Roemers model of a health care delivery system shows the different necessary elements for system to be successful. As health needs are the input; the system needs resources, organization of programs, economic support mechanisms, and delivery of services to provide the health needs output. As we see healthcare has always been a high cost and a detrimental burden to many Americans. According to AMA Journal of Ethics, (Burke & Ryan, Feb 2014), Although the rate of growth in spending has attenuated in recent years, per capita spending on healthcare is estimated to be 50 to 200 percent greater in the United States in other developed countries. Even though we lead the world in costs, however, the United States ranks twenty-sixth in the world for life expectancy and ranks poorly on other indicators of quality. This in turn, downgrade the quality of healthcare to a minimum, and prevent people from even seeking to obtain access to get health insurance. We see evidence of how low of value, especially here in the US healthcare has been wasteful spending. In the roemer model, for economic support, this can keep costs low by offering and tailoring health plans to the individual needs and preferences according to family size and affordability. Future efforts to reduce costs and promote quality will undoubtedly involve a multimodal approach. Due to the substantial differences in doctors, physicians, nurses, and other care workers in practice patterns that lead to varying degrees of health care quality. To have access, quality, and costs all work hand in hand, we need to strive to tailor payments to decision-making entities (clinicians or health care organizations) based, in part, on measures of quality. We need increase adoption of value based purchasing practices.

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