THE ORGANIZATION OF U.S. HEALTH CARE

The Organization of U.S. Health Care

The Organization of U.S. Health Care

Introduction

Health care in the United States is provided by many separate legal entities. Health care facilities are largely owned and operated by the private sector. Health insurance is primarily provided by the private sector, with the exception of programs such as Medicare, Medicaid, TRICARE, the Children's Health Insurance Program and the Veterans Health Administration.

The Organization of U.S. Health Care

At least 15.3% of the population is completely uninsured, and a substantial additional portion of the population (35%) is "underinsured", or not able to cover the costs of their medical needs. More money per person is spent on health care in the United States than in any other nation in the world, and a greater percentage of total income in the nation is spent on health care in the U.S. than in any United Nations member state except for East Timor. Despite the fact that not all citizens are covered, the United States has the third highest public healthcare expenditure per capita. A 2001 study in five states found that medical debt contributed to 62% of all personal bankruptcies. Since then, health costs and the numbers of uninsured and underinsured have increased.

Active debate about health care reform in the United States concerns questions of a right to health care, access, fairness, efficiency, cost, and quality. Many have argued that the system does not deliver equivalent value for the money spent. The US pays twice as much yet lags behind other wealthy nations in such measures as infant mortality and life expectancy, though the relation between these statistics to the system itself is debated. Currently, the U.S. has a higher infant mortality rate than most of the world's industrialized nations.[nb 1] The United States life expectancy lags 42nd in the world, after most rich nations, lagging last of the G5 (Japan, France, Germany, UK, USA) and just after Chile (35th) and Cuba (37th).

The USA's life expectancy is ranked 50th in the world after the European Union (40th). The World Health Organization (WHO), in 2000, ranked the U.S. health care system as the highest in cost, first in responsiveness, 37th in overall performance, and 72nd by overall level of health (among 191 member nations included in the study). A 2008 report by the Commonwealth Fund ranked the United States last in the quality of health care among the 19 compared countries.

According to the Institute of Medicine of the United States National Academies, the United States is the "only wealthy, industrialized nation that does not ensure that all citizens have coverage" (i.e. some kind of insurance). The same Institute of Medicine report notes that "Lack of health insurance causes roughly 18,000 unnecessary deaths every year in the United States." while a 2009 Harvard study published in the American Journal of Public Health found a much higher figure of more than 44,800 excess deaths annually in the United States due to Americans lacking health ...