Amerika Birleşik Devletleri'nde Kamu ve Özel Hastanelerin Finansmanı: Küresel Perspektiflerle Karşılaştırmalı Bir Analiz

Year 2025, Volume: 4 Issue: 2, 51 - 66, 10.11.2025

Ufuk Burak Karcıoğlu

https://doi.org/10.61830/balkansbd.1746918

Abstract

ABD sağlık sistemi, kamu ve özel hastane finansmanının karmaşık bir bileşimiyle karakterize olup, eşit erişim ve finansal sürdürülebilirlik sağlama konusunda benzersiz zorluklar ve fırsatlar sunmaktadır. Bu inceleme, ABD’deki kamu ve özel hastanelerin finansman mekanizmalarını ele almakta, Medicare, Medicaid, özel sigorta ve yatırım fonları gibi birincil gelir kaynaklarını vurgulamaktadır. Bu modeller, Birleşik Krallık’ın Ulusal Sağlık Servisi, Almanya’nın sosyal sigorta modeli, Singapur’un Medisave sistemi ve Japonya’nın evrensel sağlık sigortası gibi küresel sağlık sistemleriyle karşılaştırılmış; erişim eşitliği, maliyet etkinliği, hasta memnuniyeti ve finansal sürdürülebilirlik kriterlerine odaklanılmıştır. Analiz, yapay zeka tabanlı gelir döngüsü yönetimi ve tele-tıp gibi dijital teknolojilerin dönüştürücü etkisini ve hasta sonuçlarıyla ödemeleri uyumlu hale getiren değer temelli bakım modellerini incelemektedir. Türkiye’nin Genel Sağlık Sigortası sistemiyle yapılan karşılaştırmalı bir perspektif, hibrit finansman modellerinin etkinlik ve eşitlik dengesini sağlama potansiyelini ortaya koymaktadır. Bulgular, küresel hastane finansmanını geliştirmek için artan dijital adaptasyon, hibrit finansman stratejileri ve çevresel, sosyal ve yönetişim (ESG) odaklı yatırımları savunmakta, çeşitli sağlık sistemlerinde sağlık yöneticileri ve politika yapıcılar için stratejik içgörüler sunmaktadır.

Keywords

Hastane finansmanı , kamu hastaneleri , küresel sağlık sistemleri

Financing of Public and Private Hospitals in the United States: A Comparative Analysis with Global Perspectives

Abstract

The U.S. healthcare system, characterized by its intricate blend of public and private hospital financing, presents unique challenges and opportunities in ensuring equitable access and financial sustainability. This review examines the financing mechanisms of U.S. public and private hospitals, highlighting primary revenue sources such as Medicare, Medicaid, private insurance, and investment funds. It compares these models with global healthcare systems, including the United Kingdom’s National Health Service, Germany’s social insurance model, Singapore’s Medisave system, and Japan’s universal health insurance, focusing on access equity, cost-efficiency, patient satisfaction, and financial sustainability. The analysis also explores the transformative impact of digital technologies, such as artificial intelligence-driven revenue cycle management and telemedicine, alongside value-based care models that align payments with patient outcomes. A comparative perspective with Türkiye’s General Health Insurance system underscores the potential for hybrid financing models to balance efficiency and equity. The findings advocate for increased digital adoption, hybrid financing strategies, and environmental, social, and governance (ESG)-focused investments to enhance hospital financing globally, offering strategic insights for healthcare administrators and policymakers in diverse healthcare systems.

Keywords

Hospital financing , public hospitals , U.S. healthcare system , global health systems

References

• 1.Kaiser Family Foundation. Health System Tracker. Washington (DC): KFF; 2025.
• 2.American Hospital Association. Hospital Statistics 2023. Chicago (IL): AHA; 2023.
• 3.Centers for Medicare & Medicaid Services. National Health Expenditure Data 2023. Baltimore (MD): CMS; 2023.
• 4.World Health Organization. Global Health Expenditure Database. Geneva (Switzerland): WHO; 2024.
• 5.Organisation for Economic Co-operation and Development. Health Statistics 2024. Paris (France): OECD; 2024.
• 6.Health Affairs. The Role of AI in Healthcare Financing. Health Aff. 2024;43(5):678–90.
• 7.Veterans Health Administration. VHA Budget Report 2024. Washington (DC): VHA; 2024.
• 8.Indian Health Service. IHS Budget Overview 2024. Rockville (MD): IHS; 2024.
• 9.Centers for Medicare & Medicaid Services. National Health Expenditure Data 2024. Baltimore (MD): CMS; 2024.
• 10.MedPAC. Report to Congress: Medicare Payment Policy. Washington (DC): MedPAC; 2024.
• 11.New York City Health + Hospitals. Financial Report 2023. New York (NY): NYC H+H; 2023.
• 12.Office of the National Coordinator for Health Information Technology. Health IT Adoption Metrics. Washington (DC): ONC; 2024.
• 13.HCA Healthcare. Annual Report 2024. Nashville (TN): HCA Healthcare; 2024.
• 14.Cleveland Clinic. Annual Report 2024. Cleveland (OH): Cleveland Clinic; 2024.
• 15.Deloitte. Healthcare Technology Trends 2024. New York (NY): Deloitte; 2024.
• 16.Department of Health and Social Care. NHS Budget Overview 2024. London (UK): DHSC; 2024.
• 17.NHS England. NHS Performance Statistics 2024. London (UK): NHS England; 2024
• 18.Organisation for Economic Co-operation and Development. Health Statistics 2025. Paris (France): OECD; 2025.
• 19.Commonwealth Fund. Mirror, Mirror 2024: Comparing Health System Performance. New York (NY): Commonwealth Fund; 2024.
• 20.King’s Fund. NHS Funding and Performance 2024. London (UK): King’s Fund; 2024.
• 21.Federal Ministry of Health. Health System Report 2024. Berlin (Germany): BMG; 2024.
• 22.European Observatory on Health Systems and Policies. Germany Health System Review 2024. Brussels (Belgium): European Observatory on Health Systems and Policies; 2024.
• 23.Ministry of Health Singapore. Healthcare Financing Overview 2024. Singapore: MOH; 2024.
• 24.Ministry of Health, Labour and Welfare. Health Insurance System Report 2024. Tokyo (Japan): MHLW; 2024.
• 25.Kaiser Permanente. Integrated Care Report 2024. Oakland (CA): Kaiser Permanente; 2024
• 26.Cook County Health. Quality and Performance Report 2024. Chicago (IL): Cook County Health; 2024.
• 27.Organisation for Economic Co-operation and Development. Health at a Glance: Türkiye. Paris (France): OECD; 2023.
• 28.Social Security Institution. SGK Financial Report 2024. Ankara (Türkiye): SGK; 2024.
• 29.Mayo Clinic. Telemedicine Impact Report 2024. Rochester (MN): Mayo Clinic; 2024.
• 30.McKinsey Health Institute. Sustainable Healthcare Financing 2025. New York (NY): McKinsey; 2025.
• 31.Centers for Medicare & Medicaid Services Innovation Center. Value-Based Care Report 2025. Baltimore (MD): CMS; 2025.
• 32.Ministry of Health Türkiye. Health System Performance Report 2024. Ankara (Türkiye): MoH; 2024.
• 33.Federica Bosco, Chiara Di Gerio, Gloria Fiorani, Giulia Stola; How to manage sustainability in healthcare organizations? A processing map to include the ESG strategy. Journal of Public Budgeting, Accounting & Financial Management 12 November 2024; 36 (5): 636–659. https://doi.org/10.1108/JPBAFM-04-2023-0065
• 34.Sepetis A. Sustainable finance in sustainable health care system. Open J Bus Manag. 2019;8(1):262-81. https://doi.org/10.4236/ojbm.2020.81016
• 35.Candio, Paolo. "The influence of ESG score on financial performance: Evidence from the European health care industry." Strategic Change 33.5 (2024): 417-427.