First, what are the 2 main objectives of a health delivery system? Next, what are the 10 characteristics of the U.S. health care system? What is the purpose of the systems framework? Name and define the main elements of the systems framework. 


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The primary objectives of any health delivery system are to enable all citizens to receive health care serviceswhenever needed, and to deliver health services that are cost effective and meet pre-established standards of quality (Shi & Singh, 2017). Theare many scriptures that gives us great knowledge of Christ showing that He cares for us.  

1 Corinthians 6:19-20   

19 Don’t you realize that your body is the temple of the Holy Spirit, who lives in you and was given to you by God? You do not belong to yourself,20 for God bought you with a high price. So you must honor God with your body. (NLT) 

Ten Characteristics of the U.S. Health Care System 

According to Shi & Singh (2017), there are 10 main characteristics of the U.S. Health Care System: 

 1. No central governing agency and little integration and coordination 
2. Technology-driven delivery system focusing on acute care 
3. High in cost, unequal in access, and average in outcome 
4. Delivery of health care imperfect market conditions 
5. Government as subsidiary to the private sector 
6. Fusion of market justice and social justice 
7. Multiple players and balance of power 
8. Quest for integration and accountability 
9. Access to health care services selectively based in insurance coverage 
10. Legal risks influence practice behaviors. 

Main Purpose of the Systems Framework 

Shi & Singh (2017) states that the systems framework helps to understand that the structure of the health care services in the U.S. is based on some basic principles, provides a logical arrangement of the various components, and demonstrates a progression from inputs to outputs. The main elements of this arrangement are system inputs (resources), system structure, system processes, and system outputs (outcomes) (Shi & Singh, 2017).  

The system resources include both human and nonhuman resources that are very essential for the delivery of health care services. HR comprise of the workers that are in coordinate contact with patients, for example, doctors, medical caretakers, dental practitioners, and other prepared experts. Various subordinate specialists, for example, those included in billing and collection, marketing and public relations, and building maintenance, frequently play critical yet aberrant strong parts in the delivery of the health care(Shi & Singh, 2017). 

The system processes refer to the healthcare delivery infrastructure where the patient is being treated which includes hospitals, clinics, long-term care providers, etc. Health care infrastructure must also be able to support the population that have special needs (Shi & Singh, 2017).  

System outcomes focus on the issues and concerns of whether or not the health services system is about to fulfil its primary purpose. The system outlook focuses on being able to project into the future and accomplishments that are desired of the health care system (Shi & Singh, 2017).  

Shi, L., & Singh, D. (2017). Essentials of   the U.S. Health Care System(Fourth ed.). Burlington, MA: Jones &   Bartlett Learning.


As we all know, the U.S. health care system is complex. This is largely due to our non-universal system, which has led to continual efforts to make health care affordable and accessible to all citizens. The tangled web of the U.S. health care delivery system consists of various subsystems that are geared toward certain populations i.e. the military. Then, there is also the matter of private versus government aided insurance. Access to quality, affordable health care are the objectives of a health care delivery system. In the U.S., having insurance is the primary way to obtain even the most basic health care. This is one of the main characteristics (and primary concerns) of our health care system. The Affordable Care Act of 2010 was enacted in attempt to improve access to health insurance, but the issue remains for many (Shi & Singh, 2017, p.1).

The U.S. health care delivery system is defined by ten characteristics. The foremost being no centralized governing agency. This allows for both private and public financing, leading to a costlier system. While the government has a say in health care policy, their reach into private delivery systems is limited. The governments subsidiary role acts as another characteristic of the system. Because there are so many players in the U.S. health care delivery game, it can create a power struggle (another characteristic). With so many individual interests, making any significant change to the system is almost impossible. Another characteristic is the focus on technology. America is leading the way in health care technological research. However, the demand/use of these advanced care technology are costly. Costly in terms of the cost of health care itself, as well as the resources need to research/maintain the technology. The increasing cost of health care leads right into the characteristic of the tremendous disparity between the high cost of health care, the unequal access to quality care across the nation, and the overall health of the nation being simply average if not below. The imperfect market conditions of health care services marks yet another characteristic. The U.S. system is defined as an imperfect market versus a true free market for multiple reason to include external agencies (insurance agencies) acting as payers for services as opposed to the patient themselves. This also effects a patient’s “free” ability to select providers based on quality and price. These imperfections also effect the delivery system as it tries to balance market justice and social justice i.e. people having the ability to pay versus the idea that denying people access due to the inability to pay is unfair. While most of these characteristics are directly related to the citizens and insurance agencies, the final characteristic is for the providers. The legalities of practicing medicine are vast, and in attempt to protect themselves from malpractice lawsuits providers engage in defensive medicine to ensure diagnostic accuracy. “With his mouth the godless man would destroy his neighbor, but by knowledge the righteous are delivered” Proverbs 11:9 ESV. Given the all too common reaction of Americans to file lawsuits, this practice is somewhat understandable. However, these additional procedures/appointments only continue to drive up cost (Shi & Singh, 2017, pgs. 9-19).

The framework of a system helps to understand the interworking’s of the health care delivery system. Janecka (2009) describes a system as consisting of many components with boundaries that protect the internal environment from the external environment. Also, the struggles of a complex system, such as the U.S. health care system, are often directly related to failing subsystems (2009, p.3). System resources are one element of a system framework. In terms of health care, resources include health professionals, facility administrators, and financial resources. Then there are the system processes which vary across medical facilities and/or insurance companies. Finally, system outcomes are the results of the system processes. The outcomes allow facilitators to evaluate if the organization is meeting its objectives and how to improve its processes (Shi & Singh, 2017, pgs. 23-25).


Janecka, I. P. (2009). Is U.S. health care an appropriate system? A strategic perspective from systems science. Health Research Policy and Systems, 7, 1-13. http://doi.org/10.1186/1478-4505-7-1

Piña, I. L., Cohen, P. D., Larson, D. B., Marion, L. N., Sills, M. R., Solberg, L. I., & Zerzan, J. (2015). A framework for describing health care delivery organizations and systems. American Journal of Public Health, 105(4), 670–679. http://doi.org.ezproxy.liberty.edu/10.2105/AJPH.2014.301926

Shi, L., & Singh, D. A. (2017). Essentials of the U.S. health care system — with access (4th ed.). Burlington, MA: Jones & Bartlett Learning.

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