U.S. Healthcare includes both the public and private sector. The U.S. as a whole spends approximately 17% of its GDP on health care. For each dollar spent on health care in the U.S., 31% goes to hospital care, 21% goes to physician/clinical services, 10% to pharmaceuticals, 7% to administrative costs, 7% to investment, 6% to nursing homes, 6% to other professional services such as physical therapists and optometrists, 4% to dental, and 8% on other. In 2009, the U.S. spent $2.5 trillion on health care, or $8,047 per person.

     As of 2009, over 50 million U.S. residents, about 16% of the population, were uninsured. Out of the 84% who have some form of health insurance, the majority get it through their employer or the employer of their spouse or parent, and the rest get it through government programs. All government health care programs have restricted eligibility. For example, Medicare covers citizens and long-term residents who are 65 years and older and the disabled. Medicaid covers low income people including children, pregnant women, and the disabled.

Children’s Health Insurance Program provides health insurance for low-income children who don’t qualify for Medicaid. TRICARE covers military personnel. The Veterans Administration provides care to veterans, their families, and survivors, but oftentimes veterans are only treated for medical conditions if they got them while serving in the military. Lastly, the Indian Health Service has facilities that are only open to certain Native American tribes.

     For people whose employer pays for health insurance, the employee is usually required to pay for part of the cost of the insurance. The percentage of people under employer-paid health insurance is declining as costs are rising. In addition, premiums for family coverage have increased. Most covered workers have to pay deductibles or copayments, and insurance for dental and vision care is usually sold separately. No matter what kind of insurance a person has, he is limited to medical facilities which accept his particular type of medical insurance because hospitals and doctors can refuse to accept a given type of insurance including Medicare and Medicaid. If a patient goes to a facility outside his insurance program’s network, he has to pay more “out of pocket.” The Emergency Medical Treatment and Active Labor Act requires all hospitals accept all patients, regardless of the ability to pay for emergency room care. This doesn’t provide access to non-emergency room care nor does it allow for preventative care or the ability to have a primary care physician. Therefore, patients who do not have the ability to pay for medical care often are not treated until their case is much more severe and therefore more money has to be spent than would have if they had been given preventive treatment.

     There are many different kinds of healthcare facilities in the U.S. Most healthcare facilities such as hospitals and clinics are privately owned, with about 70% being non-profit. The physicians who work in U.S. healthcare facilities must be trained in the U.S. medical education system. Because of this, physicians who were educated in other countries must go through many steps to acquire a medical license in the U.S. Because the cost of medical care in the United States has been rising much faster than inflation, reform was inevitable. Now we must learn about the new reforms that will change our system.

The US Health System and Reform

     By now, it is common knowledge that the American health care system is broken, considering the several problems that have arisen. Take, for example, the extreme lack of health coverage. Approximately 50 million Americans do not have health insurance. Instead, they walk into the ER and rack up bills. Additionally, the health care available is characterized by uneven access and quality for members of different socioeconomic categories, genders, and races. Furthermore, the health care system is focused on illness, not wellness. Instead of simply treating problems when they arise, people should be encouraged to change their lifestyle and behavior as a preventative measure. Additionally, Americans spend more money on health care than any other developed country in the world. The approximate $2.5 trillion spent averages out to about $8,000 per person. However, this investment does not pay off for Americans. Moreover, this spending is unsustainable as it outpaces general inflation. Overall, the health care system is failing.

     In response to this crisis, Congress debated health care reform and finally passed the Patient Protection and Accountable Care Act (PPACA). The act requires everyone to have health care insurance after 2015. The government will provide a health insurance exchange in which they will sell insurance to small businesses and the uninsured. People can take a government voucher, and everyone pays the same amount. These insurance plans will be required to spend 80-85% of premium on medical services. They will cover essential benefits. There are no pre-existing condition exclusions or lifetime/annual benefit caps. There will be prior approval of any rate increases. Until 2015, a high-risk pool strategy will be utilized to provide health insurance to the uninsured. Aid will be based off of the federal poverty level, which deems income under $11,000 as impoverished.

By Alex Ziehm

Works Cited

Wikipedia contributors. "Health care in the united states." Wikipedia, The Free Encyclopedia. Wikipedia, The Free Encyclopedia, 10 October. 2011. Web. 11 Oct. 2011.