In the United States, the healthcare system refers to a diverse and complex web of medical providers, supporting businesses, health insurance companies, and government agencies. According to Walden University, about 18% of the country’s annual GDP funds these organizations. This figure translates to $3 trillion of the American economy each year.
Healthcare has grown into a pervasive part of an individual’s daily life and the economy of society. On a personal level, most people make frequent choices that impact their health. These decisions range from scheduling a routine checkup to making food choices for snacks or meals, making a good understanding of the healthcare system essential for choosing sound options.
What Makes Understanding the Healthcare System Challenging?
The size and complexity of the healthcare system can make it challenging to understand. For instance, it includes such businesses as clinics, hospitals, labs, and pharmacies. It also encompasses drug companies, nursing care communities, and medical device manufacturers.
Most folks or their loved ones have interacted with these types of businesses. Especially when people need to coordinate care between different entities, they should understand the importance and difficulty of making good healthcare decisions.
Even more, everybody doesn’t refer to the same thing when discussing healthcare. Indeed, many people, including politicians, mean health insurance when they refer to the healthcare system. Even so, private health insurance companies fall into the financial industry more than the healthcare industry. Public health programs, such as Medicare and Medicaid, also make up a substantial portion of the healthcare system.
These private businesses and government programs can help more people access medical care. At the same time, they add to the complexity.
Why Is Healthcare Essential to Understand?
The types of medical providers vary wildly. Various public and private health insurance programs also differ, each with its own elaborate rules. Sometimes, patients present the only apparent connection between all these components. Thus, understanding the entire healthcare system might offer an impossible task for any one person.
At the same time, individuals, families, and healthcare employees should learn about slices of the healthcare pie that pertain to them for several excellent reasons:
- Improve individual and family health: Individuals and families can make better decisions. Information about healthcare options can improve the choice of employee benefits, health insurance, preventive care, and even lifestyle choices.
- Reduce healthcare costs: Most people control out-of-pocket medical expenses with public or private insurance programs. Informed people can learn which programs they qualify for and do a better job of balancing benefits and costs.
- Enhance public health: Understanding community, national, and global healthcare needs helps people work together for the public good. High-quality information helps voters and politicians make better choices for public health policies.
- Better-run healthcare businesses: The complexities of the healthcare system challenge providers because they have to work with other pieces of the system. Many healthcare businesses work with a healthcare consulting company to ensure they can efficiently deliver good patient outcomes, stick to their budgets, and remain in compliance with another source of complexity: government regulations.
Should the Public Simplify the Healthcare System?
Many policy experts believe that simplifying the healthcare system would yield obvious advantages. Some potential benefits of a streamlined system could include greater efficiency and accessibility. In turn, these benefits should lead to improved health outcomes, lower costs, and more transparency.
At the same time, various stakeholders include patients, health insurance companies, medical facilities, and manufacturers, all with their own competing motivations. Other folks have concerns that upsetting the status quo may lead to unintended consequences, such as shortages of vital services.
Undoubtedly, it will take time before the public achieves the admirable goals of a better and simpler healthcare system. Today, everybody should strive to understand the current healthcare system, at least regarding their own needs.