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Health Care Model Complexity
The U.S. system involves multiple players (patient, employer, insurer, provider, government), making it difficult to manage efficiently.
Health Care Expenditures
Total spending on health care; extremely high in the U.S. (~trillions, large % of GDP).
Stakeholders
Key participants: patients, providers, insurers, employers, government.
Premium
Monthly payment for insurance.
Deductible
Amount paid before insurance starts covering.
Coinsurance
Percentage of costs paid after deductible.
Out-of-Pocket Maximum
Maximum you pay per year before full coverage.
In-Network
Cheaper providers approved by insurance.
Out-of-Network
More expensive or not covered providers.
Market Failure
When the market does not allocate resources efficiently.