The Importance of Health Care

Health care is not just about treating illnesses. Rather, it is about the personal and collective desires of individuals and society to preserve health potential and provide access to essential services that are safe, effective, and efficient. Such a system must be based on principles that are consistent with the highest level of scientific, medical, and technical knowledge. Moreover, its implementation must be guided by the social, ethical, and religious values of individual and societal stakeholders.

Currently, the United States spends a greater percentage of its GDP on health care than any other country in the Organization for Economic Cooperation and Development (OECD). Despite these expenditures, many Americans are not adequately insured. For some, the cost of health insurance premiums exceeds their disposable income. For others, coverage may be limited to a specific hospital or set of doctors. And for still others, the cost of medical procedures and other health-related expenses can make it difficult to afford the services they need.

In addition, there is increasing concern about the lack of efficiency in our current health care delivery system. This is a result of the high cost of providing a wide range of health care services, as well as the uncertainty about whether these services actually improve patient outcomes. Some have called for more emphasis on patient-directed, consumer-driven health care. Others have favored the resurgence of selective contracting by managed care organizations to ensure that patients receive the health care services they need at the lowest possible cost.

These concerns are justified. Both economic theory and a review of the evidence suggest that government monopoly financing and provision achieves a less efficient allocation of resources to health care than would a well-designed private market system. For example, although some countries with more centralized government control over health budgets appear to have controlled costs more successfully than the United States, these reported statistics do not necessarily mean that they are more efficient in terms of delivering medically necessary care.

It is important to distinguish between problems of cost and those of quality in health care. The latter include such aspects as adequacy of treatment to meet a patient’s clinical needs, safety and effectiveness of services, and appropriateness of procedures in relation to the medical and social context of a particular population. Such quality problems are influenced by factors such as physician training and experience, the presence of informational, organizational, and financial barriers to obtaining good care, the availability of alternative health care options, and the degree to which patients participate in health-related decision making.

Those responsible for achieving and maintaining health care should be able to identify these issues, separate them from costs and other resource allocation factors, and then make appropriate decisions about the level of quality they desire. In addition, they should be able to assess and address any misallocation of resources that may occur. This is not an easy task and will require the cooperation of all parties, including government agencies and the private sector.

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