Major Characteristics Of U.S. Healthcare Delivery

Major Characteristics of U.S. Healthcare Delivery The two main objectives of the U.S. health

The two main objectives of the U.S. health delivery system are to address certain populations' health needs and provide cost-effective healthcare that is aligned with quality standards (Shi & Singh, 2022). The ten characteristics of the U.S. healthcare system include no central governing agency and little integration and coordination, a technology-driven delivery system focusing on acute care, high cost, unequal access, and average outcome, delivery of health care under imperfect market conditions, government as a subsidiary to the private sector, a fusion of market justice and social justice, multiple players and balance of power, the quest for integration and accountability, access to health care services selectively based on insurance coverage, and legal risks influencing practice behaviors (Shi & Singh, 2022).

Through a thorough analysis of the two characteristics of the U.S. health delivery system concerning access to health care services selectively based on insurance coverage, and the lack of a central governing agency and little integration and coordination, conclusions will be reached about similarities and differences between these characteristics as compared to the developed country of Germany’s health care delivery system. When it comes to the characteristic of the U.S. health delivery system that access to health care services is selectively based upon insurance coverage, Germany starkly contrasts. Germany’s healthcare system provides universal access to healthcare for all German citizens and is not selectively based on an individual’s level of insurance coverage (Gleason et al., 2012).

Purposed to provide citizens with equitable access to care, healthcare organizations are steered away from a posture of profit maximization, instead seeking to ensure universal benefits for all (Gleason et al., 2012). Alternatively, the U.S. health delivery system does not guarantee healthcare services for those with limited resources and no insurance coverage and may only receive care by paying out of pocket or seeking care from safety net providers or hospital emergency departments (Shi & Singh, 2022). Further, the U.S. healthcare system lacks a central controller that commands the financing, payment, and delivery of services to patients (Shi & Singh, 2022). The financing of the U.S. healthcare system relies on both public and private sources, resulting in variations in the payment and delivery of services to patients (Shi & Singh, 2022).

Similarly, while the federal government of Germany is required to provide social services such as healthcare to its citizens, it is not tasked with control and delegates this requirement to state governments and institutions (Döring & Paul, 2010). These institutions may include health insurance companies or physicians within statutory health insurance associations, for instance (Döring & Paul, 2010). The comparison between the U.S. and German healthcare delivery systems reflects a broader principle addressed within the scriptures of caring for the vulnerable, sick, and marginalized. Matthew 25:35-36 demonstrates the commandment for Christians to care for those in need, stating “For I was hungry and you gave me food, I was thirsty and you gave me drink, I was a stranger and you welcomed me, I was naked and you clothed me, I was sick and you visited me, I was in prison and you came to me” (ESV).

This scripture is directly relevant to individuals in their personal lives, and practitioners of health care administration, providing direction in how we are to proceed in our treatment of our community members, neighbors, and as practitioners, patients. Although resources are limited in the U.S. for individuals who lack the ability to afford care, placing emphasis on making referrals to safety net providers available to underserved populations and using our best efforts in assisting individuals to the best of our ability is a direct reflection of our obedience to God’s law.

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The healthcare delivery systems of the United States and Germany present contrasting approaches rooted in their foundational policies, governance structures, and societal values. A comprehensive understanding of these differences sheds light on how each system strives to meet its objectives of providing equitable, accessible, and quality care.

One of the most salient differences between the U.S. and German healthcare systems pertains to healthcare access. In the United States, access to healthcare services is predominantly contingent upon individuals’ insurance coverage. This system relies heavily on employer-based insurance, private plans, and safety net programs for the uninsured. Consequently, millions of Americans, especially those with low incomes or without employment-based insurance, encounter barriers to accessing timely and comprehensive care (Shi & Singh, 2022). In contrast, Germany offers universal healthcare coverage for all residents through a statutory health insurance scheme. This system ensures that every German citizen has equitable access to essential healthcare services regardless of socio-economic status, fostering a healthcare environment that emphasizes social solidarity (Gleason et al., 2012).

The differences extend to the structural organization and governance of the respective healthcare systems. The United States lacks a central governing authority overseeing healthcare delivery. Instead, numerous private and public entities operate independently, leading to fragmented care coordination and inconsistency in service delivery (Shi & Singh, 2022). This fragmentation is further exacerbated by the absence of a universal system for financing and regulation, which results in disparities in quality and costs. Conversely, Germany's healthcare system is characterized by a decentralized yet coordinated structure operated through statutory health insurance funds supervised by regulatory agencies at national and state levels (Döring & Paul, 2010). The federal government in Germany mandates social health insurance, but actual administration and service provision are delegated to regional health funds and social insurance organizations. This structure promotes integrated care and equitable resource distribution.

The philosophical underpinnings of each system further influence their operational differences. The U.S. system leans toward market justice, emphasizing individual responsibility, competition, and consumer choice. Healthcare providers operate in a competitive environment where market forces largely dictate the availability and quality of services, often leading to disparities and high costs (Shi & Singh, 2022). Meanwhile, Germany’s system underscores social justice principles that prioritize equitable access, social welfare, and collective responsibility. This approach fosters solidarity and shared responsibility, significantly reducing disparities and ensuring access for vulnerable populations (Gleason et al., 2012).

In addition to structural and philosophical distinctions, funding mechanisms play a critical role. The United States employs a mixed financing system involving private insurance, out-of-pocket payments, and government programs like Medicare and Medicaid. This multiplicity introduces administrative complexity, variable coverage, and financial barriers for many individuals (Shi & Singh, 2022). Conversely, Germany’s healthcare funding primarily stems from payroll contributions shared between employees and employers, supplemented by government subsidies for low-income groups. This system's predictability and universality contribute to reduced financial barriers and promote overall health equity (Döring & Paul, 2010).

Despite these differences, the systems strive toward some shared objectives, such as improving quality and efficiency. Both countries emphasize advancements in medical technology, quality standards, and patient safety. However, the U.S. system’s focus on innovation and specialization often results in higher costs and disparities, while Germany’s emphasis on universal coverage and integrated care aims to balance quality with equity (Gleason et al., 2012; Shi & Singh, 2022).

From a moral and ethical standpoint rooted in religious principles such as those expressed in Matthew 25:35-36, healthcare systems have a moral obligation to care for the vulnerable. In the context of the U.S., this moral imperative is often addressed through safety net programs and community-based clinics that seek to serve underserved populations despite systemic fragmentation. In Germany, universal access embodies the biblical call to care for those in need through collective responsibility and social justice. These principles underscore that regardless of systemic differences, healthcare systems must prioritize compassion and equity.

In conclusion, the comparison between the U.S. and German healthcare systems highlights the significance of structural organization, governance, funding, and philosophical foundations in shaping healthcare delivery. While the U.S. system emphasizes market mechanisms and individual responsibility, Germany’s approach underscores social solidarity and universal access. Both systems reflect their societal values and priorities, but the overarching moral principle of caring for the vulnerable remains central in guiding healthcare practices and policies in both countries.

References

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• Shi, L., & Singh, D. A. (2022). Essentials of the U.S. Health Care System. Google Books.
• World Health Organization. (2013). The World Health Report 2013 — Research for Universal Health Coverage.
• Schmidt, H., & Busse, R. (2018). The German health care system. In Neue Herausforderungen für das Gesundheitssystem.
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