Health Care Delivery System

Health Care Delivery System The American healthcare system is a very complex system that utilizes the private sector to grow and impact medical research and technology in the attempt at making healthcare more beneficial for patients. There are three main categories of players in the American healthcare system, each with a distinct role. The first category is administrators. Included in this category are physicians and hospital administrators. The next category is insurance companies. Companies such as Aetna provide healthcare coverage for citizens and pay percentages to the administrators.

The final player is research. This includes the medical drug and technology companies that continue to expand and improve modern medicine. Hard providers are those that utilize strict healthcare management systems and refuse to grant coverage to anyone seeking to go outside of that coverage. For instance, if a person wishes to see a doctor that is not within the hard provider's network, then the costs would be paid out of pocket.

Soft providers are those that use a more flexible network with recommended care options, but do not require that those covered under the plan utilize these services. The majority of American healthcare is paid for by health insurance providers. According to recent figures, 84.7% of Americans have health insurance. The average U.S. Citizen spends $7,026 annually on medical-related expenses (OECD Health Data, 2011). Managed care is a series of techniques used by hospitals and physicians in an attempt to reduce overall medical costs.

The most common technique is using an integrated medical delivery system where insurance companies contractually arrange themselves with specific physicians and hospitals and require that patients remain within that specific network of care. Other types of managed care include case management, disease prevention, and wellness incentives. The iron triangle of American healthcare involves three healthcare delivery factors, quality, cost, and access. These three factors are constantly at odds in the American healthcare system. For instance, it is impossible to give the.