Priscilla Tutu HLTH 6710

Priscilla Tutu
HLTH 6710: Public Health Concepts
Reflection Paper 2Describe the critical components of a well-functioning health care system?
Health is a very complex issue. As discussed in lectures, many factors go into the understanding of the health of an individual which in turn provides knowledge about the health of a population in general. Factors including but not limited to income or employment, level of education, social support networks, gender, genetics and access to quality health care services. According to Wilson and Mabhala, social determinants are mostly being explored as the factor which has greater influence on population health status than the healthcare service (Wilson & Mabhala, 2009). On the other hand, health care services in my opinion, does have a great influence in achieving the best quality of life. Without access to continuous check-ups and screenings, it is difficult to ensure the health of individuals let alone populations. Within the health care system itself, there are many challenges present that affect the provision and practice of better health care services. For a health care system to be considered as well-functioning, it must have among others, the following critical components; improving the health status of individuals, families and communities and protecting people against the financial consequences of ill-health (WHO, 2010).
The health care system must always be working towards improving the health status of communities not just the individuals. In the Institute of Medicine Report (2003, pg. 178), it is stated that the complexity of the health care delivery system and the emphasis on individual health have led to the focus of policy and resources on the high-technology and research ends of the health care delivery field which has led to the overlooking of the role that community plays in attaining health gains in the United States. However, this way of looking at the health care delivery system is changing. There is a shift now to the development of partnerships between the community and the health departments who serve these communities where health department leaders go out to the communities to gain a better understanding of the health care system directly from the people living in that community. With the formation of these developments, one of the benefits is the likelihood of empowering the participants, strengthening social engagement, establishing trust, and ensuring accountability. (The IOM Report, 2003, pg. 181).
One might ask what has the community got to do with the establishment of a health care system? To answer this, it is imperative to understand the meaning of a community as well as health care. Community can be defined in many ways. Guttmacher, Kelly and Ruiz-Janecko explained in their book, Community-Based Health Interventions, that “community is a group of people connected by visible and invisible links” (Guttmacher et al, 2013, pg. 4). Universal health care is “health care coverage for all citizens and other eligible residents in a country or governmental region that provides, at a minimum, basic health care services such as primary care and hospital services” (Andresen and Bouldin, 2010, pg. 350). Thus, when developing a health care system, the health of a community not just the individual should be taken into consideration because the health of communities can have an impact on the health of an individual and vice versa.
Having access to quality health care is very important to the achievement of quality of life. Lately, gaining access to health care has been very difficult for individuals and when people do get access, they are over-burdened with the financial consequences of ill-health. Lack of financial assistance has been a major reason as to why many people do not visit a health facility for a check-up, screening or even treatment. (Taber et al, 2015). Thus, many programs have been implemented to help lighten this burden on individuals so that they would more likely begin to seek help with regards to their health problems. There are both government and private programs, for example, in the United States to help combat the crisis of and protect people against financial consequences. According to Andresen and Bouldin, health insurance was created to take “the risk from an individual to a group by pooling resources, and all members of the insured group share actual losses. Some of these government programs include; Medicare which is a health insurance program given to Americans who are 65 and older regardless of their income, Medicaid which offers support to states to help the eligible poor, and Children’s Health Insurance Program (CHIP) created with the purpose of covering children whose families make too much money to qualify for Medicaid but too little to get the private health insurance. Another way that the cost of health care is being controlled is by involving consumers in the decision making of how to spend money on their health care through the Health savings account (HAS) which “is a medical savings account that is paired with a high-deductible health plan and is used to pay for health care expenses until the high deductible is met” (Andresen and Bouldin, 2010, pg. 354-357).
With all these programs that have been implemented to help take the financial load of individuals and have them more involved in the decision making when it comes to the cost of their health care, there are more uninsured and underinsured individuals than insured. This becomes a very difficult situation for individuals who have chronic illnesses and need to be seen on a regular basis or even people who simply cannot afford to have insurance for various reasons. It is stated in the IOM report that because “insurance status affects access to secure and continuous care, it also affects health, leading to an estimated 18,000 premature deaths annually”. It goes on to explain that for people who do not have any form of insurance, there is no chance of early detection and treatment of diseases and that even if they do receive care, their recovery if far less than those individuals who have insurance (IOM Report, 2003, pg. 216).
There are many more critical components of a well-functioning health care system and though the health care system here in the United States is considered as state of the arts compared to the health care systems of other countries, it is extremely flawed and does not 100% benefit the people it claims to be created to help. It has however helped over the years with diminishing the increased burden that individuals face financially whenever they are ill. No system is perfect when it comes to resolving issues of health either on the individual or the population levels but with different sectors and systems collaborating and communicating together, much better approaches to improving the health status of individuals, families and communities and protecting people against the financial consequences of ill-health will be developed and implemented to assist everyone not just a subset of the population.

References
Andresen, E., ; Bouldin, E. D. (Eds.). (2010). Public health foundations: concepts and practices (1st ed). San Francisco, CA: Jossey-Bass.

Institute of Medicine (U.S.) (Ed.). (2003). The future of the public’s health in the 21st century. Washington, D.C: National Academies Press
Kelly, P. J., Ruiz-Janecko, Y., & Guttmacher, S. (2013). Community-based health interventions. San Francisco, Calif.: Jossey-Bass. Retrieved from http://rbdigital.oneclickdigital.com
Taber, J. M., Leyva, B., & Persoskie, A. (2015). Why do people avoid medical care? A qualitative study using national data. Journal of General Internal Medicine, 30(3), 290–297. https://doi.org/10.1007/s11606-014-3089-1WHO (2010) | Key components of a well-functioning health system. (n.d.). Retrieved September 12, 2018, from http://www.who.int/healthsystems/EN_HSSkeycomponents.pdf?ua=1
Wilson, F., & Mabhala, M. (2009). Key concepts in public health. Los Angeles Calif.: SAGE. Retrieved from http://www.credoreference.com/book/sageukph