10-3: Final Exam
SNHU
IHP-600
1. What are the basic characteristics that differentiate the U.S. health care delivery system
from that of other countries?
The U.S. has a lot of differences in the healthcare field, compared to other countries. The
healthcare delivery system in the U.S. has been categorized as less efficient than in other
countries. The main difference is universal healthcare. The U.S. does not offer universal
healthcare available to all its citizens, instead patients seek care based on their insurance. Most
people have employer based health insurance, others are covered under a government healthcare
program, and others will need to pay for their own private health insurance. If someone doesn’t
have health insurance, they will need to pay for any services they receive as self-pay patients.
Some clinics do offer charity or payment plans to self-pay patients (Shi 1). Another difference in
the U.S. healthcare system is that we don’t have a central agency that controls the system.
Therefore, we also have multiple payers instead of having one central payer, such as the
government, like other countries do.
2. List the four health determinant categories and provide an example of how the
government is supporting improvement in each determinant.
The four health determinant categories are environmental, behavioral and lifestyle,
genetic factors, and medical care (Shi 36). Environmental factors can include socioeconomic and
sociocultural factors. The government can help by offering education and basic needs to low
income neighborhoods. Behavior and lifestyle can include diet, exercise among other things. The
government can help by offering programs at schools and clinics that teach people about the
importance of diet and exercise as well as mental health. Hereditary aspects can affect people too
as sometimes they are more prone to a specific disease, therefore people should be educated in
ways they can take care of themselves and try to prevent disease. The government can also help
communities by offering easy access to medical care. Rural communities might be more at risk
of not receiving medical care because they are so far from cities with hospitals. These
communities can have clinics on site, therefore people can have access to basic medical needs.
(Shi 37).
3. Explain how the United States has both market and social justice aspects of health care.
Market justice is a healthcare delivery system based on people’s ability to pay for
medical care. In the U.S., market justice is employer-based health insurance, self-employed
health insurance, and private health insurance. These are all health plans according to what each
person can afford. Social justice is the opposite, in which being able to access healthcare is not
based on what you can pay. It is like an essential right, and everyone has access to medical care.
This is seen in countries with universal healthcare. However, in the U.S. we see a type of social
justice system, which is the government based healthcare programs. If someone is not able to pay
for health insurance, then they qualify for a government health insurance program. These
programs do require the person to meet certain qualifications, such as being unemployed or
employed but low income, among others. We see both systems used in the U.S. (Shi 17).
4. Discuss reasons why national health insurance has not developed in the United States.
Around the time of World War 2, employer based health insurance started. It was a
benefit started by companies as wages could not be increased according to law, therefore they
began offering other benefits, such as health insurance. Even before employer health insurance
started, national health insurance carried a stigma comparing it to socialism and even
communism. Since the U.S. is a capitalist country, companies have been using this to lobby
against national health insurance. For example, the American Medical Association (AMA) is an
association of medical professionals and students, and they also lobby for and against certain
health topics. They are the biggest organization opposing national healthcare, and as such, they
lobby against it (Shi 66).
5. Explain how interest groups affect health care policymaking in the United States.
Like the AMA, other organizations also lobby for and against certain healthcare topics.
Therefore, interest groups can affect healthcare policymaking by lobbying and putting their
resources to use. These groups spend money towards different goals, they attend conferences, set
up public meetings, make phone calls, etc. All efforts go to changing policy and the public's
mind. In 1948, “the AMA launched what was to become one of the most expensive lobbying
efforts in U.S. history. Its campaign directly linked national health insurance with communism
until the idea of socialized medicine was firmly implanted in the public’s minds. By 1950,
national health insurance was a dead issue, and it remained so for several decades” (Shi 66). This
is a great example of lobbying and how it can influence people.
6. How can technology reduce health care costs?
Technological innovations have mostly raised costs in the healthcare industry; from
obtaining new equipment to training the people in the new equipment, and other costs. Besides
the increase of costs, there are also benefits to technology as it can reduce healthcare costs. As
technology advances, less expensive treatment options might become available as well.
Expensive procedures can be replaced with cheaper procedures. Technology can also help
procedures become less invasive, therefore hospital stays might not be needed (Shi 114). Also,
training staff might be expensive at first, but after some time, it might reduce labor costs. For
example, computer software makes it easier to take notes, medical coding is also more efficient
and faster than it was in the past.
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?
There are different technologies affecting healthcare. Patient care delivery such as
telemedicine, and software that keeps and tracks medical records, and billing. Patient care
delivery has been positively affected by technological innovation, because it helps providers
keep better track of patient records, therefore mistakes are less likely to happen. Also, billing has
been more efficient, as people used to handwrite bills to insurance companies, now it is
electronically sent to insurance companies, therefore less mistakes and payments tend to come
faster as well. With Doctors, technology has helped quality, diagnostics, and treatment (Shi 103).
For example, many years ago, there was no cure for certain diseases and illnesses, but there are
cures now.
8. Discuss the four main aspects of globalization in health care delivery.
Globalization is when a company or organization operates internationally, so it works
nationally but also reaches other countries. One aspect is telemedicine or outsourcing medical
services out of the country. Examples of outsourcing include, data entry, translator, billing and
coding, among others. Second aspect can be medical tourism, which means patients travel to
other countries seeking medical care. For example, stem cell treatments are not all allowed in the
U.S., therefore some people might travel outside the country, in order to receive stem cell
therapies. Other people also travel in order to receive less expensive treatments. Another aspect
is investment and collaboration with other healthcare organizations, even international
organizations. Last aspect is that health professionals travel to other countries where their
services are needed (Shi 71). Sometimes they can go to countries on medical missions, even
when the pay might be a lot less than they will get in the U.S.
9. Explain the significance of gatekeeping in regard to primary care and keeping health
care costs Down.
Gatekeeping is when all medical care goes through a primary care physician. The PCP is
in-charge of a patient’s medical care, and if more testing or more treatment is needed, then it
needs to be approved (referred) by PCP. This ensures the patient is only receiving necessary
treatment. It also helps keep health care costs down as the patient will not pay for unnecessary
treatments and procedures they don’t need (Shi 195).
10. How does a third-party payment system increase health care costs in today’s society?
Health insurance is the party making payment for healthcare services. Patients and
providers don’t usually have costs, therefore they might not care about how many services are
being used. It is different if the patient has costs as they would be more careful on what services
they would use, as they wouldn’t want to pay for something non-necessary (Shi 252). This is
why health insurance companies and medical providers sometimes agree on contracts in which
they agree to a contracted rate for each procedure, this way they can try to control some of the
costs.
References
Shi, L. (2023). Essentials of the U.S. Health Care System. 6th Edition. Jones & Bartlett Learning.
