The Health Care Delivery System: The US and Worldwide

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  • 0:04 What is a Healthcare…
  • 1:13 United States…
  • 3:01 Universal Healthcare
  • 3:35 The U.S. vs Other Countries
  • 6:02 Lesson Summary
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Lesson Transcript
Instructor: Zona Taylor

Zona has taught Nursing and has a master's degree in Nursing Education and Maternal-Infant Nursing from University of Maryland Baltimore.

This lesson looks at the terms health care delivery system and universal health care and what each means. It also discusses health outcomes in the United States in comparison with some other industrialized countries.

What Is a Health Care Delivery System?

Let's open this lesson with a question: if you are born in the U.S., are you likely to have a longer or shorter life span than if you are born in another industrialized country? It's an interesting question, isn't it? Ever brought it up to your friends?

Discussing health care among friends can get a little sticky sometimes. Everyone seems to have his/her own opinion of what works and what doesn't when it comes to what approach works best in taking care of the health needs of the residents of a given country. The questions that often come up are things like:

  • What is a health care system, anyway?
  • What's the difference between universal health care and whatever the U.S. has?
  • Which approach to health care has the best health outcomes?

Let's look at each of these.

The World Health Organization (WHO), an agency of the UN (United Nations), focuses on international health. WHO has defined a health system, also called a health care delivery system, as ''all the activities... to promote, restore, or maintain health.'' This broad definition includes policies, regulations, laws, and both direct and indirect patient care.

United States Health Care Delivery

In the United States, health care delivery grew from a local family doctor to larger group practices. Often, a family member could be taught to follow the doctor's orders and no outside help was needed. The family paid the doctor however they could, and bartering was common. Hospitals came on the scene to make it easier for doctors to see their patients in one place and for nurses to care for more patients at once. People who had money and could pay for the services of doctors and nurses received health care. Those without money or resources to pay simply managed to get by without professional health care.

That approach to paying for health care changed when Medicare, Medicaid, and employer-paid health insurance arrived on the scene. However, that still left about 15% of Americans who were uncovered and could not afford private health insurance. The Affordable Care Act (also known as the ACA) was a step in trying to close that gap, and - to some degree - it did.

People who had no health insurance coverage prior to ACA could buy health insurance through the insurance marketplace. Depending on their income, they might be able to get help paying for the insurance. Many people chose plans with lower monthly costs so it would be more affordable. Unfortunately, the lower cost plans came with higher deductible and higher co-pays. When the person needed to use his newly acquired health insurance, he was faced with deductibles of $5,000 or more that had to be met before the insurance would pay, and that was in addition to the co-pays.

In practical terms, these individuals still were not covered unless there was a medical emergency. With a continued lack of coverage for everyone, how does that compare to universal health care programs in other countries? First, let's define universal health care.

Universal Health Care

Most industrialized countries other than the United States provide a system of Universal Health Care coverage for its residents. Universal health coverage, commonly known as universal health care (UHC), is defined by WHO as a method to ensure that all people obtain the health services they need without suffering financial hardship when paying for them. According to WHO, health care systems' goals are:

  • Good health for the citizens
  • Responsiveness to the expectations of the population
  • Fair means of funding operations

The U.S. vs. Other Countries

Let's look at the first and third goals and see how the U.S. measures up to other industrialized countries. According to statistics gathered by WHO, there are two countries that spend more money per person for health care than the U.S. (at $9,146). They are Norway (at $9,715) and Switzerland ($9,276). All other countries spend less and have a larger percentage of their population covered, resulting in better overall health outcomes.

So if they spend less, how do they pay for it? There are several ways to fund the cost of UHC:

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