Health care is a huge industry. It can account for between 3 and 18 percent of a country’s gross domestic product, depending on the country. Health care is a service industry, and it provides vital employment opportunities to skilled and unskilled workers. It can support communities, bringing economic prosperity and a sense of social well-being to a region. It can also be an important part of a country’s cultural fabric, bringing together people from many different backgrounds and facilitating the development of a strong sense of community.
The primary functions of the health care system are diagnosis, treatment and prevention of disease, rehabilitation, and palliative care. These services are provided by trained medical professionals. The health care system must be accessible and affordable. All people, everywhere, have the right to achieve the highest attainable level of health.
There are many ways to pay for health care, and the system varies widely between countries. Some countries have a single-payer system, in which all citizens pay taxes into a fund that covers their healthcare. Others have a mix of private and public insurers. In the United States, health insurance is a major component of the economy and covers approximately one-third of all spending on healthcare.
In addition to paying for coverage, Americans must bear the burden of expensive administrative costs associated with the delivery of health care. This includes patient out-of-pocket expenses such as copayments and deductibles, which can be deterring for low-income individuals. The complexity of the billing and coding systems required by insurance companies to reimburse providers for their work adds significantly to these out-of-pocket costs. A small number of physicians have opted to waive insurance entirely and charge a monthly retainer fee to patients for access to their services, a practice known as concierge medicine.
A key issue for all health care systems is finding a way to provide high-quality and cost-effective healthcare at the right time and place. For example, preventive health screenings can detect cancer or other diseases at early stages, when they are easier and less costly to treat. Yet these services are often overlooked, and they are not always available close to home.
The United States performs better than most countries on measures of care process but worse on those of outcomes. This may reflect the aggressive “pay for performance” or value-based purchasing efforts that many private and public payers have undertaken in recent years. These efforts can help drive more consistent conformance with clinical guidelines, particularly for preventive services. Additional research is needed to determine whether these efforts are helping improve health outcomes in the U.S.