Furthermore, most universities are private or receive private aid as well as public financing in the case of state-run medical schools, thus management of care is taught and passed on through private institutions.
In terms of economic support, even nationally funded systems or free systems are dependent upon taxes and other forms of public aid — health care always costs in some way. Health care organizations are for-profit businesses in the U.S. And make up 34% of health care payments and costs within the national system (Koehlmoos 2008). Out-of-pocket payments make up 15%, and Medicare and Medicaid 17% and 16% respectively (Koehlmoos2008). The selling of services to hospitals and physicians dominates the bulk of money spent on care in the U.S. Of the funds allocated to health care delivery, 33% of all the money spent on health care goes to hospitals, 23% to physician services. Healthcare is the largest industry in the U.S., employing 11.9 million workers (Koehlmoos 2008).
Individual hospitals may be for profit or not-for-profit and rely upon volunteers, donations, and public funding. Out-of-pocket funding is an occasional, personal method of economic support, on a case-by-case basis, when individuals have no insurance, and private financing also occurs outside of the U.S. when some citizens seek out private health care providers in countries with the option of going to free national providers. Thus private funding and insurance through the private market, even privately-financed research on drugs and medical technology creates the financial basis of the U.S. system, and tangentially sustains many other systems.
Capitalism fuels health cares continued existence in the U.S., however, and is not merely a subsidiary component. This fact also provokes occasional allegations conflicts of interest, such as when doctors who are being paid by drug companies publish their research in allegedly unbiased fashion in peer-reviewed medical journals of repute. However, most research on drugs is still undertaken by the federal government, and all drugs must be approved by the FDA.
The final components of the production and the delivery of such services requires skilled expertise, properly staffed facilities, proper resources such as drugs and equipment, and knowledge — not simply skilled personnel at hospitals but proper universities and training to dispense that knowledge, which does not always exist in all nations. Finally, the best types of delivery systems in the U.S. And in all nations are those which have preventative primary care, as well as secondary and tertiary care and treatment of specialized symptoms and conditions spanning from the mundane to the serious and chronic. The U.S. has such methods of care, but is not always effective in delivering them to all of the population through private or even public means.
Koehlmoos, Tracey Lynn (2008). U.S. Health Care: Roemer Model. Lecture 2: HSCI 609
Comparative International Health Systems George Mason University. Retrieved 1 Sept 2008 at http://gunston.gmu.edu/healthscience/InternationalHealth/USHealthCareRoemerModel.ppt.