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Health Care Systems November 5, 2015 Dr. Irish Patrick Williams Healthcare Service Management
The structural components of the health care system in the United States. The interactions among the components, specifically health care providers, patients, and payers are presented. Strengths and weaknesses of current health care delivery and finance mechanisms are described in terms of impact on health care expenditures and health status. The article concludes with a brief discussion of why the U.S. health care system is in need of reform. A health care system is an organized collection of individuals and organizations that provide for the access, financing, and delivery of medical services to individuals. As a general definition, a system is a logical "set of interdependent parts organized with a sense of logic and consistency" (Southby, 2004). Yet, there are those who argue that the health care system in the United States is both illogical and inconsistent. The U.S. spends more on health care (as measured by percent of GDP) with worse health outcomes than many other developed nations (Southby, 2004). Health care costs impact both public and private sectors and have enormous implications for global competitiveness, employee productivity, and economic stability. Health care reform is a dominant issue on the public discussion agenda but the formation of realistic or meaningful approaches for reform does not yet have a place on the decision agenda in both the federal and state governments. The structural components of a health care system refer to the methods and means of health care delivery and access: the who, the and the where of providing health care to individuals and groups. In modern societies, health care is traditionally provided by a physician trained in the medical sciences. As a society, we grant to physicians the technical, legal, and cultural authority to give patients information and render treatment for their medical conditions. This has not always been the case. Up until the late nineteenth century, most medical care was provided within families. Physician services were a last resort. As research began to provide physicians with proven treatments (especially through the understanding of disease, the importance of asepsis, and the development of antibiotics), medical knowledge became the exclusive domain of
physicians. This position was reinforced through standardized training and the rise of physicians as a sovereign profession (Starr, 1982). As specialization emerged within medical practice, conflict between general practitioners and specialists emerged as specialists sought to maintain exclusivity in certain types of practice. Ophthalmology, endocrinology, and neurology are a few examples of specialization. By controlling access to specialty training through governing boards, e.g. the American Board of Ophthalmology, specialists effectively restricted general practitioners from taking on patients with specific types of conditions (Starr, 1982). As a result, a hierarchy within the practice of medicine arose, with general

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