The term health care is generally used to describe medical services and other activities related to the prevention, diagnosis and treatment of illness and injury. It is a major industry, consuming anywhere from 3 to 18 percent of gross national product in most countries and supporting large numbers of skilled professionals and unskilled laborers. It is also vital to local economic well being and often a source of pride and community identity. It is one of the most highly regulated industries. It is expensive, and its effectiveness in preserving or improving health is uncertain. Its use varies considerably across small geographic areas and among patients, for reasons that cannot be fully explained.
Individuals want health care that maximizes their potential for good health and is accessible to them in ways that do not impose excessive burdens on them or society. Physicians feel a special responsibility to provide their patients with care that is safe, effective, patient centered, timely and efficient. They are concerned about a growing trend toward the integration of financing and delivery of services, which may increase the financial risk to them and their patients. They are troubled by increasing marketing activities that emphasize price competition and by the prevalence of for-profit enterprises in health care. Some see these developments as undermining the traditional doctor-patient relationship and eroding quality of service.
Various mechanisms are used to assure that health care is delivered in accordance with accepted standards of practice and evidence-based medicine. These include external control through regulation, voluntary accreditation through the Joint Commission and quality-of-care criteria. Some critics believe that these efforts tend to impose external control that is more extensive and intrusive than would be the case in other industrialized nations. They also contend that they tend to obscure other important factors that affect health care costs and the quality of its delivery.
There is a growing movement that suggests untrammeled market forces and competition will serve patients better than government intervention. This view is supported by a belief that information about costs and outcomes should be available to all parties, allowing them to compare options and make choices. It is based on the premise that market forces will lead to improvements in quality if patients, physicians and outside evaluators can recognize poor performance.
When choosing a health insurance plan, it is important to consider the premium (the amount you pay each month) as well as the deductible and co-pays. You should also check to make sure your trusted clinicians are included in the plan’s network and that it covers the types of care you need. It is also a good idea to ask family members and friends about their experiences with health plans and insurers. When selecting a marketplace plan, be sure to look at its summary of benefits and provider directory. You can find these documents on the plan’s online marketplace or by requesting them from the insurance company. You should also consider whether you have a qualifying life event that allows you to enroll during open enrollment, such as getting married, having a baby, moving to a new ZIP code or turning 27.