Delivering healthcare in America


Delivering healthcare in America
What is meant by health care financing in its broad sense? What impacts do various financing options have on different population segments that are reliant

upon the health care delivery system?


The financing of the health care system is an extremely complex set of processes known to drive services in the USA. American consumers often over-utilize

the traditional health care system and expect a quick fix to physical and mental problems. Furthermore, the use of emergency rooms for health care

provision for the uninsured is a high-cost solution to the issue of underinsured/uninsured people and access to health care. Currently, private and public

health care insurance is represented by several modalities and is discussed in the context of fiscal impact.

Health care finance is a branch of finance that helps patients and health care beneficiaries pay for medical expenses in the short and long terms. Health

care finance (Health insurance companies) affect patient care indirectly by driving what tests, medications, and procedures doctors can use to diagnose and

treat patients and even which patients doctors can care for.

Expenditures and Components
The one large system of financing health care is health insurance, usually provided by employers or the government. Doctors use the insurance system to

derive how much they will be paid. Such financing represents who has access to health care and what programs are developed, such as Home Health Care. The

fraction of payment due lends consumers to use more services because the full cost is reduced. These issues, related to overspending and use, are of major

concern in overall system delivery.
Influencing of Financing Model
There is a strong nexus between cost control and health care financing. The influence of financing model, as developed by Shi and Singh (2008), classified

insurance as the pivotal variable. Insurance drives demand for services and higher utilization. Based on the experience of other nations and this model,

health care costs would need to be controlled by rationing services. Government programs, such as Medicare (for the elderly), control costs by limiting the

types of services available.
Medicaid, or Title XIX of the Social Security Act, is comprehensive health insurance for children, the blind, disabled, or elderly and are considered

indigent. Both the federal government and states pool resources to fund the large pool. Financial allotments represent 11% of overall spending. States

define who qualifies according to need. Each state administers their own program, thus the services differ between states. The Federal government partners

with states to provide some ancillary services such as prescription drugs, home care, etc.
Several factors, such as providers, purchasers, and politics, influence the costs and financing of health care. Nearly 50 million people are uninsured,

impacting the current system of access to care in the most expensive form: visiting the emergency room. Several insurance processes exist, yet health care

costs are exceeding spending projections and inflating our gross domestic product over 20%.
Shi, L. and Singh, D. A.(2008).Delivering health care in America (4th ed.). Boston, MA: Jones and Bartlett