The United States has one of the least universal and most costly health care systems in the world. Over the last century, several “patches” have been put into place to address the increasing need for health care delivery, which has left us with a fragmented system. In today’s system, access to appropriate health care is a multi-factorial challenge.
There is the question of financial barriers where some individuals receive too little care because they are uninsured or under-insured, some Medicaid beneficiaries cannot find physicians that will access their coverage, while other individuals receive too much care that may be harmful, excessive and costly to the health system.
There is also the question of non-financial barriers to care such as language, literacy, cultural differences, factors of gender and race and lack of prompt access due to limited availability of appropriately capable facilities and primary care providers.
Today, four basic modes of paying for health care exist: out-of-pocket payment, individual private insurance, employment-based group private insurance, and government financing. Out-of-pocket payment was the foundation upon which the country started, with individuals paying cash or bartering for health care.