Business Models that Determine the Delivery of Healthcare Services in the United Stated of America
Healthcare is one of the largest single industries that operate in the United States of America. Health policymaking and healthcare services in the U. S. involve a complex network ofdecisions made by various institutions and political actors from both the public and private sectors. Public sector is represented by federal, state and local governments. Private sector includes such institutions as hospitals, insurance companies and nursing homes and such individuals as healthcare providers, healthcare professionals and consumers of healthcare goods and services (Heirich 1998).In addition, a wide variety of interest groups influence and shape the delivery of healthcare services process. Virtually all these institutions and actors interact at every stage of the cycle and each contributes to the process by providing input that often is designed to promote the institution's own interests.
As do all health care systems in different countries, the U.S health caresystem is comprised of five major components: the facilities and institutions where healthcare is provided, people who provide healthcare services, the providers of healthcare pharmaceuticals and medical equipment, the educational and research institutions that train new people and conduct studies on the healthcare services improvement, and finally the financing mechanism, which provides financialresources for all the items listed above.
Five major types of healthcare services sectors are also distinguished here. The differentiation on the sectors is dependant from the type of activity of the institution and its form of property. They are as follows: “the principal governmental healthcare authorities, other agencies of government with healthcare functions, the private healthcare sector,non-healthcare commercial enterprises with healthcare functions, and voluntary healthcare agencies” (Jonas, 2007).
Being an example of the mostly private, the U.S. health system significantly differs from the health systems of other countries due to differences in financing, delivery of healthcare and the scale of the governmental intervention. It is characterized with workers coveredthrough private insurance, even though the insurance is generally bought through employers. Government provides public insurance programs for such groups as the poor, the elderly, and veterans. Nevertheless, an amount of those who cannot afford private health insurance for one reason or another still remains significant.
The United States spends proportionately more money on healthcare thanall other Western industrialized nations. However, despite this fact, it does not rank very high on many healthcare indicators. For example, the United States has a higher infant mortality rate, 9.7 per 1,000 live births, than the majority of developed Western countries and has the lowest life expectancy at birth, 71.5 years for males, among the same countries.
The U.S. health care systemalso has other problems. Healthcare costs continue to soar. The number of uninsured Americans continues to rise and is currently estimated to be around 37 million. Many hospitals in large cities are reporting long waiting lines in emergency rooms, with many Medicaid patients leaving in frustration without receiving treatment. Rising malpractice insurance costs are forcing many of the nation'scommunity health centers to cut or eliminate services for low-income patients. Law enforcement officials in several states after thorough investigation of one of the America’s largest private psychiatric hospital chains, Psychiatric Institutes of America, reported “that it systematically misdiagnosed, mistreated, and abused patients to increase its profits from insurance claims”.