US Healthcare Delivery Structure and Its Elements

Introduction

The United States health care delivery system is complex and massive, especially because it is not a system in the true sense; it is named a system when several characteristics, components, and services are referred. The collection of institutions and persons involved in health care include research institutions, medical providers, insurers, and clients. The health care system has employed over 14.4 million people who include doctors of medicine, nurses, dentists, therapists, and administrators. The system has more than 5,000 hospitals, over 15,000 treatment homes, over 10,000 medical state organizations, and sanatoriums. Over 201 million U.S. citizens have private medical cover; 40 million are Medicare donees with 38 million being Medicaid beneficiaries (Pitts, Carrier, Rich, & Kellermann, 2010).

Interaction of chief constituents of health care delivery structure

Financing

The government is the chief supporter of the nation’s healthcare structure. Financing in the U.S healthcare system can be broken down into the payments made by the public sector, payment by the private (insurances and businesses), and the out of pocket payments by the consumer. The military health care scheme is available at no cost to the working military personnel, and the scheme is well-organized and fully covers treatment that is provided by the experienced health care personnel in the military. The dependents of military personnel are covered through TRICARE, a program financed by the military, or seek treatment in the local hospitals and dispensaries. The state has established medical cover schemes such as Medicare, Medicaid, and other children’s medical cover programs, which offer medical services to the poor, uninsured and immigrants who are economically underprivileged. Even though Medicare and Medicaid have taken important steps to deal with safety, further actions need to be taken to avoid errors like the drug to drug contacts and other avoidable complications that occur in the healthcare setting. The government should add in other incentives and measures like a high priority safety measure in the Medicare’s Hospital Value-Based Purchasing programs (VBP) to enhance the effectiveness of this program (Thorpe & Ogden, 2010).

Delivery

This includes all persons and institutions that provide healthcare services to US consumers such as medical practitioners, hospitals, and nursing homes. Although medical experts are essential to the body that provides care, hospitals, and present the environment in which care can be provided; payers fund health care systems for the services offered and a significant share of healthcare resources is utilized in hospitals. The department of Health and Human Services (HHS) with private and public partners has concentrated on eliminating the medical faults, contaminations, and problems that bring harm to millions of American patients every year, but there is still more left to be done. The biggest priority for HHS and associated institutions should be to initiate discussions with the public and private stakeholders to determine the origin of the problems and outline efficient solutions.

Technological Development

The United States has been the breeding ground of research and innovation in the medical technology with the country’s development in the science field frequently creating more demand for latest services despite the contracting reserves to fund the advanced care. The health care consumers believe that contemporary expertise present the most excellent concern with doctors wanting to test the newest tools. Even though technological advancements have introduced a modern generation of thriving involvements, the harmful effects resulting from its excessive use are countless. The cost of the highly technical involvements includes the growing health expenditure, making it difficult for companies to extend insurance cover to part-time workers or for insurers to reduce their premiums (Shi, Lebrun, & Tsai, 2008). The stakeholders in the health care industry should rethink before presupposing that the best way out invariably entails technology.

Healthcare Access

Although America provides some of the most excellent medical services in the world, access to health care in the United States is limited to persons who are covered through medical insurance through their employers, state medical schemes, and those who have enough money to pay for health services privately. Access to healthcare in the US has become problematic especially to poor and uninsured due to the rising medical costs and cost pressures in the industry. Increasing costs have lead to a greater share of the costs being passed on to persons and families in the form of increased payments and other pocket expenses. However, health insurance is the principal way of ensuring access to medical services in the United States, and the lack of insurance restrains an individual’s capacity to get well-conducted, synchronized, and timely specialty services. Experts have attributed the reduced access to fundamental and regular primary care services as the major cause why America draws behind other industrialized countries in measures of inhabitants’ wellbeing like infant death and general life expectancy.

Health expenditure

The healthcare expenditure has been rising every year; in 2010, the National Health Expenditure (NHE) totaled to $ 2.6 trillion, representing 17.95% of GDP; in 2012, the NHE was $ 2.8 trillion, representing 17.7% of the GDP. The rising trend of NHE as a percentage of GDP and the depressed growth in other sectors is becoming a matter of concern. Studies show that much of the resources used up on healthcare are not well spent and that 30 cents of every dollar spent on healthcare goes to care that is ineffective. Furthermore, patients have 50-percent chances of receiving the most desirable care with millions of people continuing to experience medical errors that cost billions of dollars every year. Various approaches have been recommended by experts to control healthcare costs, such as venturing in information technology, the advancement of the value of care to improve efficiency, modification of supplier compensation, extra government laws, consumer involvement, and tax inducements to increase insurance coverage. Cutback on wastage in the system should be included in the list because it is a considerable part of the general expenditure and worth its category.

Quality of care

Recent studies indicate that there is a gap in quality of care between the rich and the poor, with the rich being able to access quality healthcare than the disadvantaged and the underprivileged immigrants. United States, however, is making plans to improve the quality of healthcare to its citizens by developing numerous quality assurance programs. One example of such programs is the Quality Management for Health care Delivery; a program which provides a scheme that assists medical facilities to regulate, examine, and constantly advance all areas of health care delivery. The program aims to identify troubles in the delivery of care, initiate actions to overcome the problems, and examine monitoring to make sure that the system is effective in correcting the problem. The government should demand public reporting of the performance of hospitals, health practitioners, and providers on strategies and efforts they make towards improving consumer care (Bohmer & Lee, 2009).

Conclusion

The United State must look forward to developing a dynamic health care system where all citizens will enjoy and have access to the country’s top-quality health services equally. The stakeholders in the health care industry must visualize the future to achieve the preferred system results given the projected social, cultural, and economic transformations.

References

Bohmer, R. M., & Lee, T. H. (2009). The shifting mission of health care delivery organizations. New England Journal of Medicine, 361(6), 551-553.

Pitts, S. R., Carrier, E. R., Rich, E. C., & Kellermann, A. L. (2010). Where Americans get acute care: increasingly, it’s not at their doctor’s office. Health Affairs, 29(9), 1620-1629.

Shi, L., Lebrun, L. A., & Tsai, J. (2008). US Reforming healthcare delivery. Harvard Health Policy Rev, 9(1), 68-77.

Thorpe, K. E., & Ogden, L. L. (2010). ANALYSIS & COMMENTARY The Foundation That Health Reform Lays For Improved Payment, Care Coordination, And Prevention. Health Affairs, 29(6), 1183-1187.