WGU C425 Topic 1 - Healthcare Delivery Systems, Regulation, and Compliance. Exam Review Questions and answers, VERIFIED 2024 | 39 Pages

The current model of U.S. healthcare focuses on identifying symptoms or diseases in patients and eliminating them. The U.S. has a unique system of healthcare delivery, which did not emerge by mere accident, but as a result of market forces and an obligation to treat special populations. Medicaid joint federal-state health insurance program for low-income adults, children, the elderly, and the disabled. Medicare A federal program of health insurance for the elderly, certain disabled individuals, and people with endstage renal disease. Demand-side rationing Prices and ability to pay ration the quantity and type of health care services people consume (consumers are on the demand side) Planned rationing or supply-side rationing Generally carried out by a government to limit the availability of health care services, particularly expensive technology In the U.S., those who support social justice principles seek to find public solutions to provide more equitable access to medical services, whereas market justice drives the privatized, employer-based model of health insurance, which has become the predominant model in the U.S. The current model of health insurance evolved from risk pooling in the lumber industry. Today's healthcare managers must navigate complex administrative territory that requires solid knowledge of: