"It is important as a healthcare consumer to understand the history of the U.S. healthcare delivery system, how it operates today, who participates in the system, what legal and ethical issues arise as a result of the system, and what problems continue to plague the healthcare system. We are all consumers of health care. Yet, in many instances, we are ignorant of what we are actually purchasing. If we were going to spend $1000 on an appliance or a flat-screen television, many of us would research the product to determine whether what we are purchasing is the best product for us. This same concept should be applied to purchasing healthcare services. Despite U.S. healthcare expenditures, disease rates in the United States remain higher than those of many other developed countries because the United States has an expensive system that is available to only those who can afford it. A recent Gallup survey indicates that over 55% of Americans are greatly concerned about the availability of the rising cost of health care, which marks the fifth year in a row that this issue is ranked or tied first with concerns (Jones, 2018). Because the United States does not have universal health coverage, there are more health disparities across the nation. Persons living in poverty are more likely to be in poor health and less likely to use the healthcare system compared to those with incomes above the poverty line. If the United States offered universal health coverage, the per capita expenditures would be more evenly distributed and likely more effective. The major problem for the United States is that healthcare insurance is a major determinant of access to health care. Although there has been a decrease in the number of uninsured in the United States as a result of the individual mandate to purchase health insurance by the Affordable Care Act (ACA), there is still limited access to routine health care. The infant mortality rate is often used to compare the health status of nations worldwide. Although our healthcare expenditures are very high, our infant mortality rates rank higher than those of many countries. Racial disparities in disease and death rates continue to be a concern. Both private and public participants in the U.S. health delivery system need to in-crease their collaboration to focus on health education aimed to reduce the prevalence of obesity and disease. Leaders need to continue to assess our healthcare system using the Iron Triangle to ensure that there is a balance between access, cost, and quality"--
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