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Health Care Delivery System


The United States has a unique health care system. Unlike in most of the developed countries, American citizens are not guaranteed to access basic health care services. In these countries, there are national health insurance programs run by the government and financed through general taxes. As a result, the majority of citizens are entitled to receive health care services. On the contrary, the United States has developed multiple subsystems that do not provide a universal delivery system. In addition, the healthcare in the USA is influenced by internal factors and external factors. In this paper, the health care system of the United States will be explored by focusing on issues of access to health care, health care expenditure, and quality of care.

Access to Healthcare (Physically and Financially)

The financing of healthcare is one of the internal factors in the United States that includes payments made by the public sector, private sector, and the consumer. In public sector, these are payments made by the federal government, state, and local government, while the private sector includes private insurers and business (Jonas, Goldsteen, & Goldsteen, 2007). The payments from the consumers include out-of-the pocket expenses and self-pay. In addition, public funding includes federal sources such as Medicaid and Medicare programs, the Veterans Administration, and the Department of Defense. In addition, delivery of health care system is another internal factor that influences health care providers. They are individuals and organizations that provide health care services to American citizens (Shi & Singh, 2012). They include health practitioners, hospitals, and nursing homes. Secondly, individual practitioners, general hospitals, ambulatory facilities, and special hospitals are also integrated into the health care system as health care providers (Jonas et al., 2007).

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On a further note, the health care system in the United States is also inclusive of suppliers and consumers. The suppliers are companies that provide pharmaceuticals and medical equipment to health care facilities (Shi & Singh, 2012). These are for-profit companies that operate in a competitive environment. On the other hand, consumers are people who receive the health care services. However, in a health care environment, consumers are slightly different from the consumers in other sectors. They must depend on the advice of health care professionals to make decisions regarding their health conditions (Jonas et al., 2007).

In terms of accessing the health care system, one should note that American health care system does not provide a universal health care coverage for its citizens. As a result, a significant number of the population does not have insurance covers (Jonas et al., 2007). Therefore, when non-insured citizens access health care services within the system, they are required to pay out-of-pocket to meet the expenses. Consequently, this is a major reason that hinders the uninsured citizens from accessing medical services (Shi & Singh, 2012).

Healthcare Expenditure in the United States

The total national health care expenditures in the United States have increased steadily since 1960s. One should note that the rate of growth in health care expenditures has seen significant growth in GDP and population over the same period. Between 1960 and 2010, the growth in the U.S population ranged from as high as 70.2% to as low as 15.1 % (Patel & Rushefsky, 2014). Per capita expenditures on health care have increased from 147 dollars in 1960 to 8, 402 dollars in 2010 (Patel & Rushefsky, 2014). Additionally, in 1960, national health care expenditures accounted for 5.2% of the GDP, increasing to 17.9% in 2010 (Patel & Rushefsky, 2014). The government of the United States spends more money to meet health care expenses and per capita than any other country in the world. For instance, no country has come close to the spending of 17.9% of its GDP on health care (Patel & Rushefsky, 2014). However, many of these countries, especially France, rank higher on several indicators of health outcomes than the United States (Jonas et al., 2007).

Notably, the comparison of health care expenditure between the United States and other developed countries indicates that the American government has the highest spending in health care over the past decade. For instance, in 2006, the spending accounted for 15.3% of the GDP, which was almost double the average of all OECD countries together at 8.9 % (Patel & Rushefsky, 2014). The disparity of health care expenditure between the United States and other countries is further influenced by a variety of reasons. These include high administrative costs, investments in medical technology, and high prices of prescription drugs (Shi & Singh, 2012).  Moreover, the health care system in the United States has complexities that have significant impact on the administrative expenses and financing of health care. For instance, the multi-layered system creates redundant layers that pose logistical challenges leading to the increases in operational costs (Jonas et al., 2007).

Quality of Care in the US Health Care System

The United States has the highest spending on health care. However, the harsh reality is that the quality of care delivered to American citizens is lower than in other developed countries (Shi & Singh, 2012). For one, the United States is not among the top performers in terms of life expectancy. Although it stands at 65 years, the United States has high death rates that result from conditions that could have been treated or prevented successfully. This means that issues of disease prevention have not been dealt with a proper manner in the United States health care delivery system (Jonas et al., 2007). Therefore, more costly health care resources are to be directed towards treating health problems that could have been prevented. Moreover, the administrative costs associated with the management of financing, insurance, and payment functions compromise the quality of health care (Patel & Rushefsky, 2014).

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Furthermore, population characteristic is another external factor with significant influence on the health care system in the USA. It should be mentioned that as baby-boomers age, the United States experiences a significant increase in its elderly populations. Consequently, the elderly consume more health care resources than other age groups (Shi & Singh, 2012). For example, in 1998, the average medical expenses for a person over 65 years were $6265 as compared to $1810 per person under the age of 65 (Patel &Rushefsky, 2014). This makes it challenging for the health care system to provide optimum care across all populations. Another shortfall that contributes to low quality of health care for Americans is the fact there are many uninsured Americans. Therefore, in seeking health services, these citizens are supposed to meet all the expenses (Patel & Rushefsky, 2014). This means that poor Americans cannot afford to pay to get comprehensive medical services. In addition, although the government spends more money per person on health care, the system is not effective in utilizing preventive care, drug therapies, and self-management services (Shi & Singh, 2012).


In conclusion, the health care in the United States is influenced by the internal factors such as financing and delivery. It is also influenced by the external factors such as technological developments and population characteristics. Financing are payments made by the public sector, private sector, and the consumers. Secondly, while the United States spends the highest percentage of GDP on health care as compared to any other country, the quality of services is much lower. Many Americans do not have private insurance covers that would enable them to access high-standard care. Americans do not have access to a universal health care coverage, and   citizens under government-funded programs are not guaranteed to receive optimum medical services. On the other hand, the high costs of health care system in the United States is influenced by the redundancy created in the administrative models, high costs for drug prescription, and investments for medical technology.