Intent.Health US Health care System Overview
The Iron Triangle
In healthcare economics, it is notoriously difficult to improve one factor without negatively impacting the others. The US system struggles to balance these three competing demands.
Focus: COST
The US spends ~18% of GDP on healthcare (highest in the world). High costs are driven by administrative complexity, drug prices, and high utilization of expensive technology.
Who Pays the $4.5 Trillion Bill?
Government (Public)
Medicare (Elderly) & Medicaid (Low Income).
Private Business
Employer-sponsored insurance plans.
Households / OOP
Out-of-pocket costs, deductibles, premiums.
Why This Matters
Funding sources shape decision dynamics. Government = Compliance Focus. Private = Cost Control Focus.
From Volume to Value: The Shift
1946: 1980s: The Era of Expansion
Hill-Burton Act: Government funded hospital construction everywhere.
Focus: Access & Infrastructure. "Build it and they will come."
Model: Fee-For-Service (FFS). More volume = More profit.
1990s: 2010: The Managed Care Era
HMOs & DRGs: Payers tried to control spiraling costs by limiting networks and capitating payments.
Focus: Cost Containment.
Result: Provider consolidation began to negotiate better rates.
2010: Present: The Value-Based Era
ACA & Digital Health: Focus on outcomes, preventative care, and digital access.
Focus: Quality & Value.
Current State: Massive consolidation (IDNs), Consumerism, and AI adoption.