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Although some essential health care services in the United States are administered through governmental agencies, such as Medicare and Medicaid, much of the U.S. health care system is privatized. Most industrialized nations employ other systems, often falling into one of three different categories:

National health insurance systems, such as the Canadian system: National and local governments oversee and pay for the bulk of required medical services, and private insurance supplements that coverage.

National health systems, such as the British system: All residents have access to the same health care benefits, provided at no cost to the residents.

Socialized insurance systems, such as the German system: Health care is provided at no charge to residents.

Even after passing the Patient Protection and Affordable Care Act (PPACA) in 2010, the health care system in the United States remains markedly different from the systems described above. However, the legislation aims to address one of the fundamental philosophies historically missing from U.S. health care policy: access to health insurance and health services at all levels of income.

In this Discussion, you analyze different provisions of the PPACA to predict the possible impact they may have on public health spending and public health outcomes. You base part of your analysis on the three national health care systems described in the preceding bullet points and the media listed in the Learning Resources. As you think about the potential impact on public health spending, you may want to consider the impacts on pharmaceutical and dental health care spending as well-two categories that are sometimes overlooked when health care expenses are discussed.

Post initial responses to the topic. Review the different provisions of the PPACA, keeping in mind that different provisions are enforced on different timelines. Based on your analysis, describe at least one important impact you think the PPACA has had or will have on U.S. public health, especially regarding health care spending and public health outcomes. As part of your discussion, describe how American health care spending and outcomes compare to other countries.

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