Pillars of the U.S. Health System Paper

Pillars of the U.S. Health System Paper

Cost, quality, and access are three pillars of the U.S. health system. Write about some of the key characteristics of the U.S. healthcare system related to cost, quality, and access.

Your textbook and other learning materials (see below) for Week 1 are good resources for this assignment, but you can also use other sources.Pillars of the U.S. Health System Paper

Textbook Chapters 1,2,3,13

Shi, L., & Singh, D. A. (2019). Delivering health care in America: A systems approach (7th ed.). Jones & Bartlett Learning.

  • For this discussion, you must refer to at least one article from a reputable newspaper (can be online) or other media source that is current (from the last month) and post the resource in APA format.Pillars of the U.S. Health System Paper
  • You must have at least two references in your initial post and the media source can be one of the two.
  • Summarize your post in at least 500 words.


These are additional materials

The Characteristics of the United States Healthcare System With Regard to Cost, Quality, and Access

Healthcare in the US is one of the most controversial and emotive policy issues in the country. This is especially true from a minority standpoint. That the US healthcare system is the most expensive in the world is a known fact. One of the reasons for this is that it concentrates on the expensive tertiary stage of disease that is resource intensive, avoiding concentrating efforts on primary and secondary prevention (Sultz & Kroth, 2018). This is a discussion of the characteristics of the US healthcare system in terms of cost, access, and quality.

The Cost of healthcare in the United States

Compared to other developed countries, the US has the most expensive healthcare system in the world. Unfortunately, this high cost is not matched by commensurate quality. According to Kliff (2020), providers and even payers are fiercely guarding their pricing strategies which they do not want either the public or patient advocates to get hold of. Reports of many patients feeling ripped off after a simple visit to the emergency department for a simple procedure are manifold. Writing in The New York Times last month (August 7), Kliff states that he curiosity to investigate the irrationally expensive healthcare costs of the US healthcare system started when a reader complained to her about being charged USD 629 for a simple disposable bandage put on her daughter’s finger as an outpatient. The child had been well and just suffered a small cut when clipping her nails. In fact, the bandage fell off in the car on their way home! An important reason why healthcare is expensive in the US is that the private Managed Care Organizations or MCOs that finance healthcare aside from the Centers for Medicare and Medicaid Services (CMS) are owned by providers. This way, they decide on how much to charge for their services (Shi & Singh, 2019; Sultz & Kroth, 2018).Pillars of the U.S. Health System Paper

Healthcare Access in the United States

Because of the high cost of healthcare in the US, access to the services is not uniform across the socioeconomic spectrum. Vulnerable populations such as the elderly and the poor are the ones who are most disadvantaged in this. The problem of access was however partly addressed by the signing into law of “Obamacare” or the Patient Protection and Affordable Care Act 2010 (ACA). It brought into the coverage bracket close to 30 million vulnerable Americans who could hitherto not access healthcare services because of the high cost (Kominski et al., 2017). Despite this, however, close to 25 million vulnerable Americans still cannot access healthcare services. These are the poor, the elderly, the unemployed, and those with pre-existing conditions such as diabetes and heart disease. They are more likely to be Black, Hispanic, and unemployed or working in high risk jobs. Access to healthcare is therefore still a major challenge in the US (Shi & Singh, 2019).


Quality of Care in the United States

The Institute of Medicine (IOM) defines quality healthcare as that which fulfils six dimensions of quality. According to it, quality healthcare must be timely, safe, effective, efficient, patient-centered, and most important of all – equitable (Beattie et al., 2013). If the discussion about access above is anything to go by, then healthcare in the US is far from being equitable. The article by Kliff (2020) is a testament to the reality that indeed the high cost of healthcare in the US does not match up to the quality offered, which is deplorable in most cases. Attempts have been made to try and address this quality gap, the most notable being the provision in the ACA 2010 that payment be value-based instead of the previous volume-based payment system (Kahn, 2017).


The performance of the US healthcare system compared to other developed countries in terms of cost, quality, and access is poor. Despite efforts to correct this – such as provisions in the ACA 2010 – there is still a lot that needs to be done for healthcare in the US to be accessible to all, affordable, and of high quality.  Pillars of the U.S. Health System Paper


Beattie, M., Shepherd, A., & Howieson, B. (2013). Do the Institute of Medicine’s (IOM’s) dimensions of quality capture the current meaning of quality in health care? – An integrative review. Journal of Research in Nursing, 18(4), 288-304. https://doi.org/10.1177/1744987112440568

Kahn, C. (2017). The future of value-based payment: Time to re-examine and refocus our efforts. Health Affairs. http://dx.doi.org/10.1377/hblog20170811.061426

Kliff, S. (2020, August 7). Why I’m obsessed with patients’ medical bills. The New York Times. https://www.nytimes.com/2020/08/07/insider/coronavirus-medical-bills.html

Kominski, G.F., Nonzee, N.J. & Sorensen, A. (2017). The Affordable Care Act’s impacts on access to insurance and health care for low-income populations. Annual Review of Public Health, 38. http://dx.doi.org/10.1146/annurev-publhealth-031816-044555

Shi, L., & Singh, D.A. (2019). Delivering health care in America. A systems approach, 7th ed. Jones & Bartlett Learning.

Sultz, H.A., & Kroth, P.J. (2018). Sultz and Young’s health care USA: Understanding its organization and delivery, 9th ed. Jones & Bartlett Learning. Pillars of the U.S. Health System Paper