Health Care Delivery System in the United States

Last Updated: 24 Jun 2020
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Abstract The United States health care delivery system is comprised of a complex, unorganized and flawed health system, compared to that of Australia’s health care system. The four components of the inefficient system in the United States are categorized into a quad-functional model. Financing, insurance, deliver and payment are the four flawed components. Australia’s efficient and organized system is based on a national health system, which consists of one central agency; the government. The United States health system is comprised of countless public and private entities.

Australia’s health care system is superior to that of the United States. Table of Contents Title Page……………………………………………………………………………………1 Abstract……………………………………………………………………………………... 2 Table of Contents……………………………………………………………………………3 Introduction…………………………………………………………………………………. 4 References…………………………………………………………………………………... 9 Introduction The quality of health care is vital to a nations well being. The United States is comprised of one of the most complex health care delivery systems throughout the world.

The complexity of the United States health care delivery is comprised of countless individuals and organizations, which include both public and private entities. Unlike the health care delivery system of Australia, the network of interrelated components of the U. S. health care system does not work together in an organized and efficient manner. Some of the components tend to overlap one another. The United States health care delivery system is based on the quad-function model, which consists of four components that are categorized into financing, insurance, delivery and payment.

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The fact that the United States health care system is not governed by a single central agency, opposed to Australia’s national health system, countless Americans endure physical and emotional suffering from the inefficiency of the system. Financing is one of the most important components of health care delivery system in the United States. This component pertains to the methods of paying for costly diagnostic tests, procedures, hospitals visits and treatment. Demand and supply has inflated the cost of health related services.

Paying for health services is extremely costly without health insurance. Thanks to the a majority of employment establishments, most employed Americans, as well as their dependent children and spouses, are provided affordable health insurance. Although most employed Americans are provided health insurance, the United States health delivery system is fragmented and lacks to provide much needed health insurance for the majority of the unemployed American population. The second component of the quad-functional model pertains to insurance.

Ownership of a health insurance plan protects individuals against health related issues. Insurance is very beneficial during occurrences when needing costly health care services. Insurance policies also determine the extent of health services the insured individuals are entitled to receive. Most insurance policies specify details of the health care policy holders are entitled to receive. Unlike Australia, the citizens of America, except for the elderly who receive Medicare, must obtain their own insurance. The third component of the United States quad-functional model pertains to delivery.

In terms of delivery, the quad-functional model refers to the proviso of health care services, along with the receipt of insurance payments for the health related services received. The payments are paid to providers who deliver health care supplies and services. The recipients of payment consist of doctors, therapists, hospitals, diagnostics and imaging clinics, and suppliers of health care related equipment. The difference between the health care systems of the United States versus the health care system of Australia is that Australia’s healthcare system is based on a national health care program.

The highly organized and efficient system mainly consists of private practitioners (Hall 1999; Podger 1999). The fourth and final component of the United States quad-functional model pertains to payment. The payment function deals with reimbursement to providers for services delivered. Reimbursement is the determination of how much to pay for a certain service. The fact that Australia’s health care system is based on a national health care program, individuals who receive health related services are not overwhelmed with stress of worrying about making payment the providers of health services.

Australia’s government handles all aspects of health care. The four components of the United States health care system dramatically vary from the components of the health care system in Australia. The health care system of Australia is classified as a national health care system. Unlike the United States, Australia’s health care system is referred to as a single-payer system or a system that is governed by a single central agency; the Australian government. The government finances health care through the means of general taxes, even though health care is delivered by private providers.

The benefit of a central agency governing the health care system is that it eliminates the complexity by eliminating components that exists in the multi-payer system of the United States health care system. Although the citizens of the United States are free to choose the method of obtaining health care, countless individuals are left without any means of health care. There are many negative characteristics that differentiate the United States health care delivery system from that of other countries, such as Australia. These characteristics result in fragments and inconsistencies within the system.

The United States health care system is flawed based on the fact that it is not governed by a central agency, health care services are limited to the confined terms of the insurance policy, multiple public and private entities results in lack of efficiency, and extremely high cost of health care services. Australia spends 8. 7 percent of its GDP on health care and covers everyone, irrespective of their employment status (Grant 1987; Lapsley 1987) Due to the complexity and inefficiency of the United States’ health care delivery system, many people in the U. S. go without much needed health care.

The extremely high cost in the U. S. results in countless uninsured American from having the financial ability to receive access to health care services. More than two-fifths of lower-income adults in the U. S. said they went without needed care because of costs in the past year (Davis 2007; Schoen 2007; Holmgren; Shea 2007). The uninsured have options to receive services at county hospitals and government establishments, but their quality of services is much lower. The finding from my in depth research indicates that many changes need to be implemented into the health are delivery system in the United States, to improve the complex and fragmented system. The private health insurance covers care received in private hospitals (Australian Government 2004). To improve quality of life, the system in the United States should be changed from a multi-payer to a single-payer system, which is classified as a national health system or NHS. Aquiring private health insurance is voluntary, but strongly encouraged by the Australian government through tax subsidies for purchasers and tax penalties for non-purchasers (Healy 2002).

The government will manage the overall infrastructure of the health system, without any regard to capitalism. All entities who seek personal financial gain will not be included in the NHS. This change will terminate most of the components that bring injustice to the citizens who are excluded, which mostly consists of unemployed individuals. The United States economy is driven by capitalism, where the where motives behind actions derive from pursuit of monetary gain. In a loosely organized system, countless entities and individuals seek monetary gain, without regard or compassion for human life.

Greed is the main element in the United States complex health care delivery system. In 1998, the death rate pertaining to the health care delivery system was 25 to 50 percent higher in the United States than in Australia. Australia ranks highest on healthy lives, compared to the United States (Davis 2007; Schoen 2007; Holmgren; Shea 2007). The implementation of a national health care system, similar to that of Australia, will foster ethical practices and equality for all citizens of the United States.

This change will impact health professionals greatly. Most likely their salaries will be reduced drastically and their employers will be the national government. In my opinion, most physicians are overpaid currently. Price inflation based on a free market economy will be more controlled. References Australian Government, Department of Health and Ageing (2004). Australia: selected health care delivery and financing statistics. Davis, K. , Schoen, C. , Schoenbaum, S. C. , Doty, M. , Holmgren, A. L. , Kriss, Shea, K. Mirror, Mirror on the Wall (2007): An International Update on the Comparative Performance of American Health Care, The Commonwealth Fund, 3. Grant & Lapsley (1987). The Australian Health Care System, 1987, 139, Table 7. 15 Hall, J. 1999. Incremental change in the Australian health care system. Health affairs 18, no. 3:95-110 Healy, J. 2002. Australia. In Dixon, A. , and E. Mossialos, eds. Health care system in eight countries: trends and challenges. London: The European Observatory on Health Care Systems, London School of Economics & Political Science, 3-16.

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Health Care Delivery System in the United States. (2017, Apr 07). Retrieved from

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