Health care encompasses an ecosystem of businesses and services dedicated to improving and maintaining human health, such as physician offices, hospitals, labs, radiology centers and physical therapy clinics.
Some individuals believe healthcare should be allocated with maximum efficiency in mind; others place greater importance on fairness as an important consideration.
Costs
Health care costs can have an enormous impact on patients in several ways. High deductibles and out-of-network fees may prompt individuals to skip physician visits out of fear for the bills that will follow; rising medical inflation threatens the purchasing power of household incomes dedicated to healthcare expenditure.
Most insurers pay physicians on a fee-for-service basis, meaning each test or procedure results in an additional bill to the payer. Unfortunately, this system often leads to redundant testing and overtreatment – including for those without any hope of improved health outcomes.
High healthcare prices can also be attributed to increased provider consolidation, leading to near-monopolies that can raise prices without facing competition from competing services. Consumers bear these higher costs in the form of rising premiums on private health insurance policies primarily funded by employers; individuals may bear some health care expenses directly through workers’ compensation and temporary disability premiums and Medicare hospital insurance payroll taxes.
Quality
Although many countries have made great strides toward improving health care quality, reaching this goal remains elusive. Achieve it requires clear vision, achievable initiatives, competent implementation and frequent evaluation. Also remembering to be patient throughout this process!
An integral step in defining healthcare service quality is understanding what patients want. This should encompass considerations like safety, effectiveness, patient-centredness, timeliness and efficiency as well as protecting those most at risk while encouraging innovation. A quality system should also prioritize protecting vulnerable groups while encouraging innovation.
To accurately assess quality, it is vital that information used in its evaluation be complete, relevant and accessible; standardization allows easy comparison; validity means being reliable and impartial – this criteria may be established through quality standards, which can then be measured against benchmarks such as SOPs or clinical guidelines.
Access
Health care access refers to our ability to use medical services for health promotion and maintenance, which is determined by an individual’s finances, social expectations and physical limitations. Barriers such as poverty are especially influential on accessing care – those living below poverty line tend to delay seeking medical assistance due to high out-of-pocket costs, are less likely to have private health insurance plans and cannot afford medications as quickly.
Health systems are working to address this challenge by increasing access to clinicians and facilities. This involves optimizing scheduling capacities, decreasing no-show rates, creating a standardized referral process, as well as increasing access through education about different forms of care – retail clinics, urgent care centers, microhospitals, freestanding emergency departments. Such interventions allow patients to make more informed decisions when seeking medical assistance.
Financing
Finance of health care is an integral component of its system, impacting patient choice and their interactions with physicians on an economic basis.
Finances of health care also determine the quality of services provided. Financing includes both methods for raising funds and allocating them effectively; most national health expenditures consist of healthcare services and supplies (HSS), while private revenue includes gifts from philanthropists or revenue from non-health services like cafeteria or gift shop operations.
Out-of-pocket spending tends to be lower in countries that primarily fund healthcare through public funds through universal insurance or voluntary coverage, such as universal Medicare coverage. Conversely, out-of-pocket expenditure in countries with greater private funding than public spending on health is significantly higher, due to current payment policies which pay providers differently depending on where their service was provided (i.e. hospital, ambulatory surgery center or physician office). Such inequities could be addressed more fairly with site neutral payments.
