Overview of the U.S.
Healthcare System
Maura McGuire, MD, FACP, CPC
Learning Objectives
• Explain the concept of healthcare systems and
their significance in society
• Identify and describe the major stakeholders
involved in healthcare delivery
• Discuss the evolving healthcare landscape and
the challenges faced by the industry
• Analyze the role of managers in addressing
healthcare challenges
Defining Healthcare Systems
and Their Significance
Healthcare vs. the Healthcare System
Health care is a fundamental human good… It affects our opportunity to pursue life
goals, reduces our pain and suffering, helps prevent premature loss of life, and
provides information needed to plan for our lives. Society has an obligation to make
access to an adequate level of care available to all its members, regardless of ability
to pay.
- American Medical Association Ethics Code
Health care services are generally provided
through healthcare systems. A health system as
an organization that provides comprehensive care
(including primary and specialty care) via
connections among one or more provider(s) and
hospital(s).
Paraphrased from Defining Health Systems. Content last reviewed January 2023. Agency for Healthcare
Research and Quality, Rockville, MD. https://www.ahrq.gov/chsp/defining-health-systems/index.html
Healthcare System and Society
A well functioning health system responds to a population’s needs
and expectations by:
• Improving the health status of individuals, families and
communities.
• Defending the population against what threatens its health.
• Protecting people against the financial consequences of ill-health.
• Providing equitable access to people-centered care.
• Making it possible for people to participate in decisions affecting
their health and health system.
World Health Organization, May 2010, https://www.paho.org/derechoalaSSR/wp-
content/uploads/Documentos/Bloques-Basicos-de-un-Sistema-de-Salud-OMS.pdf
Societal Impact: Healthcare Spending
• In the U.S., healthcare spending consumed 17% of the GDP,
and $4.5 trillions in 2023. Costs are increasing as the population
ages.
• Per capita expenses are the highest in the world, but outcomes
of the U.S. healthcare system lag behind other nations.
• Hospital care, physician and clinical services, and prescription
drug costs, and provider costs account for 70% of costs.
18.3% of
U.S. GDP is
Healthcare:
$4.5 Trillion
Source: Centers for Medicare
and Medicaid Services compiled
by USAFacts.
https://usafacts.org/data/topics/p
eople-society/health/healthcare-
expenditures/healthcare-
expenditures-as-of-gdp/
Spending vs. Outcomes
Life Expectancy (2021) and Per Capita Healthcare Spending
Life Expectancy Health Spending, Per Capita
Japan 84.5 $4,666
Switzerland 84 $7,179
Australia 83.4 $5,627
Sweden 83.2 $6,262
France 82.5 $5,468
Comparable Country Average 82.4 $6,003
Belgium 81.9 $5,274
Netherlands 81.5 $6,190
Austria 81.3 $6,693
Germany 80.9 $7,383
United Kingdom 80.8 $5,387
United States 76.1 $12,914
70 75 80 85 90 $0 $5,000 $10,000 $15,000
Life Expectancy Health Spending, Per Capita
Where Are
Healthcare
Dollars Spent?
Source: Centers for Medicare and Medicaid
Services compiled by USAFacts.
https://usafacts.org/articles/how-much-is-spent-on-
personal-healthcare/
Who Pays
for
Healthcare?
Source: Centers for Medicare and Medicaid Services
compiled by USAFacts.
https://usafacts.org/articles/how-much-is-spent-on-
personal-healthcare/
