IHP 600: Final Exam
Southern New Hampshire University
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1. What are the basic characteristics that differentiate the U.S. health care delivery system
from that of other countries?
The U.S. healthcare delivery system differs quite a bit from other countries. Unlike other
countries, the U.S. does not have a universal uniform health care system, universal health care
coverage, and only recently enacted legislation mandating healthcare coverage for almost
everyone. “Rather than operating a national health service, a single-payer national health
insurance system, or a multi-payer universal health insurance fund, the U.S. health care
system can best be described as a hybrid system” (Barrows, 2020). Financing of health care is
either public or private and includes public programs such as Medicare and Medicaid. These
programs are financed by the federal government. Majority of all other health insurances are
privately held. Also, high administrative costs are a contributing factor to the inflated costs of
U.S. health care (Barrows, 2020). While the majority of U.S. citizens have health insurance,
premiums are rising, and the quality of the insurance policies is falling (Barrows, 2020).
2. List the four health determinant categories and provide an example of how the
government is supporting improvement in each determinant.
Four health determinant categories that were discussed in our text are environmental, behavior
and lifestyle, heredity, and medical care. Environmental factors encompass the physical,
sociopolitical, and sociocultural dimensions of life (Shi & Singh, 2017). The United States
Environment Protection Agency is a federal program that is tarted to protect both people and the
environment from significant health risks by sponsoring and conducting research in which
environmental regulations are enforced (EPA.gov, 2022). a Behavior and lifestyle include diet,
exercise, a stress-free lifestyle, risky or unhealthy behaviors, and other individual choices that
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may contribute to significant health problems (Shi & Singh, 2017). Multiple health classes are
offered by hospitals which majority are government funded to educate the people about healthy
lifestyle modifications. Some of these classes include wellness programs which include classes
on diabetes. These classes help people who are dealing with diabetes and educate them how they
can improve their health as well as tackle the medical condition. Heredity factors include an
individual’s genetics and help determine their predispositions to certain diseases, illnesses, or
medical conditions. The National Institutes of Health awarded a genetic testing company in
Burlingame, California to offer genetic testing to individuals who would like to know about
possible health conditions that they are likely to get. Medical care is a key factor in influencing
health. Both individual health and population health are closely related to access adequate
preventive and curative health care services (Shi & Singh, 2017). During this pandemic, the
COVID vaccine was available to the general population in which incentive programs were being
placed to reward as well as help individuals fight the Coronavirus. In California, Uber vouchers
were given to patients who had no transportation in getting the vaccine.
3. Explain how the United States has both market and social justice aspects of health care.
The United States has both market and social justice aspects of health care within its system.
Market justice places responsibility for fair distribution of health care on market forces in a free
economy (Shi & Singh, 2007). Meanwhile, Social justice emphasizes the wellbeing of the
community over that of an individual; thus, the inability to obtain medical services because of a
lack of financial resources in considered unjust (Shi & Singh, 2017). An example of market
justice is how the insurance medical coverage and benefits are distributed solely based off of an
individual’s ability to pay. A person will only aim to receive health insurance if he or she can
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afford it. Financing for healthcare should be based off of need rather than cost is a prime example
of Market justice. The US healthcare system gears social justice through Medicare and Medicaid
to support those who cannot afford insurance or who are disabled, injured disease, elderly, and
young. The market justice side drives profit competition for insurance companies (HMOS,
PPOS) to hire and drive competition, technology and implement highest quality of through
people. The theory is that social justice keeps the majority of the population health and uses
standards to drive competition. The market justice system lets the people through capitalism
drive competition, and improvement.
4. Discuss reasons why national health insurance has not developed in the United States.
National health insurance has not developed in the United States because it deviates from our
beliefs, values, and culture as well as creates challenges to players within the system. Health
insurance within the United States is more so an economic interest rather than the individual’s
health. Americans have also supported the ideologies of capitalism, self-determination, and
distrust of big government. Another reasoning is that powerful interest groups, primarily the
AMA, have consistently opposed national health care.
5. Explain how interest groups affect health care policymaking in the United States.
Interest groups, AARP, the AHA, and the AHCA, can support expensive lobby campaigns and
influence policy changes. Interest groups allows companies combine their resources to make
health care more affordable which they are able to offer more services to consumers by cutting
the cost which allow the physicians to provide services and guarantee the consumers they will be
able to afford and pay their bill. Policies are often designed to satisfy key interests and demands
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of these groups and rep- resent a variety of individuals and entities (Shi & Singh, 2017). Interest
groups have collective resources that can drastically impact political markets and change
policies.
6. How can technology reduce health care costs?
Technology can reduce health care costs by the replacement of more expensive procedures and
less invasive procedures that eliminate hospital stays. Innovations have paved the way for new
procedures and treatments. Initial investment in new technologies is costly. Facilities can recoup
these costs by providing proper training to employees and mainstreaming the technologies.
7. Improving access to medical care has been a challenge in the U.S. health care system.
How has technology affected access to medical care?
Technology has had a positive effect on access in rural and geographically remote areas. Mobile
equipment can be transported to these sites. Telemedicine has enabled generalists to consult
specialists located at a distance without having to transport the patient to a distant medical center.
Technology has also made it possible for many patients to receive in home care instead of being
admitted to a healthcare facility. Telemedicine and telehealth have also benefited patients. This
technology allows for patients to access health care remotely from the comforts of their home.
8. Discuss the four main aspects of globalization in health care delivery.
Globalization refers to various forms of cross border economic activities including information
exchange, goods and services, and interdependence of economies (Shi & Singh, 2017). Cross
country telemedicine and outsourcing of resources allows for health care delivery anywhere in
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the world. Medical tourism, when patients travel abroad for medical care, allow for patients to be
treated in advanced facilities for a fraction of the cost in their home market. Foreign direct
investment in health services enterprises has become common (Shi & Singh, 2017). Health
professionals move to other countries that present high demand for their services and better
economic opportunities than their native countries.
9. Explain the significance of gatekeeping in regard to primary care and keeping health care
costs down.
Gatekeeping lowers costs by eliminating unnecessary trips to specialist and incurring higher
prescription costs as well as health assessment expenses. Gatekeeping is very important to
primary care because of the ability to lower costs but also is in place to improve or upgrade our
primary care services, more comprehensive. Primary care coordinates the delivery of health care
services between patient and other entities within the system. Patients may not always see a
specialist unless referred by their primary care physician. This reduces costs through means of
not subjecting patients to unnecessary procedures or tests.
10. How does a third-party payment system increase healthcare costs in today’s society?
Third party payment systems are contributing to the increasing health care costs. This is due to
reimbursements being paid to the health care system as opposed to the patient. It also shields the
consumers from the direct or true cost of the service. Facilities usually use a contract rate when
providing services and bill the insurance directly. As a result, the propensity to utilize greater
quantities of health care than one would if services are paid out of pocket leads to excessive
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utilization (Shi & Singh, 2017). Another factor is fraud. There have been reports of higher priced
services being billed when a lower priced service was delivered.
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References
• Shi, L., & Singh, D. A. (2017). Essentials of the U.S. health care system (4th ed.).
Burlington, MA: Jones & Bartlett Learning.
• Barrows, K. (2020, March 3). The U.S. Health Care System: An international perspective
- department for professional employees, AFL. CIO. Retrieved from
https://www.dpeaflcio.org/factsheets/the-us-health-care-system-an-international-
perspective
