The delivery of healthcare and the regulatory control over healthcare systems vary from country to country. Different nations have different methods of cost-sharing at the point of service and offer varying ranges of benefits (The Commonwealth Fund, 2019). While private insurance is commonly incorporated in healthcare systems worldwide, its importance varies considerably across nations (The Commonwealth Fund, 2019). The Commonwealth Fund’s 11-country report reveals that in the United States, the level of a person’s income significantly determines the quality and accessibility of healthcare when compared to other wealthy nations (The Commonwealth Fund, 2019). In fact, the United States ranked last among these nations in terms of providing equally accessible and high-quality healthcare to people of all income levels. Although the Affordable Care Act has improved access and coverage of healthcare in the U.S., there are still a significant number of Americans who struggle to access healthcare services (The Commonwealth Fund, 2019).
The healthcare delivery system in the United States is composed of a range of public and private entities (Green, 2018). The public health system includes government entities that collaborate with community nonprofit organizations and faith-based organizations. On the other hand, private healthcare settings include inpatient, outpatient, ambulatory, long-term care, mental health, home care, wellness centers, and alternative care, all of which are regulated by governmental agencies (Green, 2018). While individuals can pay for medical services individually, the costs may not be feasible for most people. Therefore, healthcare insurance, whether provided by the government or a private company, plays a crucial role in guaranteeing payment for healthcare services (Green, 2018). Eligibility for these services can be based on public or private insurance, but either way, individuals may still accumulate out-of-pocket costs. Despite a decrease in the percentage of uninsured individuals since the implementation of the Affordable Care Act, there are still 28 million uninsured people in the U.S. as of 2017 (Berchick, 2018).
Several studies have shown that a physician-patient relationship focused on quality and personalized preventive care leads to positive healthcare expenditure outcomes and improved health management over time (Musich, Wang, Hawkings, & Klemes, 2016). The Centers for Medicare & Medicaid Services report that healthcare spending in the U.S. increased by 3.9% in 2017, amounting to $3.5 trillion or $10,739 per person. A significant portion of these expenditures could be reduced if the healthcare system focused more on prevention rather than disease management.
In summary, the delivery of healthcare and regulatory control over healthcare systems differ across countries. The United States lags behind other wealthy nations in providing accessible and high-quality healthcare to people regardless of their income. The healthcare system in the U.S. comprises both public and private entities, with individuals relying on insurance to cover the often prohibitive costs of medical services. While progress has been made in increasing access to healthcare through the Affordable Care Act, millions of Americans remain uninsured. Focusing on prevention rather than disease management could help reduce healthcare expenditures in the U.S.