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Abstract

The U.S. healthcare system is rife with complexities and is consistently a source of political debate. One’s interaction with the system may directly impact the understanding of the system. The objective of this research is to examine the perceptions of the United States healthcare system from the viewpoint of healthcare providers, insurers, and consumers. Using a grounded theory approach, theoretical sampling was used to explore similarities and differences between the three groups of actors in the healthcare system. Data were collected through interviews with thirty-one participants using a semi-structured interview schedule. Themes of cost, access, and inefficiency emerged from the data. The theme of cost included the ability to pay, innovative care delivery, and relation to access. Access included the need for guidance, geographical proximity to healthcare, and socioeconomic status. The theme of inefficiency included how insurance dictates care, and the unwieldy system. Similarities among groups were the high cost of care, ability to pay, and complexity. Differences discovered were the insurers’ dual role as professional and consumer, providers’ informal access to care, and differing views on who is to blame for the high cost of healthcare. This research unveils perspectives of three stakeholders of actors in the healthcare system, providing a foundation for further research to better understand these perspectives in improving equity and access in healthcare.

Experience Framework

This article is associated with the Staff & Provider Engagement lens of The Beryl Institute Experience Framework (https://www.theberylinstitute.org/ExperienceFramework).

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