United States Health Care Delivery System


It is worth noting that several tasks were set for the U.S. healthcare system to improve public health. They include achieving an increase in life expectancy and a decrease in the overall mortality rate and specific goals for improving the system itself (Goldsteen, Goldsteen, & Goldsteen, 2017). In particular, it is necessary to create an optimal structure of medical personnel and make sure they are qualified enough, establish sufficient drug supply on an outpatient basis, and make management more effective. Thus, this paper aims to discuss the aspects of the American health care delivery system.

Discussion of Factors

Several factors have led to care being offered outside of the hospital setting. Some of the main goals were associated with the need to reduce costs and improve patient health. The changes in the system were aimed at increasing access for different patient groups to care and achieving coordinated care when handling clients (Girard, 2013). In addition, it was planned to shift risk from insurers to providers by transitioning towards outpatient care. Moreover, if patients got an opportunity to receive help in outpatient settings, this would positively affect expenditures since clients would not be handled in such expensive settings as hospitals and emergency units.

It should be stressed that the nature of care for patients experiencing chronic conditions has changed. Through the intention to decrease costs and achieve greater accessibility for different population groups, significant changes were observed in terms of the kind of help people receive. However, it has also affected how much care they are suggested, who provides care to them, when they are offered services and in which environment (Shi & Singh, 2017).

Advantages and Disadvantages

Outpatient care has several advantages as compared to hospital settings. First, in an ideal scenario, it is cheaper than the typical residential program of care. Second, clients get more freedom if they are handled in outpatient settings (Goldsteen et al., 2017). Third, this type of care is less rigid due to the fact that the plan of care becomes flexible, and patients have an opportunity to maintain other commitments.

However, this system has several disadvantages connected to an uncontrolled increase in spending on the healthcare system. For example, in E.U. countries, health care spending is about 8.3% of the gross domestic product (GDP), while in the U.S., it is about 17.5% and higher. If health care spending continues to grow at such a pace, then in 60-70 years, health care spending in the U.S. will amount to around 40% of GDP (Goldsteen et al., 2017). Moreover, insurance programs from which medical care is paid make up the most significant expense item of the federal government. If expenditures on the health care system are not balanced, then in the next decade, the federal budget will require substantial additional funds, which will lead to increased taxes.

Another disadvantage of the approach is that health care providers, who deliver medical care to those who cannot pay for it, are forced to raise tariffs for their services for everyone. It may be assumed that there is a cross-coverage of medical costs for the uninsured from the funds of the insured (Goldsteen et al., 2017). Thus, such conditions imply a constant increase in medical care tariffs. In addition, experts argue that this approach has led to the disintegration of the process of providing medical care to patients, which is associated with the free choice of general practitioners and hospitals by patients.

Based on the discussion above, it may be stated that there are more benefits for organizations than for consumers. The ability to choose between providers leads to a lack of uniform treatment standards at all stages and levels of medical care (Goldsteen et al., 2017). In its turn, this leads to unnecessary and repeated appointments and tests, and in general, complicates the practical organization of the process of providing medical care to patients.

Affordable Care Act

The Affordable Care Act (ACA) has impacted the trend in regards to outpatient care quite significantly. For instance, it has been observed that people have check-ups and physician visits more often (Goldsteen et al., 2017). Citizens have primary care visits more frequently, and there has been an evident shift toward preventive care. The ACA did not put the care back into the hospital setting because patients tend to opt for outpatient services since it is more convenient and less expensive (although not in all cases). Low-income adults started using preventive services more actively, which is also noted among senior adults (Goldsteen et al., 2017). Overall, it may be assumed that the influence of the ACA is observed in increased outpatient utilization among various population groups.

Conclusion

Thus, it can be concluded that the transition to outpatient care is a consequence of the attempt to reduce costs and regulate the performance of private insurers and health care providers. The implementation of health care reform in U.S. regions has led to some positive results in solving existing problems. Nonetheless, specific negative consequences may be observed, and greater outpatient utilization is an attempt to make the healthcare system more efficient.

References

Girard, K. (2013). Health care delivery systems [Video file]. Web.

Goldsteen, R. L., Goldsteen, K., & Goldsteen, B. (2017). Jonas’ introduction to the U.S. health care system (8th ed.). New York, NY: Springer.

Shi, L., & Singh, D. A. (2017). Essentials of the U.S. health care system (4th ed.). Burlington, MA: Jones & Bartlett Learning.