Healthcare delivery system in the US
Define and describe the healthcare delivery system in the US.
Healthcare delivery system can be defined as the healthcare processes and components that make it possible to access and receive health care. The healthcare delivery system in the U.S. involves different healthcare facilities, physicians and various institutions that help people in the country to receive the health care they need.
Describe the objectives of healthcare delivery in the US.
The main objectives of healthcare delivery in the U.S. is to help all the citizens regardless of gender, race or financial ability to receive health care services. Another objective is to deliver health care services that meet the laid down standards while at the same time being cost-effective. Healthcare delivery system in the US
What are the different types of ways that healthcare can be financed? How do most people pay for healthcare?
The different ways that healthcare can be financed are employer-based health insurance (private), privately-purchased health insurance (private), government programs like Medicare, Medicaid and CHIP. Most people pay for healthcare through private insurance employer-based health insurance and privately-purchased health insurance.
What are some characteristics that make the US healthcare system different from others?
- No central agency governs the system
- Access to healthcare is based on one’s insurance
- Health cate is provided in an imperfect market
- Third party insurers who act as intermediaries between finance and delivery
- Has multiple payers making it cumbersome
- There is balance of power and no one organization dominates this sector
- Practice behavior is affected by legal risk
- Use of new technology making it technology driven
What type of access to healthcare do we have in the US?
The type of access to healthcare in the U.S. is fee for service system where people access healthcare based on how much they can pay for it.Healthcare delivery system in the US
Describe a multiple payer system vs. a single payer system.
Single payer system is whereby only one agency usually the government is responsible for paying healthcare claims. On the other hand, multiple payer system is whereby more than one agency is tasked with paying for health care claims.
What roles do the US government play in the healthcare system?
- Regulates the healthcare system by issuing licenses to personnel and health care establishments.
- It is the major financier of the health care delivery
- Decides on reimbursement rates to providers of Medicaid and Medicare services
- Passes and enforces health policy to protect the citizens.
What are the four functional components of healthcare delivery?
- Financing- To purchase insurance or pay for health care services provided.
- Insurance- To protect against catastrophic risk and decides on the packages to be provided to each individual.
- Delivery- To offer any type of health care services. An agency that provides the health care services and is compensated for the services it has offered.
- Payment- To reimburse healthcare providers for services they have rendered. The funds paid come from the contribution paid to insurance companies.
What is a national health system?
This is a national health care model that is used by any country that helps in offering better health care services to the citizens.Healthcare delivery system in the US
What is social health insurance?
This is a health care financing program through government mandated contributions by employees and employers.
What self interests do you think the following have within the healthcare delivery system: physicians, administrators, insurance agencies, the government, employers?
Physicians want few working hours and high salaries. Administrators want few working hours but also want physicians to work for longer hours. They also want to charge more money for healthcare services in order to generate more profits for the healthcare facilities they oversee. Insurance agencies want to charge customers more monthly premiums while at the same time want to pay less as healthcare coverage for their clients. Government wants to pay physicians less blaming it om high wage bills it has to deal with. Employers want to contribute a small portion towards insurance coverage for their employees. They also want to limit the healthcare services that an employee can access. This is all geared towards increasing their profit margins