Health Care may be

Primary - first contact medicine, screening, prevention,
investigation, diagnosis, treatment, referral, management and care.

Secondary - hospital care - in patient/out patient
investigation, operation, palliation, treatment.

Tertiary - The management and care of the long term sick and the dying.

The final decision is a financial decision - to spend or not to spend. Public Health must have a place at the table where those decisions are made.