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Home arrow Health arrow Introduction to health care services


Bernard J. Healey


After reading this chapter you should be able to

• Identify the major challenges found in the U.S. health care delivery system.

• Understand how health policy is formulated and implemented in the United States.

• Understand the value of health education programs in the prevention of chronic diseases.

• Discuss the reasons why the U.S. system of health care delivery needs to be reengineered.

• Explain how the reorganization of physician practices will change health care delivery.

Up until this point this book has focused on various components of the U.S. health care industry as they are currently structured, making recommendations on how they can be changed in order to improve the health of the population. It has also looked at the historical development of the major sectors of the health care industry, along with their role in delivering health care to consumers. This chapter will examine the future of health care delivery in the United States as a result of the various ongoing health care reforms that will alter the way that we deliver and receive health care.

Goodman (2012) argues that health care is a complex system that is so complicated that every individual sees only a small part of that system, making it very difficult for anyone to understand all the working parts. Over the years special interest groups (frequently with the aid of professional lobbyists) have manipulated health legislation so that it favors those special interests. Our current system of health care delivery is clearly in danger of bankrupting our country, and it does not seem that even the new health care reform efforts can save it. The newest health reform legislation, the Patient Protection and Affordable Care Act (ACA), does very little to change the way health care is financed, although it does succeed in increasing access for millions of the uninsured. This law also ignores the waste and fraud in health care delivery that is only going to increase with more people receiving their health insurance from the government The ACA does encourage some preventive care but does very little to help educate the population about high-risk health behaviors that quite often result in the development of chronic diseases and complications from these diseases as people age.

The entrenched powers of special interest groups have long worked to prevent necessary change from occurring in the U.S. health care system. Quite often they stop change from occurring by citing the quality of health care as their reason when in reality they are protecting their own power, influence, and income. Fortunately, the debate surrounding the Affordable Care Act has helped millions of Americans better understand the current health care problems and potential solutions. These better-informed citizens and current or future consumers of health care services are now asking questions and becoming active rather than passive consumers of health care services. Power is shifting from special interest groups to the more informed and concerned consumer.

The American health care system exists in a capitalist system that utilizes markets and a pricing system, along with a decision-making process that relies heavily on profits and incentives, in order to function properly. Once we understand that health care delivery has become one of the largest businesses in the United States, we can begin to understand why many of its problems go unsolved. Fixing the problems facing our health care delivery system will result in fewer profits for special interest groups. These powerful groups have designed a health care system that meets their need for power, influence, and profits but does very little to increase quality and efficiency in delivering the necessary health services to the population.

The health care system pays little attention and devotes few resources to the prevention of disease because there is little profit to be made from healthy people. Health care organizations keep their power, prestige, and profits when people become ill and then spend a great deal of money trying to become well again. However, this system is now being confronted by numerous major challenges that can no longer be ignored by those responsible for health care delivery in our country.

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