The U.S. has a unique healthcare delivery system that has many problems, much of which lies with the fragmentation of the delivery system. We are a country that is filled with highly educated and experienced health professionals but continue to deliver low-quality and inefficient care in many parts of the country. There are no policies that guide the health care system and primary care providers practicing within the same area, many times, have no connection to each other. The current healthcare models of payment, which include private and public insurers, each have their own set of rules causing further fragmentation of healthcare delivery. All of this leads to increased costs.
Many developed countries, such as Canada and some Western European countries, have national health insurance programs that are government-run and subsidized by general taxes. This coverage is referred to as universal access. The U.S. healthcare delivery system has evolved in response to concerns about access, cost, and quality with the development of the Affordable Care Act (ACA). The ACA was enacted with the goal of increasing the quality and affordability of health insurance and expanding insurance coverage hence decreasing the amount of uninsured in the U.S.
The definition of healthcare is important to the delivery of healthcare services. In the U. S. the medical model has directed the concepts of health and healthcare. Health, as defined by the medical model, is the absence of illness or disease. The primary focus of this definition is medical care delivery or clinical diagnoses and medical interventions to treat diseases, placing health promotion and prevention as a secondary focus. Healthcare should include more than just medical care and should include services that improve a person’s health and well-being (Denisco & Barker, 20130. Holistic care integration into the definition of health has been researched and found to improve overall health and recovery.
Access to healthcare must be both fair and just. Governing the production and distribution of healthcare services are two contrasting theories; market justice and social justice. Market justice puts the emphasis on the individual and their ability to pay. Healthcare delivery under market justice is determined by how much the consumer is willing and able to purchase at the prevailing market prices (Denisco & Barker, 2013). Those individuals that do not have sufficient income can’t obtain health care, therefore, creating a barrier to services. Social justice on the other hand is based on the principle that health care is a responsibility of society that is best achieved by a central agency, such as the government, assuming the responsibility for the production and distribution of health care. This brings us back to the same question that has been asked for years, “Is healthcare a right or a privilege?