The Structure of a Health Care System
The structure of a health care system provides a framework for the delivery of services to a wide range of people and communities. There are four distinct levels to the health care system: individual care providers, microsystems and the organization. These layers include decision-making systems, information systems, operating systems and processes. They coordinate activities across multiple care teams and manage the flow of resources. The organization is a key component in achieving an integrated health care system.
The structure of a health care system varies from country to country, based on the culture and economics of a region. Health care is increasingly viewed as a human right, with certain populations valuing prevention of disease over addressing specific illnesses. The health system’s design, financing and management must balance competing priorities and the ability to provide high-quality, affordable care to all citizens. The structure of health care systems is also affected by cultural, economic and political factors.
The costs of the health care system have become increasingly burdensome on employers, who have shifted costs to employees by introducing higher premiums, eliminating coverage for dependents, reducing coverage, and increasing deductibles and copayments. Private insurance companies have also become more aggressive in eliminating benefits, while tying premiums to prior year expenditures. The system has become increasingly fragmented, which creates problems for patients. The American health care system is a complex web of regulations and overlapping responsibilities.
A country’s health care system reflects its culture and history. It can be categorized into two main types: public and private. Public health systems are generally financed by general tax revenues. Countries with public health care systems include Great Britain, the Scandinavian countries, and former Soviet republics. Germany, Canada, and France all have universal health insurance. Public health care systems may require private insurance to ensure coverage for citizens. They also differ greatly in their level of coverage.
Ideally, patients become partners in their care. The clinicians should incorporate patient values into their decisions and practices. The amount of responsibility patients take depends on their preferences. While some patients are content with delegating decision-making to their trusted clinicians, others prefer to take full responsibility. Either way, it’s critical that patients are free to share information and communicate with their care team. Informed decisions can lead to better outcomes. And a patient’s values must be respected.
The optimal health care system should take into account both quality and productivity. Although both are important in their own ways, they may conflict. For instance, patient-centeredness may be more important than cost-cutting. Productivity can be defined as increasing the number of patients served per hour, while patient-centeredness may mean fewer wait times. However, the quality and efficiency of care must also be reflected in the system as a whole.
The proportion of public financing in health care systems has been increasing steadily. It increased from 23.3 percent in 1960 to nearly 44.3 percent in 2000. In contrast, countries with strong central control tend to have a small private health insurance market. The wealthy and politically connected often opt for private insurance as it provides better access to medical services. Further, countries with a mixed system have a market for private health insurance. So, how does the health care system compare to the U.S. health system?