U.S. Healthcare Systems
What are the four basic functions of the U.S. health care delivery system?
What are financing, insurance, delivery, and payment?
This is the amount an individual or employer pays to maintain health insurance coverage.
What is a premium
This philosophy argues that market forces should determine the distribution of health care services.
What is market justice?
In this country, health care is largely financed through government taxation but services are delivered by both public and private providers.
What is Canada?
Diet, exercise, smoking, alcohol use, and other personal choices fall under this determinant.
What are behavior and lifestyle?
his function involves obtaining money to pay for health insurance or health care services
What is financing?
This type of payer pays for medical services on behalf of the patient and is a major feature of the U.S. system.
What is a third-party payer?
This philosophy views equitable distribution of health care as a responsibility of society.
What is social justice?
In this country, the government manages much of the health care infrastructure and finances a tax-supported national health service.
What is the United Kingdom?
This determinant includes genetic factors that can predispose a person to certain diseases.
What is heredity?
Physicians, hospitals, nursing homes, and diagnostic centers are examples of organizations involved in this function.
What is delivery?
Under this arrangement, an employer assumes responsibility for paying its employees' health claims rather than purchasing traditional insurance.
What is self-insurance?
Under market justice, access to health care is largely based on a person's ability and willingness to do this.
What is pay?
This country uses government-mandated contributions from employers and employees to finance its health insurance system
What is Germany?
Air pollution, contaminated food and water, radiation, and toxic chemicals are examples of this type of determinant.
What are physical environmental factors?
The U.S. healthcare system is often described as having this characteristic because it does not have a single unified structure.
What is fragmentation?
This system attempts to coordinate care and control costs through mechanisms such as provider networks and utilization controls.
What is managed care?
This term refers to the fair distribution of health care resources and essential services throughout society.
What is distributive justice/equity?
Germany's health insurance system traditionally relies on these organizations to collect contributions and pay providers.
What are sickness funds?
Access to preventive and curative health services falls under this determinant.
What is medical care?
The two major objectives of a health care delivery system are to provide access to needed services and accomplish this second goal.
What is providing services efficiently/cost-effectively while maintaining quality?
Why is health insurance considered an intermediary in the U.S. health care system?
What is because it connects patients who need care with providers while helping finance and pay for services?
A major criticism of relying primarily on market justice in healthcare is that it can result in this problem for people who cannot afford care.
What is unequal access to healthcare?
What major characteristic distinguishes the U.S. system from many countries with universal health care?
What is the United States relies heavily on a mixture of private insurance, employer-sponsored coverage, and public programs rather than one universal system?
Name the four broad dimensions of environmental factors that can affect health.
What are physical, socioeconomic, sociopolitical, and sociocultural factors?