Health Care for All: A Framework for Moving to a Primary Care-Based Health Care System in the United States (2023)


To ensure health care coverage for everyone in the United States through a foundation of comprehensive and longitudinal primary care.

The intent of this policy document is to give the American Academy of Family Physicians (AAFP) and its Board of Directors the needed advocacy flexibility to consider all options that might come before federal and state governments and the American people in working to achieve the goal of health care coverage for all – a goal based upon AAFP policy which recognizes that health is a basic human right for every person and that the right to health includes universal access to timely, acceptable and affordable health care of appropriate quality.


The health care system in the United States is uncoordinated and fragmented and emphasizes intervention rather than prevention and comprehensive health management. Health care costs continue to increase at an unsustainable rate and quality is far from ideal.i,ii

Over the past two decades, policies implemented through the Children’s Health Insurance Program (CHIP) and the Patient Protection and Affordable Care Act (ACA) have extended access to affordable health care coverage to millions of previously uninsured, non-Medicare eligible adults and children. The uninsured population reached a historic low of 8.8% under the implementation of these policies.iiiThe greatest gains in coverage have occurred among our most vulnerable populations and young adults. However, the rollback of some provisions of these policies has increased the percentage of those uninsured to 15.5%,ivclose to what it was one decade ago when our uninsured rate was nearing 17%, with nearly 50 million people uninsured.v

Ensuring that all people in the United States have affordable health care coverage that provides a defined set of essential health benefits (EHB) is necessary in order to move toward a healthier and more productive society. Additionally, our health care system must begin to account for and address social determinants that have a profound impact on individual and population health outcomes and costs, such as socioeconomic status, housing and occupational conditions, food security, and the environment. As noted by the Commonwealth Fund, the design of a system to provide health care coverage to all people “will have a deep impact on its ability to make sustainable and systematic improvements in access to care, equity, quality of care, efficiency, and cost control.”vi

Any successful health system reform designed to achieve health care coverage for all must re-emphasize the centrality of primary care, reinvigorate the primary care infrastructure in the United States, and redesign the manner of primary care delivery and payment. Compelling research demonstrates that the ever-increasing focus of resources on specialty care has created fragmentation, decreased quality, and increased cost. Studies confirm that if primary care practices redesign how they operate so that they are more accessible, promote prevention, proactively support patients who have chronic illnesses, and engage patients in self-management and decision-making, health care quality improves along with the cost efficiency of care.vii

Family medicine and primary care are the only entities charged with longitudinal continuity of care for the whole patient. The patient and primary care physician relationship and its comprehensiveness have the greatest effect on health care outcomes and costs over the long term. However, the current United States health care system fails to deliver comprehensive primary care because of the way primary care has been, and is currently, financed.

According to the Center for Evaluative Clinical Sciences at Dartmouth (now called the Dartmouth Institute for Health Policy and Clinical Practice), U.S. states that rely more on primary care have lower Medicare spending (inpatient reimbursements and Part B payments); lower resource inputs (hospital beds, intensive care unit [ICU] beds, total physician labor, primary care labor, and medical specialist labor); lower utilization rates (physician visits, days in the ICU, days in the hospital, and patients seeing 10 or more physicians); and better quality of care (fewer ICU deaths and a higher composite quality score).viii

(Video) Value-Based Healthcare: A Framework for Turning Around Healthcare Systems

The patient-centered medical home (PCMH) is one approach to providing comprehensive advanced primary care (APC) for children, youth, adults, and the elderly. It is a model of health care that facilitates a partnership between an individual patient, the patient’s personal physician, and, when appropriate, the patient’s family or caregiver. Each patient has an ongoing relationship with a personal primary care physician trained to provide first-contact, coordinated, continuous, and comprehensive care. The personal physician leads a team of individuals at the practice level and beyond who collectively take responsibility for the ongoing care of patients.ix

Fundamental change is required to shift the direction of the U.S. health system toward one that covers all people and emphasizes comprehensive and coordinated primary care. Current resources must be allocated differently, and new resources must be deployed to achieve these desired results. Payment policies by all payers must change to reflect a greater investment in primary care to fully support and sustain primary care transformation and delivery. Workforce policies must be addressed to ensure a strong cadre of the family physicians and other primary care physicians who are so integral to a high-functioning health care team. Congress and/or state legislatures must enact comprehensive legislation to achieve this change. If such legislation only addresses the uninsured and fails to fundamentally restructure the system to promote and pay differently and better for family medicine and primary care, any solution will not reach its full potential to achieve the Quadruple Aim of better care, better health, smarter spending, and a more efficient and satisfied physician workforce.

Key Elements of the Framework

  • Everyone will have affordable health care coverage providing equal access to age-appropriate and evidence-based health care services.
  • Everyone will have a primary care physician and a medical home.
  • Insurance reforms that have established consumer protections and nondiscriminatory policies will remain and will be required of any proposal or option being considered to achieve health care coverage for all. Those reforms and protections include, but are not limited to, continuation of guaranteed issue; prohibitions on insurance underwriting that uses health status, age, gender, or socioeconomic criteria; prohibitions on annual and/or lifetime caps on benefits and coverage; required coverage of defined EHB; and required coverage of designated preventive services and vaccines without patient cost sharing.
  • Any proposal will reflect at least a doubling of the percentage of health care spending invested in primary care.xThis investment must result in a payment model for primary care that supports and sustains primary care medical home transformation and reduces the current income disparity between primary care and subspecialty care to ensure an adequate primary care physician workforce.
  • Federal, state, and private funding for graduate medical education will be reformed to establish and achieve a national physician workforce policy that produces a primary care physician workforce sufficient to meet the nation’s health care needs. Additionally, U.S. medical schools will be held to a higher standard in regard to producing the nation’s needed primary care physician workforce.
  • A defined set of visits and services to a primary care physician will not be subject to cost-sharing.
  • In any system of universal coverage, the ability of patients and physicians to voluntarily enter into direct contracts for a defined or negotiated set of services (e.g., direct primary care [DPC]) will be preserved. Additionally, individuals will always be allowed to purchase additional or supplemental private health insurance.

To achieve health care coverage for all, the AAFP supports bipartisan solutions that follow the above referenced principles, are supported by a majority of the American people, and involve one or more of the following approaches, with the understanding that each of these have their strengths and challenges:

  • Apluralistic health care system approachto the financing, organization, and delivery of health care is designed to achieve affordable health care coverage that involves competition based on quality, cost, and service. Such an approach involves multiple for-profit and not-for-profit private organizations and government entities in providing health insurance coverage. Such an approach to universal health insurance coverage must include a guarantee that all individuals will have access to affordable health care coverage.
  • ABismarck model approachis a form of statutory health insurance involving multiple nonprofit payers that are required to cover a government-defined benefits package and to cover all legal residents. Physicians and other clinicians operate independently in a mix of public and private arrangements.
  • Asingle-payer model approachthat is clearly defined in its organization, financing, and model of delivery of health care services would be publicly financed and publicly or privately administered, with the government collecting and providing the funding to pay for health care provided by physicians and other clinicians who work independently or in private health systems.
  • Apublic option approachthat is a publicly administered plan directly competing for customers with private insurance plans could be national or regional in scope. Physicians and other clinicians would continue to operate independently.
  • AMedicare/Medicaid buy-in approachwould build upon existing public programs by allowing individuals to purchase health care coverage through these programs. In such a scenario, there must be at least Medicaid-to-Medicare payment parity for the services provided to the patients of primary care physicians.

As noted in the AAFP’sDiscussion Paper on Health Care Coverage and Financing Models, which was commissioned by the AAFP Board of Directors in 2017, each of these options for achieving health care coverage for all has its strengths and challenges, which need and deserve to be debated by the American people and their elected officials and representatives. These include, but are not limited to, the following important issues:

  • Level of administrative and regulatory burden for physicians, clinicians and other health care providers, and patients/consumers
  • Impact on overall health care costs to government, employers, and individuals
  • Level of patient, consumer, physician, and clinician satisfaction
  • Level of tax burden
  • Impact on the timely delivery of health care services (wait times) and delays in scheduling elective health care services
  • Clarity of the financing model and levels of payment to physicians, clinicians, and other health care providers
  • Inclusion of family physicians on payment, delivery, and other health care decision-making boards
  • A description of and clarity on a core set of essential health care benefits available to all, especially primary and preventive care, management of chronic illnesses, and protections from catastrophic health care expenses
  • Impact on the equitable availability and delivery of health care services
  • Impact on quality and access
  • Determination of whether there are global budgets and price/payment negotiations
  • Need for a clear and uniform definition of a “single-payer health care system”

Comprehensive Primary Care

Advanced primary care embodies the principle that patient-centered primary care is comprehensive, continuous, coordinated, connected, and accessible for the patient’s first contact with the health system. APC aims to improve clinical quality through the delivery of coordinated, longitudinal care that improves patient outcomes and reduces health care spending. The AAFP believes APC is best achieved through the medical home model of practice. We define a primary care medical home as one that is based on the Joint Principles of the Patient-Centered Medical Homeixand has adopted the five key functions of the Comprehensive Primary Care Plus (CPC+) initiative, which establishes a medical practice that provides comprehensive care and a partnership between patients and their primary care physician and other members of the health care team, as well as a payment system that recognizes the comprehensive work of providing primary care. The key functions of a primary care medical home are:

  1. Access and Continuity
  2. Planned Care and Population Health
  3. Care Management
  4. Patient and Caregiver Engagement
  5. Comprehensiveness and Coordination


All proposals or options to provide health care coverage for all will be required to cover a defined set of essential health benefits. At a minimum, these would include items and services in the following benefit categories:

  1. Ambulatory patient services
  2. Emergency services
  3. Hospitalization
  4. Maternity and newborn care
  5. Mental health and substance use disorder services, including behavioral health treatment
  6. Prescription drugs
  7. Rehabilitative and habilitative services and devices
  8. Laboratory services
  9. Preventive and wellness services and chronic disease management
  10. Pediatric services, including oral and vision care

In addition to requiring coverage for EHB, all proposals or options will ensure that primary care is provided through the patient’s primary care medical home. To foster a longitudinal relationship with a primary care physician, all proposals or options will provide the following services independent of financial barriers (i.e., deductibles and co-pays) if the services are provided by the patient’s designated primary care physician:

a. Evaluation and management services
b. Evidence-based preventive services
c. Population-based management
d. Well-child care
e. Immunizations
f. Basic mental health care

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To achieve the goal proposed in this paper: “to ensure health care coverage for everyone in the United States through a foundation of comprehensive and longitudinal primary care,” it will not be sufficient to focus on health care coverage and primary care alone. There will need to be an effort aimed at identifying and reducing the costs of health care services including the administrative costs of delivering those services.

A health care system that is comprehensive and prioritizes primary care must also emphasize the cost and affordability of care. This is important not only for consumers, but also for the decision-making of physicians, clinicians, payers, and government agencies. Affordability is a critical component in efforts to reform the United States health care system.

  • Prevention & Public Health – there should be increased investment in preventive care, specifically those preventive services that have been proven to reduce the prevalence of preventable diseases (e.g., access to free vaccines and screening programs). A focus on reducing preventable diseases likely would reduce or, at minimum defer, future high-cost spending for preventable diseases. In addition, there should be an increased focus on identifying societal and environmental factors that contribute to increased health care spending.
  • Transparency – an increased investment in primary care and the medical home allows health plans to not only reduce the costs of treating high-risk patients but improve the quality of health services.xiThis increased investment should be supported by aggressive efforts to establish price transparency for all health care services. Such transparency likely will contribute to reducing excessively high health care costs by informing the public about their costs of care and creating more competition in the health care industry.
  • Consolidation – consolidation in the health system is cause for concern when it comes to affordability. Although consolidations between health systems may allow for reductions in internal costs, such as operating expenses, they create a less competitive market which leads to higher health care costs and insurance premiums.xii
  • Site-Neutral Payment Policies – for many health care services, current payment policies often are highly variable depending on the site of service (payment higher for the same service performed in a hospital versus an ambulatory surgery center versus a physician’s office for example) despite no significant differences in quality or outcomes of care. Such payment policies contribute to excessive spending in our current system. In addition, such payment policies incentivize consolidation, decrease competition between providers of care, and facilitate over-utilization of high-cost health care services. This issue could be addressed effectively through site-neutral payment policies and the elimination of some facility fees.
  • Administrative Costs – a share of the overall costs of health care in United States health care is due to high administrative costs. Much of these high administrative costs is due to complexities in billing which is exasperated by multiple payers. Countries with lump-sum budgets and fewer health care payers have seen lower costs in administrative spending.xiiiOf all hospital spending in the United States, 25% is dedicated to administrative costs--- nearly $200 billion. In comparison, Canada dedicates only 12% of hospital spending to administrative costs, while England spends 16% on administrative costs. Additionally, no link has been found between higher administrative costs and higher quality care.
  • Pharmaceutical & Biologics – advances in pharmaceuticals and biologics have improved the health of millions of people, decreased the prevalence of preventable diseases, and allowed for chronic diseases to maintained over a prolonged period of time. These advances have extended life expectancy for millions of people, especially those with chronic diseases and some cancers. These advances should be celebrated for the positive impact they have had on millions of people. However, the escalating costs of pharmaceuticals and biologics places these interventions and treatments out of reach for far too many people. Policies should be established that allow purchasers of health care, including Medicare, to negotiate the costs of prescription drugs. Additionally, there should be greater flexibility in the design of formularies that allow for increased use of generic and bio-similar products.


The AAFP believes all primary care physicians should be compensated in a manner that is consistent with the AAFP’s comprehensive payment model for family medicine and primary care, the Advanced Primary Care Alternative Payment Model (APC-APM). The AAFP believes the APC-APM is a foundational element of a greater investment in primary care that is essential to a better system of care in the United States.

The model builds on previous programs and years of research showing the benefits of movement away from fee-for-service (FFS) payment and increased support for population-based care. It better supports small and independent practices and reduces administrative burden in the health care system.

Key Components of the APC-APM

For any health care system to achieve its goals, there will be a need for greater investment in primary care. The AAFP strongly supports increased investment in primary care as part of any U.S. health care system.

Family physicians, other primary care physicians, and primary care teams provide comprehensive primary care through two distinct functions: direct patient care and non-face-to-face care, which we label as “population-based care.” The AAFP has concluded that traditional FFS payment is largely incongruent with these core functions. The APC-APM, which is outlined inFigure 1, is better designed to recognize the value of these complementary, yet distinct, functions.

The APC-APM establishes a payment model built on the realization that high-quality primary care is delivered through both direct patient care and the population-based services that are provided by the primary care team. Additionally, we believe the revenue cycle for primary care must move to a prospective payment model with a retrospective evaluation for performance and quality. Therefore, our model establishes prospective payments for a direct patient care global payment, a population-based global payment, and a performance-based incentive payment.

(Video) An Introduction into Behavioral Health and Primary Care Integration

Building on our belief that primary care should remain comprehensive, the APC-APM maintains an FFS component as a means of driving comprehensive care at the primary care level. The presence of this FFS component recognizes that a comprehensive primary care practice will provide episodes of care that are beyond the scope of the direct patient care global payment.

We believe the APC-APM will support a greater investment in primary care and will allow primary care practices of all sizes and in any location to achieve and sustain success through its simplified payment structure and dramatic reduction in administrative burden. More importantly, we believe patients will achieve better outcomes and have a more favorable experience through this model.



This framework offers important policy options for the AAFP to move the United States toward a primary care-based health care system in which all people have appropriate and affordable health care coverage, are provided a medical home, and have primary care-oriented benefits. This can be achieved only if Congress and/or state legislatures act to ensure that these policy objectives are implemented. All people in the United States must have appropriate and affordable health care coverage, but this is not sufficient by itself. A fundamental change in the health care system to move toward a primary care-based system is essential to achieve improvements in access, quality, and cost. Extensive worldwide research supports the value of a primary care-based health care system in which all people are covered.xivThis framework is grounded upon the documented value of primary care in achieving better health outcomes, higher patient satisfaction, and more efficient use of resources. The United States will only achieve the type of health care system that our people need, and our nation deserves through a framework of health care coverage for all that is foundationally built on primary care.


i. Institute of Medicine Committee on Quality of Health Care in America. Crossing the quality chasm: a new health system for the 21st century. Washington, DC: National Academies Press; 2001.

ii. Institute of Medicine Committee on Quality of Health Care in America. To err is human: building a safer health system. Washington, DC: National Academies Press; 2000.

(Video) Oregon Universal Health Care Task Force, Warren George report

iii. Barnett JC, Berchick ER. Health insurance coverage in the United States: 2016. Washington, DC: U.S. Government Printing Office. 2017. Current population report no. P60-260. Accessed July 1, 2018.

iv. Collins S, Gunja M, Doty M, Bhupal H. First look at health insurance coverage in 2018 finds ACA gains beginning to reverse. May 1, 2018.Accessed July 1, 2018.

v. DeNavas-Walt C, Proctor BD, Smith JC. Income, poverty, and health insurance coverage in the United States: 2009. Washington, DC: U.S. Government Printing Office. 2010. Current population report no. P60-238.Accessed July 1, 2018.

vi. Collins S, Schoen C, Davis K, Gauthier A, Schoenbaum S. A roadmap to health insurance for all: principles for reform. October 1, 2007.Accessed July 1, 2018.

vii. Bailit M, Hughes C. The patient-centered medical home: a purchaser’s guide. Washington, DC: Patient-Centered Primary Care Collaborative; 2008.Accessed July 1, 2018.

viii. Dartmouth Atlas of Health Care Working Group. The care of patients with severe chronic illness: an online report on the Medicare program by the Dartmouth Atlas Project. 2006.Accessed July 1, 2018.

ix. American Academy of Family Physicians, American Academy of Pediatrics, American College of Physicians, American Osteopathic Association. Joint principles of the patient-centered medical home. March 2007.Accessed July 1, 2018.

x. Koller C. Getting More Primary Care-Oriented: Measuring Primary Care Spending.Accessed July 5, 2018.

xi. Collins S, Piper K, Owens G. The opportunity for health plans to improve quality and reduce costs by embracing primary care medical homes. Accessed July 3, 2018.

xii. Kacik, A. Monopolized healthcare market reduces quality, increases costs.Accessed July 3, 2018.

(Video) Launch of the strategic framework for the integrated control and management of skin NTDs

xiii. Himmelstein, D. A comparison of hospital administrative costs in eight nations: U.S. costs exceed others by far.Accessed July 3, 2018.

xiv. Patient-Centered Primary Care Collaborative. Results and evidence.Accessed July 1, 2018.

(1989) (2018 COD) (Board Chair Dec 2019)


What is a framework in health care? ›

Healthcare Framework (HCF) is a cloud-based healthcare platform which is used to capture clinical data, manage patient workflow, electronic medical records (EMR), consultations (in person or virtual) by healthcare service providers.

What are the 4 levels of primary health care? ›

Healthcare is divided into four levels; primary, secondary, tertiary, and quaternary. Doctors use these different categories to distinguish between the complexities of medical cases and the level of care they require.

Why are frameworks important in healthcare? ›

Frameworks provide the ability to measure and compare health system functions in different countries in order to make better and more meaningful decisions, to make comparisons within and between countries, identifying gaps, and sharing information.

What would universal healthcare look like in the US? ›

Under a Medicare for All plan, patients would have complete freedom to choose their doctors, hospitals, and other providers with no cost sharing, including premiums, copayments, and deductibles. Patients would have no out-of-pocket costs except for prescription drugs.

What are the 5 frameworks? ›

The five frameworks you should consider are:
  • Angular.
  • React.
  • Vue.
  • Ember.
  • Svelte.

What are the 7 components of primary health care? ›

8 Components of Primary Health Care
  • Public Education.
  • Proper Nutrition.
  • Clean Water & Sanitation.
  • Maternal & Child Health Care.
  • Immunization.
  • Local Disease Control.
  • Accessible Treatment.
  • Drug Provision.
25 Oct 2017

What are the 3 types of primary care? ›

Primary care includes general practice, community pharmacy, dental, and optometry (eye health) services.

What are the six elements of primary health care? ›

The elements identified are context, governance and leadership, infrastructure, financing, engagement, and communication.

Why is it important to have a framework? ›

It provides a structure in which software developers can build programs for a specific platform. For example, a framework may include predefined classes and functions that can be used to process input, manage hardware devices, and interact with system software.

What's the purpose of a framework? ›

In general, a framework is a real or conceptual structure intended to serve as a support or guide for the building of something that expands the structure into something useful.

Why is it important to follow a framework? ›

IT frameworks lay out guidelines, best practices and operating principles to help IT organizations achieve objectives defined in business terms. IT frameworks ensure alignment between the way IT services are delivered and the value they enable. Frameworks are useful because IT processes can be large and complex.

Why is America against universal healthcare? ›

Beyond individual and federal costs, other common arguments against universal healthcare include the potential for general system inefficiency, including lengthy wait-times for patients and a hampering of medical entrepreneurship and innovation [3,12,15,16].

Why should the US switch to universal healthcare? ›

Most agree that if we had universal healthcare in America, we could save lives. A study from Harvard researchers states that not having healthcare causes around 44,789 deaths per year. 44,789 deaths per year means that there is a 40% increased risk of death for people who are uninsured.

Does a universal health care program exist in the United States? ›

United States. The United States does not have universal health insurance coverage.

What are the 2 nationally approved frameworks? ›

There are two nationally approved learning frameworks that support and promote children's learning. The frameworks are: Belonging, Being & Becoming: The Early Years Learning Framework. The Framework for School Age Care: My Time, Our Place.

How many types of frameworks are there? ›

There are four major types of enterprise architecture framework, which professionals choose based on the framework's fit for their specific project. These framework subtypes include the Zachman, Federal, Gartman and the Open Group enterprise framework (TOGAF). Professionals most commonly use the latter.

How many frameworks are there? ›

There are generally two types of development frameworks – client side and server side frameworks. While client side frameworks are used for dealing with the user interface, a server side framework works in the background to ensure the smooth functioning of the website.

What are the 5 components of the 5 component framework? ›

The five-components consist of hardware, software, data, procedures, and people.

What are the 3 main components of a result framework? ›

Results Framework: A results framework comprises three components: a Results Diagram; a Results Measurement Table; and a Monitoring and an Evaluation Workplan.

What are its three parts of framework? ›

Framework Core

The Core consists of three parts: Functions, Categories, and Subcategories. The Core includes five high level functions: Identify, Protect, Detect, Respond, and Recover.

What are the 12 component of primary health care? ›

What are the components of primary health care?
  • Health education. ...
  • Availability, accessibility, and affordability of health services. ...
  • Immunization. ...
  • Provision of essential medicines. ...
  • Treatment of communicable diseases. ...
  • Water and sanitation. ...
  • Promotion of mental health and rehabilitation. ...
  • Maternal and child healthcare.
12 Oct 2022

What are the 5 A's of primary health care? ›

1. 4 A's = Accessibility, Availability, Affordability & Acceptability, Appropriateness of health services.

What are the 8 principles of primary health care? ›

There are eight essential components of PHC [13], including [1] health education, on prevailing health problems and the methods of preventing and controlling them, [2] nutritional promotion including food supply, [3] supply of adequate safe water and sanitization, [4] maternal and child health care, [5] immunization ...

What are the two elements of primary health care? ›

Box 1.2 Elements of Primary Health Care

Adequate and safe water supply and basic sanitation. Immunization against major infectious diseases.

What are the 10 elements of primary health care? ›

Elements of primary health care
  • Education about prevailing health problems and how to prevent and control them.
  • Food supply and proper nutrition.
  • Adequate supply of safe water and basic sanitation.
  • Maternal and child health, Family planning.
  • Immunisation against infectious diseases.
  • Prevention and control of endemic diseases.

Why is it important to have a framework of what you are planning to do? ›

Strategic planning frameworks help you dig deep into a specific section of your plan, so you can create something comprehensive that actually helps you turn ideas into action.

What makes a framework effective? ›

Framework makers should strive to follow the dictum attributed to Albert Einstein: Things should be made as simple as possible, but not simpler. Structure, visual depiction, or language can help make a framework memorable.

What are the key elements of a framework? ›

A strategic framework serves to provide structure to this type of long-term planning by focusing on four key elements: vision, mission, time frame and objectives.

What is an example of framework? ›

Here are some of the most well-known frameworks: Net is Microsoft Framework and one of the most used. Symphony: PHP free software project. Zend Framework: Open source framework for developing web applications and with PHP web services.

What does a framework include? ›

It provides a foundation on which software developers can build programs for a specific platform. For example, a framework may include predefined classes and functions that can be used to process input, manage hardware devices, and interact with system software.

What are two reasons for having a process framework? ›

A process framework provides a standardized checklist of processes that can be used to:
  • classify processes into groups of related processes,
  • support end-to-end process ownership,
  • establish a common language between groups,
  • provide visibility on how work gets done within the organization,
29 Jan 2015

What is the main problem with universal healthcare? ›

More government control in individual health care. A universal health care system may limit costly services that have a low probability of success. This may eliminate access to care that could potentially save a person's life, because of the large possibility that it could fail and the associated cost.

Why can't the US have free healthcare? ›

The United States does not have universal health care because no one has ever voted for a government willing to provide it. While Obamacare did reduce the number of Americans without health insurance coverage from 40 million to less than 30 million, Obamacare is not universal healthcare.

What is wrong with the United States healthcare system? ›

The US health-care model relies on a direct-fee system and private health insurance. This model has been criticized for contributing to high health-care costs, high rates of uninsured individuals, and high rates of health problems in comparison to the situation in other Western nations.

What are the 3 pillars of universal coverage? ›

Definition and Concept of Universal Health Coverage

The main concepts of UHC include 1) population coverage, 2) range of health services provided, and 3) out-of-pocket expenditure (Figure).

Will the US have universal healthcare by 2030? ›

Unless COVID-19 hastens a severe disruption in our economy such as a multi-year recession, depression, or runway inflation, U.S. health care will be largely socialized by 2030.

Does universal healthcare improve public health? ›

UHC strategies enable everyone to access the services that address the most significant causes of disease and death and ensures that the quality of those services is good enough to improve the health of the people who receive them.

How does the US health care system differ from other countries with universal health care? ›

However, despite higher healthcare spending, America's health outcomes are not any better than those in other developed countries. The United States actually performs worse in some common health metrics like life expectancy, infant mortality, and unmanaged diabetes.

What is the difference between free healthcare and universal health care? ›

The terms are often used interchangeably, but they are not synonymous. Free Healthcare means that all citizens receive health care without having to pay for services. Universal Healthcare means there is a health care system that provides coverage to a high percentage of citizens.

What are the arguments against universal healthcare? ›

Counterargument: P1: Universal healthcare would cause our taxes to go up. P2: Universal healthcare will cause doctor's wages to decrease. P3: People may abuse universal healthcare and cause the overuse of health care resources. C: Therefore, universal healthcare needs not to be available for every individual.

What is framework in simple terms? ›

In general, a framework is a real or conceptual structure intended to serve as a support or guide for the building of something that expands the structure into something useful.

What do we mean by a framework? ›

a supporting structure around which something can be built. C2. a system of rules, ideas, or beliefs that is used to plan or decide something: a legal framework for resolving disputes.

What does frameworks mean in health and social care? ›

2.1 The UK policy framework for health and social care research sets out principles of good practice in the management and conduct of health and social care research that take account of legal requirements and other standards.

What are the two types of frameworks? ›

Theoretical & conceptual frameworks

Although they are both used to understand a research problem and guide the development, collection, and analysis of research, it's important to understand the difference between the two.

How many types of framework are there? ›

There are four major types of enterprise architecture framework, which professionals choose based on the framework's fit for their specific project. These framework subtypes include the Zachman, Federal, Gartman and the Open Group enterprise framework (TOGAF). Professionals most commonly use the latter.

What are the 3 conceptual framework? ›

There are three sources for a conceptual framework: (1) experience, (2) literature, and (3) theory.

What is the main use of framework? ›

The purpose of a framework is to assist in development, providing standard, low-level functionality so that developers can focus efforts on the elements that make the project unique. The use of high-quality, pre-vetted functionality increases software reliability, speeds up programming time, and simplifies testing.

Why is framework so important? ›

IT frameworks lay out guidelines, best practices and operating principles to help IT organizations achieve objectives defined in business terms. IT frameworks ensure alignment between the way IT services are delivered and the value they enable. Frameworks are useful because IT processes can be large and complex.

Why a framework is important? ›

In other words, most organizations use frameworks for their primary purpose: as a reference model that they can use to understand their processes and create a model or structure that ensures work is being accomplished efficiently and monitored consistently.

What is a framework and what types of problems does one tend to solve? ›

What is a framework? A framework provides a high-level, yet a foundational structure for solving a particular type of problem. It can be considered as a model, which visually depicts the key building blocks of the problem being analyzed.

What is framework and CMS? ›

A CMS or content management system is a computer application that is used for creating and modifying digital content. A framework is a software which contains a generic functionality that can be modified by additional user-written code depending on the application. Simplicity.

How many levels are there for health framework? ›

The healthcare providers who are part of these four levels of healthcare, together provide medical services such as evaluation, diagnostics, provision of treatment or onward referrals to the next level of care based on the specific health needs.


1. Positively equal: How NICE is working to reduce health inequalities virtual event
(National Institute for Health and Care Excellence (NICE))
2. Health and Adult Social Care Scrutiny Commission, 7.00 p.m., Thursday 10th November 2022
(Newham London)
3. Chapter 1 History and Overview of the Health Care System
(Dr. A's Clinical Lab Videos)
4. Health economists may be getting the supply-and-demand framework all wrong
(Health Affairs)
5. How The United Kingdom's Health-Care System Works
6. Carolyn Clancy: Evidence-based decision making in health care
(Nuffield Trust)
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