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HSD 266 WEK 4 PART 1 U.S. Healthcare System Overview

Sep 28, 2025

Overview

This lecture provides a summary of Chapter 4, focusing on the structure, characteristics, and challenges of the U.S. health care system.

U.S. Health Care System Structure

  • The U.S. health care system is a complex mix of public and private institutions.
  • Health care delivery occurs in settings such as hospitals, clinics, and long-term care facilities.
  • Health insurance is provided through private employers, government programs, or purchased individually.
  • Major government health programs include Medicare (for elderly) and Medicaid (for low-income individuals).
  • The Veterans Health Administration serves military veterans.

Key Characteristics and Issues

  • The U.S. spends more on health care per capita than any other country.
  • Despite high spending, the U.S. does not achieve the best health outcomes compared to other developed countries.
  • Many people experience barriers to accessing health care, including lack of insurance or high costs.
  • The system faces challenges of inefficiency, fragmentation, and unequal access.
  • Technological innovation is a strength but also contributes to rising costs.
  • There are significant disparities in health outcomes related to income, race, and geography.

Recent Changes and Reforms

  • The Affordable Care Act (ACA) aimed to increase insurance coverage and regulate the health insurance market.
  • The ACA expanded Medicaid eligibility and set rules for private insurance coverage.
  • Coverage rates improved after the ACA, but gaps and uninsured populations remain.

Key Terms & Definitions

  • Medicare — A federal program providing health insurance to people age 65+ and some disabled individuals.
  • Medicaid — A joint federal and state program offering health coverage to low-income individuals.
  • Affordable Care Act (ACA) — A 2010 law aimed at expanding insurance coverage and reforming health insurance practices.
  • Fragmentation — Lack of coordination among providers or parts of the health care system.

Action Items / Next Steps

  • Review Chapter 4 in the textbook for more detailed explanations.
  • Prepare questions on the U.S. health care structure for class discussion.