A health care ecosystem includes all the people and organizations – from doctors and nurses to hospitals and labs – that provide medical services to patients. It’s a complex network with many unique moving parts that suits each patient’s needs, which can change over time.
Health care is the diagnosis, prevention, treatment and management of illness and injury. It also includes efforts to promote good mental and physical well-being and reduce disability. Health care is a global concern because people are increasingly living with chronic diseases. These diseases are largely the result of lifestyle choices, including sedentary habits, poor diet and lack of exercise. They’re often expensive to treat and can lead to long-term disabilities.
In some countries, such as the United States, healthcare is a mix of private and public systems. Some people have insurance through their employer, and the government provides a safety net for low-income and elderly people. Other nations have a fully government-funded system. In Europe, which has a mixed model, healthcare is mostly funded through taxes and contributions from employers, trade unions or other groups.
Until recently, most health care was delivered in small, local communities. Physicians practiced independently or in small groups, and sometimes competed against but also cooperated with hospitals, imaging and laboratory facilities, dietary and drug stores, and other health care entities. Today, a typical city has three to four integrated health care systems anchored by large hospitals and extending into the surrounding community. These systems generally have their own in-network medical providers, whose rates are negotiated by the system. Patients are more likely to see in-network physicians, but they can choose to go elsewhere for treatment.
The idea of a national healthcare system dates back to 1912, when President Theodore Roosevelt ran for re-election on a platform that included a centralized national health service. Although Roosevelt lost the election, his effort planted a seed that healthcare could become a right, not a privilege.
Access to quality, affordable health care remains an issue for millions of people in the US. In 2009-2010, people with family incomes below 200 percent of the poverty level were more likely than those with higher incomes to report that they delayed or avoided medical care because of cost (NCHS, 2012).
Some people lack health insurance altogether, and others are unable to use their existing coverage to obtain necessary care. Other nonfinancial barriers to care include excessive wait times for appointments, inadequate transportation or lack of interpreters and other aides.
Ultimately, the best way to ensure affordable healthcare for all is to allow patients and their health care providers to benefit from the efficiency, fairness and multiple price options of a free market. Only then can consumers become smart, healthy and thrifty — which is how we can expect them to ultimately solve the challenges of providing better health care for all.