What Is Health Care?

health care

Health care is all the goods, services and payment mechanisms that support a person’s goal of achieving and maintaining good health. The broad landscape includes physician offices, hospitals, labs and radiology centers, pharmacies and pharmaceutical companies. It also includes group purchasing organizations, pharmacy benefit managers and corporate healthcare systems. It is in this landscape that insurance has inserted itself and, in 100 percent of interactions with people, has not been necessary. The ultimate ends of health insurance are improved individual and population outcomes, and to that extent it has succeeded. However, it is impossible to isolate its contributions to success in these goals because health outcomes are determined by many factors, most of which do not have anything to do with insurance or with medical procedures or costs.

One of the key questions is what priority should governments place on health care amidst other areas competing for funding, laws and policies, such as defense, education and commerce. Then there are the more narrow allocation questions, such as whether to spend money on specific programs, facilities and technologies. These allocation decisions are not just about spending but also about what to focus on, and how and where new clinics should be stationed, or what algorithms should be used to match organ donors with recipients.

Some people believe that healthcare is like any other consumer product or service (blenders, oil changes) that some can afford and others can’t. They would prefer to let individuals decide what they need and then buy their own health care from the most cost effective providers. Others, on the other hand, believe that healthcare is a public good, like highways and education, and that the government has a moral obligation to provide it for all.

In the latter case, most countries have a mix of public and private health care systems. In some of these, private providers operate under a governmental license and are reimbursed for their work by the government, while in other countries the entire system is publicly funded through mandatory contributions to a health fund from all workers.

The RAND Corporation defines a healthcare system as two or more healthcare organizations affiliated for the purpose of managing care delivery, payment and operations. In some cases, the organizations are owned by the same entity; for example, a hospital and physician organization might be members of the same health system. In other cases, the organizations are separate but share a common mission or ownership structure, and contract with each other to manage care. The term is often used to refer to large-scale integrated care systems that include multiple hospitals and physicians. These systems can vary in size, scope and complexity. They may include a variety of clinical and nonclinical services, such as community outreach, mental health and substance use disorder treatment, medical education, and community partnerships. They can also have administrative functions, such as a shared IT infrastructure and data analytics capabilities. They are often referred to as Accountable Care Organizations in the United States.

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