Expository Essay on Healthcare System of the United States

Introduction

The US health care system is composed of personal health care services, the diagnosis, treatment, and restorative and preventive, as well as the personnel and institutions that offer the services and the public (government) and private agencies and organizations that fund the service delivery (Yesalis, Politzer & Holt, 2012). In essence, the U.S. health care system is considered to be a complex entity, comprised of three interrelated elements, the patients, individuals who require health care services, health care practitioners and professionals, the individuals who deliver the required services, and the systematic structures that facilitate the delivery of health care including the health care institutions and organizations. These components interact, with much of the interaction occurring between the providers and consumers of health care (Niles, 2011). Through impersonal or indirect, other interactions such as disease screening or immunization programs are conducted by public health institutions or agencies for the entire population(Garber & American Hospital Association, 2006). Nonetheless, all that health care delivery within the U.S. does relies heavily on the interactions amongst the three components. The capacity to gain from health care is dependent on the individual’s ability to access the health care system.

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What Are the Four Models of Paying for Health Care in America?

In essence, the U.S. health care system may be a health care model comprised of four functional models, namely financing, delivery, insurance, and payment. These elements overlap though the degree varies between publicly-managed systems and privately-managed systems, and between managed-care-based systems and conventional health insurance(Jonas, Goldsteen & Goldsteen, 2009). In government-managed systems, the functions are tightly integrated. In the case of financing, health care requires expensive diagnostic procedures and equipment as well as lengthy stays in hospitals. For one to access health care insurance, funding is required or rather one has to pay for health care services. A significant percentage of the privately-insured people in the U.S. enjoy employer-based health insurance, with health care being funded on their behalf as a fringe benefit. In essence, insurance protects individuals against risk when expensive health care services are needed. Insurance also determines the health care service package that an individual is entitled to specifying where and how the services would be administered. The insurer also processes the claims and disburses funds to health care providers(Shi & Singh, 2010).

The delivery of health care services refers to the process of administering health care and the receipt of payments from insurance or individuals for the services rendered. That is, health care professionals in public and public hospitals or facilities provide health care services to individuals, mostly those who have health insurance. The payment element deals with the disbursement of payment to the health care providers and institutions for the provision of service (Afifi, Rice, Andersen, Rosenstock & Kominski, 2013). This involves the determination of the amount of money to be paid for a specific service. The funds that are actually disbursed are sourced from the regular premiums that health care seekers pay to the health care insurance firms. Under a managed-care plan, as is the case for the uninsured, an individual is expected to pay a small amount of money to see the physician, while the remainder of the health care costs is covered by the managed-care plan.

Conclusion

In conclusion, the US has a unique health care system, though it lacks universal access, hence comprehensive and continuous health care is not enjoyed by all the American people. The system is characterized by a patchwork of interacting components that have been advanced by market forces, the health care consumers, providers, and institutions or entities that facilitate delivery.

References

Afifi, A. A., Rice, T. H., Andersen, R. M., Rosenstock, L., & Kominski, G. F. (2013). Changing the u.s. health care system: Key issues in health services policy and management. San Francisco, Calif: Jossey-Bass.

Garber, K. M., & American Hospital Association. (2006). The U.S. health care delivery system: Fundamental facts, definitions, and statistics. Chicago: Health Forum.

Jonas, S., Goldsteen, R. L., & Goldsteen, K. (2009). An introduction to the U.S. health care system. New York, NY: Springer.

Niles, N. J. (2011). Basics of the U.S. health care system. Sudbury, Mass.: Jones and Bartlett Publishers.

Shi, L., & Singh, D. A. (2010). Essentials of the U.S. health care system. Sudbury, Mass.: Jones and Bartlett Publishers.

Yesalis, C., Politzer, R., & Holt, H. (2012). Fundamentals of US Health Care: Principles and Perspectives. Cengage Learning.