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TODAY\'S HEALTH CARE SYSTEM: ACCESS
Access to health care is determined by numerous factors, including the supply of providers and facilities, proximity to care, ability to maneuver in the system, health status, and insurance coverage. Although there are approximately 700,000 physicians in the United States, many Americans do not have adequate access to care or other health services because of insurance barriers or maldistribution of providers. There is an oversupply of higher-paid specialists and a shortage of lower-paid primary care physicians (family practitioners, pediatricians, internists, OB/GYNs, gerontologists). Inner cities and some rural areas face constant shortages of physicians.
Under managed care health plans, access is determined on the basis of the participating provider network, the health plan benefits, and the administrative rules. Often this means that consumers do not have the freedom to choose specialists, facilities, or treatment options beyond those specifically contracted with the health plan and recommended by their primary care provider (also known as gatekeeper). In the United States, consumer demand has led to an expansion of benefits to include CAM therapies such as chiropractic and acupuncture. Most CAM therapies are generally not accessible to most people, even to a limited degree, through the available health plans.
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GENERAL HEALTH
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