The US health care system has an outsized impact on the economy. It accounted for 14.9 percent of GDP in 2002, well above the manufacturing sector’s 10.2 percent. In addition to being a major employer, the industry provides a variety of important consumer services. These include medical and dental insurance, home health aides, and veterinary care. Health care is also a major source of income for individuals, families, and communities. In addition, it is an industry that is heavily regulated. There are state licensing requirements for healthcare providers and the testing and approval of drugs and medical devices. These regulations are intended to prevent fraud, protect consumers, and ensure the safety of patients.
People’s health needs vary widely. Some require complex, expensive treatments. Others need routine or preventive care. Still, others may need emergency treatment or rehabilitation. Health care is a social good, and the effectiveness of the system is measured by how well it meets people’s health needs.
Unlike most goods and services, the benefits of health care are difficult to measure in economic terms. A person’s health is largely determined by genetics and lifestyle choices. Therefore, a good health care system is one that enables people to maintain or improve their health as well as possible given their individual characteristics.
Many factors contribute to the cost and quality of health care. Costs are usually higher in countries with more centralized government control of the health budget, but that does not necessarily mean that the system is less efficient. Other measures of efficiency include the relative proportions of health expenditures for hospital, professional, and pharmaceutical costs.
A key challenge is to balance the competing demands for resources. Health care providers need to provide care that is appropriate for each patient based on the most current professional knowledge, taking into account the patient’s values and goals. At the same time, health care must be affordable and accessible.
Another important issue is the coordination of care. Individuals often receive care from multiple sources, and there is a risk of duplication of tests and services. In addition, there is a risk of fragmentation of care as patients shift between different settings, resulting in inefficient use of resources.
It is also important for patients to have access to a physician with whom they feel comfortable and can communicate effectively. This may be more challenging in rural areas and in the case of patients with limited English skills.
In the end, a good health care system is one with which a patient can develop a trusting relationship and feel secure that they will get the necessary attention for their health needs. It is a relationship that encompasses the emotional, interpersonal, and manual aspects of health care. It is not merely a transaction between a patient and a provider, but an experience that has a powerful symbolic dimension, and it is this aspect of the system that arguably contributes most to its quality. The US has much to learn from the experience of other nations, including those with universal health coverage.