Understanding the Healthcare System of the United States

The US healthcare system is a hybrid system with no universal healthcare coverage. The major challenges include high healthcare costs and disparities in insurance coverage. The introduction of health maintenance organizations or HMOs has been a poor development. The Affordable Care Act, drug pricing, opioids, and health care workforce programs are some of the recent policies introduced.

Before understanding, the health care system of US one should know about the factors that are
essential to any healthcare system.
QUALITY: Quality is a measure of how good the medical care is and how effective the
services are.
COST: The sources and uses of money that pay for healthcare services
ACCESS: This include the five A’s that are affordability, availability, accommodation,
accessibility and acceptability.
The five major branches of US health care system are:
1. Providers
2. Payers
3. Purchasers
4. Patients
5. Policymakers
According to the report, the U.S. does not have a uniform health system. Also U.S have no
universal health care coverage, and only recently enacted legislation mandating healthcare
coverage for almost everyone which makes this country to lay behind several other nations on
health care aspects. Rather than operating a national health service, a single-payer national
health insurance system, or a multi-payer universal health insurance fund, the U.S. health
care system can best be described as a hybrid system.
Two main challenges include high health care costs and disparities in insurance coverage in
the U.S. Other issues in the healthcare systems are:
Private Health Insurance and the Lack of Insurance: Like the other nations,
medicine is a profitable business. Hence, the expenditure for the health care has increased
tenfold. Still U.S lags behind many other nations. One main reason is private health
insurance. The U.S relies largely on a direct-fee system. In these system patients, under 65
are expected to pay for medical costs themselves, aided by private health insurance.
The High Cost of Health Care: The U.S spends much more money per capita on
health care than any other industrial nation and still lags behind many other nation in terms of
health care services.
Managed Care and HMOs: A poor development in the U.S health care system has
been the introduction of health maintenance organizations or HMO’s. They are prepaid health
plans with designated providers that is the patients must visit a physician who are employed
by the HMO.
Racial and Gender Bias in Health Care: African Americans are given less priority
than the Native Americans are and gender bias is present since women’s are not given certain
diagnostics tests and medications.

Some of the health care policies introduced recently are:
The Affordable Care Act: Successes and Remaining Challenges: In 2010 March,
President Obama signed the ACA into law that made hundreds of significant changes to the
U.S. healthcare system. The various benefits included in the ACA are intended to expand
access to healthcare coverage, increase consumer protections, emphasizes prevention and
wellness, and promote evidence- based treatment and administrative efficiency in an attempt
to curb rising healthcare costs.
Drug pricing: The cost of drugs has increased dramatically over the years. In addition, this
came into notice of the political spectrum and media. Thankfully, the legislators introduced
over 25 bills and oversight committees held hearings to investigate the issue.
Opioids: Opioid drug addiction had been a serious problem, which resulted in many deaths.
Now the white house has banned the use of the opioids and declared opioid epidemic a
national emergency that is a major reform recently.
Health Care Workforce Programs: Various health care programs that comes under the
Public Health Service Act which are expired is set to roll back soon which will help to reform
the current healthcare practices.
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