Health care in the United States

Health care in the United States

See also: Health care reform in the United States, Patient Protection and Affordable Care Act and Health Care and Education Reconciliation Act of 2010

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Health care in the United States is provided by many distinct organizations. Health care facilities are largely owned and operated by private sector businesses. 58% of US community hospitals are non-profit, 21% are government owned, and 21% are for-profit.^[2]According to the World Health Organization (WHO), the United States spent more on health care per capita ($8,608), and more on health care as percentage of its GDP (17.2%), than any other nation in 2011.

60–65% of healthcare provision and spending comes from programs such as Medicare, Medicaid, the Children's Health Insurance Program, and the Veterans Health Administration. Population under 67 acquire insurance via their or a family member's employer, by purchasing health insurance on their own, or are uninsured. Health insurance for public sector employees is primarily provided by the government.

The United States life expectancy of 78.4 years at birth, up from 75.2 years in 1990, ranks it 50th among 221 nations, and 27th out of the 34 industrialized OECD countries, down from 20th in 1990. Of 17 high-income countries studied by the National Institutes of Health in 2013, the United States had the highest or near-highest prevalence of obesity, car accidents, infant mortality, heart and lung disease, sexually transmitted infections, adolescent pregnancies, injuries, and homicides. On average, a U.S. male can be expected to live almost four fewer years than those in the top-ranked country, though notably Americans aged 75 live longer than those who reach that age in other developed nations.

Americans undergo cancer screenings at significantly higher rates than people in other developed countries, and access MRI and CT scans at the highest rate of any OECD nation. People in the U.S. diagnosed with high cholesterol or hypertension access pharmaceutical treatments at higher rates than those diagnosed in other developed nations, and are more likely to successfully control the conditions. Diabetics are more likely to receive treatment and meet treatment targets in the U.S. than in Canada, England, or Scotland. A study showed that the U.S., Japan, and France recorded the highest survival rates among 31 nations for four types of cancer.

Gallup recorded that the uninsured rate among U.S. adults was 11.9% for the first quarter of 2015, continuing the decline of the uninsured rate outset by the Affordable Care Act. A 2004 Institute of Medicine (IOM) report said: "The United States is among the few industrialized nations in the world that does not guarantee access to health care for its population." A 2004 OECD report said: "With the exception of Mexico, Turkey, and the United States, all OECD countries had achieved universal or near-universal (at least 98.4% insured) coverage of their populations by 1990." Recent evidence demonstrates that lack of health insurance causes some 45,000 to 48,000 unnecessary deaths every year in the United States. In 2007, 62.1% of filers for bankruptcies claimed high medical expenses. A 2013 study found that about 25% of all senior citizens declare bankruptcy due to medical expenses, and 43% are forced to mortgage or sell their primary residence.

In 2010 the Patient Protection and Affordable Care Act (PPACA) became law, providing for major changes in health insurance. The medical system will be forced to change normal procedures. They will be required to prepare for upcoming programs to meet federal regulations.The constitutionality of the law, as well as its impact on insurance coverage, insurance quality, insurance premiums, medical quality, and the economy are subjects of ongoing debate.

Contents

• 1History
• 2Statistics
  • 2.1Nobel Prize
• 3Providers
• 4Facilities
  • 4.1Physicians (M.D. and D.O.)
  • 4.2Medical products, research and development
  • 4.3Healthcare provider employment in the United States
• 5Spending
• 6Regulation and oversight
  • 6.1Involved organizations and institutions
  • 6.2"Certificates of need" for hospitals
  • 6.3Licensing of providers
    • 6.3.1Emergency Medical Treatment and Active Labor Act (EMTALA)
  • 6.4Quality assurance
• 7Overall system effectiveness
  • 7.1Measures of effectiveness
    • 7.1.1Access to care: Cost, affordability, coverage
    • 7.1.2Population health: Quality, prevention, vulnerable populations
    • 7.1.3Innovation: Workforce, healthcare IT, R&D
  • 7.2Compared to other countries
• 8System efficiency and equity
  • 8.1Efficiency
    • 8.1.1Preventable deaths
    • 8.1.2Value for money
    • 8.1.3Delays in seeking care and increased use of emergency care
    • 8.1.4Shared costs of the uninsured
    • 8.1.5Variations in provider practices
    • 8.1.6Care coordination
    • 8.1.7Administrative costs
  • 8.2Third-party payment problem and consumer-driven insurance
  • 8.3Overall costs
  • 8.4Equity
    • 8.4.1Coverage
    • 8.4.2Mental health
    • 8.4.3Medical underwriting and the uninsurable
    • 8.4.4Demographic differences
• 9Drug efficiency and safety
  • 9.1Impact of drug companies
• 10Political issues
  • 10.1Prescription drug prices
  • 10.2Debate
• 11Reform
• 12Health insurance coverage for immigrants
• 13Health insurance coverage for visitors to the U.S.
• 14See also
• 15Notes
• 16References
• 17Further reading
• 18External links