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Hlt 244 lecture
- 1. Introduction to the US Health Care System Dr. Nicole Hatcher
- 2. Objectives By the end of the class, you should: Understand the basics of the US health care system Be able to name and describe the four key components of the US health care delivery system Be able to differentiate the U.S. health care system and the free market Have an overview of health care in other industrialized countries
- 3. Primary Objectives of a Health Care System To enable all citizens to receive health care services To deliver services that are most effective and meet established standards of quality
- 4. Major Players Physicians Administrators Insurancecompanies Large employers Government
- 5. Characteristics of the US Health Care System No central agency Access is selective Imperfect market activity Third party insurers as intermediaries Multiple payers Balance of power Legal risk New technology Continuum of services Quality
- 6. Characteristic- #1 No central agency Citizens are not entitled to receive a specific set of services Lack of a global budget
- 7. Characteristic- #2 Access is selective Insurance Affordability
- 8. Characteristic #3 Imperfect market Quasi-free market In national health care, economic markets do not exist
- 9. Characteristic #4 Third-party insurers and payers Patient Provider Intermediary
- 10. Characteristic #5 Multiple payers Billing and collection Cumbersome system
- 11. Characteristic #6 Balance of Power Multiple payers Fragmented self-interests
- 12. Characteristic #7 Legal risk Litigious society Defensive medicine
- 13. Characteristic #8 High technology R&D
- 14. Characteristic #9 Continuum of services Curative Restorative Preventative
- 15. Characteristic #10 Quality Continuous quality improvement Higher expectations
- 16. The Role of Government Major financier Determine reimbursement rates Regulator of health professionals and health care establishments Health policy
- 17. Basic Components of a Health Care System: Quad-function Financing Insurance Delivery Payment
- 18. Access to Care What is access? Key predictors of access Financing and insurance Delivery and payment
- 19. A Complex Problem The uninsured 41.6 million in 2004 16-17% of the total population (Nat’l Center for Health Statistics)
- 20. Health Care Systems of Other Countries Three predominant models National health insurance (NHI) National health system (NHS) Socialized health insurance (SHI)
- 21. References Shi,L., & Singh, D. (2011). Delivering health care in America: A Systems Approach. 5th ed. Jones & Bartlett: Boston, MA.
Editor's Notes
- Before we describe the features of the US health care system, it is important to have a baseline understanding of the purpose and objectives of the system.
- The US health care system is very complex and consists of many moving parts. Some of the major players include physicians, administrators, insurers, large employers, and government. To give you an idea of how huge the system is here are a few statistics- the US health care system employs approximately 10 million people. There are approximately 744,000 active MDs, 2.2 million nurses, 226,000 pharmacists, 700,000 administrators, 5,760 hospitals, and 16,100 nursing homes.
- The United States health care system is very unique in comparison to the health care systems of other industrialized nations. Many experts suggest that the US health care system is not a true system because of the lack of coordination. The system is unique because there is no universal health care financed by taxes and there is no entitlement. No other country operates like the US health care system. To be more specific there are 10 characteristics that differentiate the US health care system from other systems. The 10 characteristics are listed here but we will talk about each one of them, briefly, in more detail.
- Access is the ability to obtain health care when it is needed