vast number of healthcare employees that take part in service delivery. Perhaps, lack of national or universal health care system in united state has been due to failure or delay of the implementation of healthcare laws that deals with expenditure and quality of service.
The United States has a unique health care system compared to other developed countries as it lacks central body that governs it and insurance financing is done through insurance coverage. The country’s health care system is not uniform and lack universal health care provision (Shi, & Singh, 2009). Although there have been many legislations enacted towards improvement of the healthcare system, few have been implemented partially or not at all. This is the major problem affecting United States health care system today. The healthcare system does not operate as a national or universal system but it is operated through various sectors. The fragmentation is due to lack of common policy that would help to steer the health care system. In addition, the system lacks a streamlined financing, payment and delivery system. The insurers serve as intermediaries between financing and payment. As a result, it becomes difficult to manage the health care system financial expenditure.
The healthcare system in the united state is financed through insurance cover. The most employed people finance their health care through private insurance companies such as MCO that is paid by the employers. The employer makes the decision on the type of the cover to be given to employees, which prevent the employees from acquiring medical services of their choice. In addition, the employees may be limited to quality health care services as they are limited in making decisions of the insurance cover. The insurance cover provided by the employee covers the immediate family members. However, the small employers may lack the capacity to pay for their employees’ insurance cover, which may limit them from accessing healthcare services if they cannot meet their medical cover. This disadvantage most people working in small companies and fault the healthcare system financing. The government also provide insurance cover for its employees and citizens through insurance companies such as Medicare and Medicaid (Kronenfeld, 2002). However, the insurance meet the part of the payment while the patient has to meet the other part of the cost. The unemployed and poor people do not have insurance cover and government finance for some people with special needs such as elderly, disabled, and low-income earners. However, the care system is dominated by unequal access of health care across the populations (Shi, & Singh, 2009)
The current health care system of the united state offers quality health care. The health sector works under increased pressure to deliver quality services. The sector is trending from the worst situation to better situation. For example, the sector is trending from illness to wellness, actuate to primaries in order to ensure that the lives of the citizens are transformed. The sector sets quality standards and develops compliance with the standards in order to attain high quality services. In addition, the governments continue to promise its citizens high quality services in health care. Consequently, the communities and individuals have high expectations of quality services from the health care sector and thus the healthcare provider has no option but to provide quality services. The government and health care system have continued to invest in research and high technologies that will ensure the people will get the best services. However, poor coordination and lack of central healthcare governing body has resulted to some people failing to access the services such as poor, low-income earners, and other who lack insurance cover.
The United states spend a significant percentage of its gross domestic product, (GDP) in health care. For example, in 2003, the United States spent more than 15.3% of its GDP, which accounted for more than $ 1.679 trillion in health care system (Jonas, Goldsteen, R., & Goldsteen, K., 2007). The country experiences inflation in health sector more than the economy. The expenditure of the health sector is mainly through the delivery of health services, improvement of quality of services through research and adoption of technologies, and payment of part of its service providers such as physicians, clinicians and others. The main sources of the money are the government, insurance companies, and citizens’ service payment or additional cost to supplement the insurance cover. The healthcare expenditure is sourced from private funds, states, local, and federal funds, which is evidence that the system is fragmented. For example, in 2010, the 50% of the funding was sourced from private funds, 38% from federal governments and the rest from local and states funds. In 2003, the government financed health care system by more than 46% of the total expenditure, the insurance company covered more than 36%, while money from the public approximated 14% (Jonas, Goldsteen, R., & Goldsteen, K., 2007).
Most laws and policies try to address the issue of cost, access, and quality of the health care offered in United States. The current cost of health care system is rising making it difficult for most Americans to access quality health care. The introductions of high technologies and modern drugs have led to increased cost of care provided in health facilities across Americans. Consequently, high administrative cost in health care system has increased the cost of obtaining services from the system. This works to the disadvantage of the low-income earners and those that do not have an insurance scheme. Hence, the laws and public policies that are enacted ensure that poor people, children, elderly and people who are disadvantaged are able to meet the cost of health care through government sponsored insurance cover (Kronenfeld, 2002).
Consequently, the public policy on the affordability of health care services relates to access. Laws and policies formulated to reduce the cost of health care to make it affordable to low income earners, poor people, elderly, and disabled will increase the access of health care. According to Kronenfeld, (2002) many Americans do not have access to quality health care due to lack of money to pay for the services. Hence, laws that encourage the government to reduce the cost of health care will increase people’s access to health care. Laws and health care policies advocate for quality services by arguing that people and government should not get inferior services if they have paid. Consequently, investments of high technologies that is mandatory in health sector warrants quality services. Hence, the cost, access and quality laws and policies will ensure improvement of United States health care delivery and management.
The health care system is an integral part in any country’s economy. The united states health care system receives the highest government’s expenditure of about 15.3% GDP. However, the health care is a unique one as it lacks governing body and various stakeholders such as private sectors, government, and insurance companies manage it. The financing, payment, and service delivery is mediated by insurance companies. The payment is made through insurance coverage where citizens lack choice of health services. Government insures uninsured people on special cases through insurance companies such as Medicare. The policies and laws of cost, access, and quality might improve the service delivery in health care system where people will be able to afford care services, have easier access, and get quality services
Jonas, S., Goldsteen, R. L., & Goldsteen, K. (2007). An introduction to the U.S. health care system. New York: Springer.
Kronenfeld, J. J. (2002). Health care policy: Issues and trends. Westport, Ct: Praeger.
Shi, L., & Singh, D. A. (2012). Delivering health care in America: A systems approach. Sudbury, Mass: Jones & Bartlett Learning.