Drivers Affecting the United States Health Delivery System

::written circa. Fall 2013.

Over the years, countless reforms have been made, in the hopes to beneficially change its impact on consumers.  As the course continues on, one of the most debated public measures of the delivery system is heavily weighted and rooted to its outlay.  And depending on how this will unfold, the future of system is unclear.  Yet, with the inevitable lasting of the sociopolitical divide, the forward direction in improving the healthcare system appears forever hindered to reach its full potential.

Due to the vast complexity of the United States healthcare system, it can be argued that there are numerous factors affecting the system’s delivery to the population.  Among the many: the banes of administrative paperwork, advancing medical technologies, the legislative and regulatory environment imposed on physicians, and the tax treatment of health insurance are all considered contributing factors to the climbing cost of healthcare.  However, (1) increases in chronic illness and the aging population and (2) the cost transparency for healthcare services and products are all distinguished drivers, affecting health organizations and the total expense outcomes of the system.

According to Ed O’Neil (2011), both epidemiology and demographics were considered to be top drivers affecting the healthcare arena.  Continuing on from this, increases in chronic illnesses and the population across the nation are argued to be contributing to a significant portion of healthcare costs.  Currently, one of the leading preventable diseases affecting the United States is chronic obesity.  According to the Centers for Disease Control and Prevention [CDC] (2013), “with rates remaining high, more than one-third of U.S. adults (35.7%) and approximately 17% (or 12.5 million) of children and adolescents aged 2—19 years are obese.” With many associated illnesses overtime (such as cardiovascular, renal, and respiratory complications), medical attention is forever in the market of over exhausting their resources in treating and caring for these patients.  With that being said, the swift climb in the number of individuals with chronic diseases can certainly account for the unequal percentage of overall health spending.

Next, with the slow rise in the nation’s population at hand, this only translates to a greater increase in healthcare demands.  Therefore, the burdens placed on the nation’s total health expenditures perhaps doubles.  For years, according to Jewers and Ku (2013), political activists have argued that the migration of undocumented immigrants to the United States have steadily contributed to a portion of the systems rising costs.  And though they are not eligible for health insurance, it is against legislative law to refuse treatment in cases of emergency.  However, without political influences collaborating on similar efforts to contain immigration reform, combined initiatives to support the health of illegal immigrants remain controversial.  Furthermore, according to Hughes & Rao (2012), “the aging of the population will significantly impact the federal budget and contribute to approximately 0.5 percentage points per year in spending growth.”  Without question, this statement does not intend to attack the geriatric population.  It merely implies the inadequacy of current legislative reform on Medicare enrollment and benefits, against the advancing longevity of the growing population.

The second notable driver affecting the U.S. healthcare delivery system stems down to the wide spread cost transparency for health services and products across the nation.  Historically, the field of medicine has always been distinguished and prestigious.  Today, the majority of the nation’s tarnishing claims suggest that physicians are the cause for rising healthcare costs.  Nevertheless, Rutkow (2012) recalls back in the 18th century, when medicine was established as an individualistic relationship solely between the patient and the physician.  Today, according to Shi & Singh (2012), the establishments of third-party insurers have taken over most administrative functions associated with healthcare plans, delivery, and finances. According to Brills (2013), records of the MD Anderson Cancer Center, located in Houston TX, showed various accounts of over marked priced goods given to patients.  All of which were based on the standard care and procedures of medical delivery.  For example, one generic acetaminophen tablet (standard 325 mg) was marked at $1.50.  As a side note, Amazon markets 100 tablets of the same generic for $1.49 (Brills, 2013).  With price negotiations exclusively met between providers and insurers, inevitably, the buying power of consumers continues to only be imaginative. Thus, opening the doors to a catastrophic financial abuse on consumers, and causing healthcare costs to remain irresponsibly high.

Furthermore, influences from pharmaceutical activists can certainly account to a significant portion of healthcare expenditures.  According to Choudhry & Gagne (2011) over-priced marketed goods, established by replica drugs (also known as “me-too drugs”), have nothing but contributed to capitalistic gains of large pharmaceutical corporations.  And as lobbyists continue to market these me-too drugs across the nation, there will always be a constant growth of unnecessary spending in healthcare.

Though the course to improve these drivers seemingly remains daunting, there is still hope in legislating various opportunities of beneficial reform.  As such opportunities exist, there is not a better time for influences made by health care administrators and consumers.  I believe the doors are certainly wide open for solutions to tackle the epidemic of obesity in America. Perhaps there are more ways to influence individuals to become more motivated for physical activities, other than radio broadcasts and televised commercials.  I wouldn’t mind supporting federal funds to aid gyms and physical trainers, in their attempts to increase their health campaigns across the nation.  And with this in mind, relieving physical education from grade school programs is certainly not a clever solution.  In addition, just like political advocates have been enforcing fast-food chains and other restaurants to publicize their nutritional facts, maybe it is time to expose hospital and medical costs to consumers in that same way.





O’Neil, E. (2011). Health care environment drivers. The Center for the Health Professions. University of California, San Francisco. Retrieved from

Centers for Disease Control and Prevention. (2013).  Overweight and obesity facts. Retrieved from  

Jewers, M., Ku, L. (2013). Health care for immigrant families: current policies and issues. Migration Policy Institute of Research. Washington, D.C. 

Hughes, M., Rao, A. (2012). BPC’s healthcare drivers report. Bipartisan Policy Center of Research. Retrieved from

Shi, L., Singh, D. (2012). Delivering healthcare in america: a systems approach. Burlington, MA. Jones & Barlett Learning, LLC.

Brill, S. (2013). Bitter pill: why medical bills are killing us. New York, NY. NY Times Magazine.

Rutkow, I. (2012). Seeking the cure: history of medicine in america. Scribner Publishing. New York, NY.

Choudhry, N., Gagne, J. (2011). How many “me-too” drugs is too many? Journal of the American Medical Association. 305 (7). 711-12


Author: nursesarereal

My nursing professor once said that keeping a journal, over time, will allow me to see growth. In myself? I’m not sure yet. I’m hoping. I like to believe that nursing school saved my life. Maybe I’ll have some fun doing this. Cheers.

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