Introduction to the U.S. Health Care System

Titelangaben

Sezer, Meltem ; Bauer, Franziska:
Introduction to the U.S. Health Care System.
In: Schmid, Andreas ; Singh, Simone (Hrsg.): Crossing Borders - Innovation in the U.S. Health Care System. - Bayreuth : P.C.O. , 2017 . - S. 11-28 . - (Schriften zur Gesundheitsökonomie ; 84 )
ISBN 978-3-941678-63-7

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Abstract

One of the key topics of political discussion in the U.S. these days is its healthcare system. Most recently, “repeal and replace” has been the pivotal issue of political debate. The urge to reform the Affordable Care Act comes not from its many accomplishments, such as reducing the uninsured rate, but from what still needs improving: healthcare costs and spending. In this context, the “Triple Aim” approach is the center of focus within the healthcare system and will be portrayed in this essay after giving a short overview of the U.S. healthcare system itself. The framework of the “Triple Aim” consists of goals aiming to improve the experience of care and health of the population at a lower per capita cost. Providers of the U.S. healthcare organizations are being paid by a hybrid structure with different insurance forms existing parallel to each other, resulting in an inefficient and extremely fragmented healthcare system. Like most other countries, there are both private and public insurers in the U.S., with payments coming from two main sources which will be explained in this essay. Political efforts play a big role in the American healthcare system. Health insurance marketplaces initiated by the Affordable Care Act come short of achieving managed competition where choice drives efficiency. High administrative costs also contribute to the current inefficiency of the American healthcare system, making it difficult to reach the Triple Aim. The goal of the Trump Administration to change regulations of the Affordable Care Act could not be reached either, letting the final structure and outcome of the U.S. healthcare system be unknown.