Sample Coursework Paper on Healthcare Delivery on Micro and Macro Levels

The major target of the current healthcare reform is to ensure that a greater segment of the United States’ population is able to access quality healthcare. Currently, healthcare cost constitutes a huge fraction of the nation’s GDP; therefore, one critical focus is to bring down the overall healthcare cost in the U.S. (Essential dental public health, 2013).

The American national expenditure in healthcare is greater than that in all other countries that are members of Organization for Economic Cooperation and Development.

A major reason for the huge healthcare expenditure is the private health insurance organizations that incur a lot of redundant costs in management (Wolper, 2004). The cost is subsequently transferred to the patients and the national government that reimburses the healthcare providers for their service to patients who are on government insurance – Medicare and Medicaid. The other cost comes from medical technologies that are highly expensive. The reforms have influenced many people in the US society to access health insurance cover and reduce the individual expenditure, and hence the national budget (Essential dental public health, 2013)

Managed Care

It refers to techniques that aim to reduce overall costs of healthcare in the U.S. It was spurred by the enactment of the Health Maintenance Organization Act of 1973, which sought to reduce costs while still ensuring quality healthcare for the clients. It has helped to make healthcare both efficient and competitive, and reduced inflation since the 1980s.

Three major arrangements exist; the first arrangement concerns the Health Management Organization, which enables the subscribers to choose the primary care doctor (Wolper, 2004). PPOs pay more within the network, and when they go outside, they get help with the payment. POS enables the patient to choose at the instance of need. The overall impact has been lower cost, and in some cases, it has led to poor quality care for patients who are in need of serious care.


Essential dental public health. (2013). Oxford: Oxford University Press.

Wolper, L. F. (2004). Health care administration: Planning, implementing, and managing organized delivery systems. Sudbury, Mass: Jones and Bartlett Pub.