What are the basic characteristics that differentiate the U.S. health care delivery system from
that of other countries?
2. List the four health determinant categories and provide an example of how the government is
supporting improvement in each determinant.
3. Explain how the United States has both market and social justice aspects of health care.
4. Discuss reasons why national health insurance has not developed in the United States.
5. Explain how interest groups affect health care policymaking in the United States.
6. How can technology reduce health care costs?
7. Improving access to medical care has been a challenge in the U.S. health care system. How has
technology affected access to medical care?
8. Discuss the four main aspects of globalization in health care delivery.
9. Explain the significance of gatekeeping in regard to primary care and keeping health care costs
down.
Sample Answer
The U.S. healthcare system is a complex anomaly compared to the centralized models found in most developed nations. Understanding its unique characteristics requires an analysis of its history, market dynamics, and technological integration.
1. Differentiating Characteristics of the U.S. Health Care System
Unlike the National Health Service (NHS) in the UK or the social insurance models in Germany, the U.S. system is characterized by:
No Central Agency: There is no single government entity that governs the system. Care is delivered by a fragmented array of private and public providers.
Partial Access: Access is largely dependent on health insurance coverage (employer-based, private, or government-funded), rather than being a universal right.
Imperfect Market: While it operates on market principles, it is an "imperfect" market because patients (consumers) rarely know the true price of services until after they are rendered.
Third-Party Insurers as Intermediaries: Insurers act as the wall between the "payers" (employers/government) and the "providers," creating complex billing and administrative costs.
Legal Risks: The U.S. is highly litigious, leading to "defensive medicine," where providers order extra tests primarily to protect against potential malpractice lawsuits.
2. The Four Health Determinant Categories
Government policy increasingly focuses on these four areas to improve overall population health:
Environment: Factors like air/water quality and socioeconomic status. Example: The EPA enforces the Clean Air Act to reduce respiratory illnesses.