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Concepts of Health Care in America


Primarily, anywhere in the world, people apply healthcare services to administer their health conditions. For example, in order to cure diseases and other health problems, people need health care services. Additionally, health care services acts as an additional ingredient of improving life and reducing some abnormal or consistent pains in the body. On the other hand, healthcare facilities provide people with information on their health status and inform them whether certain complications need further medical diagnosis or attention of drugs. Nevertheless, depending on the healthcare system adopted by a country, health care services can be expensive, affordable, appropriate or ineffective. Perhaps, this is the reason why, many countries all over the world are busy altering their present health care systems so that, they can be affordable by all civilians.

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The emergence of new medical technologies such as devices, drugs and surgical techniques are propelling many countries to renew their policies on health care. Nevertheless, the countries’ GDP rates dictate the healthcare system civilians’ demand. There are counties where the government controls the whole healthcare system-single player, while in some, health insurance companies are responsible in the provision of healthcare to eth people. Still, some countries have two market players where, both the government and private companies compete to offer healthcare services on a liberal market. For example, in United States of America before the passing of healthcare reform bill by Congress and then Presidential signing into law, many legalized players provide health care services to millions of Americans as of now. (Leiyu & Singh, 2005, pp. 2-32).

As by April 2010, private companies dominated healthcare provision in America. These private firms own most the facilities used in to offer healthcare services. Nevertheless, the American government provides some few healthcare programs which private companies do not offer. These include Medicaid, Medicare, TRICARE, Veterans Health Administration and Children’s Health Insurance Program. These programs allow a section of Americans to receive free healthcare services from the government. In terms of accessibility to healthcare facilities, many Americans afford healthcare services with an exception of 46 million Americans, who are either uninsured or underinsured. Additionally, 21 percent of Americans have halfway insurance premiums which cannot completely cover their healthcare services. (U.S Census Bureau, 2008, pp. 60-235).

This is the reason why many Americans want an overhaul of the current healthcare system because; Americas spend so much money to receive healthcare services more than any other people in different nations. Additionally, most of the GDP is spent on healthcare than any other sector in America making America to be one of the highest spenders in the world. As the global downturn continues to affect economies, the number of Americans underinsured or uninsured continue to rise. This has led to many Americans to protest against the system because; they cannot value their pay on healthcare. Infant Mortality rates in United States continue to increase even as life expectancy age remains low as compared to industrialized countries like Japan and United Kingdom. Nevertheless, the warring debate in United States healthcare reform target issue to do with efficiency, quality, fairness and accessibility of healthcare services to all Americans. (Kronenfeld &Kronenfeld, 2004, pp. 1-4).

Health Care Providers

In United States of America, the state, county, federal and city governments and private companies offer healthcare services to Americans. Therefore, these healthcare providers have their own healthcare facilities ranging from hospitals to medical equipments. Besides, there are many hospitals classified according to the services offered. They include non-profit, privately owned profit hospitals and government hospitals. Although the government does not have direct medical facilities, the city government and the Department Of Defense do own some hospitals to cater for interested groups. Moreover, the Veteran Health Administration has veteran hospitals that offer healthcare services to veterans only. Overall, hospitals provide inpatient services although at some point, they can offer emergency services to outpatients. There are also clinics for prenatal and antenatal care, and hospices to house patients requiring medical attention for longer periods.

Healthcare service providers are responsible for medical research and development of healthcare facilities and services. There are many pharmaceutical companies operating healthcare business through research and development. So far United States is among top class countries whose medical research is world class. Private companies are the one responsible for manufacturing of most medical devices and pharmaceutical products. Both public and private institutions fund medical research hence, medical investment. (Lumsdon, 1992, pp. 30-32).

Health Care Spending

Currently, United States is the second largest nation in the world spending big sums of money on healthcare services. In fact, the government uses at least 16 percent of its GDP where, the state allocates 35 percent of the money to hospitals, 8 percent to nursing homes, and 10 percent to pharmaceutical companies while the rest goes to pay doctor wages. United states spend these large sums of money because; the government projects on future healthcare developments. For example, in 2007, the government spent US $2.3 trillion to offer healthcare services to Americans- which is $ 7,440 per capita income. The figure has been on the rise since 2000 forcing the government to pump more resources into the sector. Clearly, these rising figures indicate that, the cost of meeting healthcare services is high and even more than what individual Americans earn as wages. (Heffler, Levit & Smith, 2001, pp. 193-202).

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The rise in healthcare costs can be as a result of the new face of medical industry coupled with new technological advancements. Additionally, the increase in wages, alteration of insurance premiums and inflation are also major contributors in skyrocketing of healthcare costs. Consequently, physicians, hospitals and pharmaceutical products consume a lot of money due to demand and technology. Additionally, healthcare spending is not uniformly distributed according to age, race and affluence. Normally, the rich will receive better healthcare services because they can afford full medical insurance premiums. Senior Americans spend more on healthcare than children and the old. Spending can also depend on the ailment. Certain diseases require more attention hence, more cost. The only solution aimed at lowering healthcare costs, is to try preventive measures which are cheaper as compared to the real treatment. For example, as a result of economic downturn, less consumers now visit physicians for consultation because, consultation fees have since become high.

Meeting Healthcare Costs

About 84 percent of Americans have at least an insurance healthcare cover. This insurance cover, fall under various categories. A person can receive insurance cover from the employer or an employee’s spouse. On the other hand, children can have their insurance cover from employed parents. Additionally, about 9 percent of Americans acquired insurance cover through purchase. Those who do not fall into these two categories can enjoy government cover only if they are classified accordingly. Nevertheless, the government programs provide insurance cover to 28 percent of Americans who are either children, soldiers, veterans, expectant mothers or aged. In 2007, the number of Americans who did not have healthcare insurance cover was, 46 million Americans.

In the case where a person receive insurance premium from the employer, an employee must contribute some money and then, under a group, the employer will parley with an insurance company of choice. On the other hand, Americans having insurance terms with private or the government, receive healthcare services according to the premium they possess. Thus, any medical attention outside insurance cover, attract personal pay. Interestingly, it is the role of hospitals to fix charges on healthcare cost on a particular ailment although the law fixes some. Usually, doctors attending insured Americans receive fewer wages as compared to when attending an uninsured person. Consequently, many doctors prefer to attend uninsured patients because of lucrative wages. Depending on the amount paid by insurance cover providers, the back stops on the hospitals and doctors as they have the power not to work with certain programs or insurance companies. This requires proper networking between insurance companies, doctors and hospitals. (Anderson, 1995, pp. 1-10).

Private insurance Cover

Statistics indicate that, most Americans receive insurance cover from out of private partnership with private insurers. These include those employed and unemployed. Though the number stands at 60 percent, there is likelihood that it will decrease following economic hardships that have led to cutting of jobs. Nevertheless, the cost of employer-paid healthcare insurance keep on rising together with family premiums due to inflation and better pay from these companies. Employees paying premiums to insurance companies are meeting new demands from their employers like copayments and other deductibles. Nonetheless, insurance covers allow payment cost-sharing between, the employer and employee. Generally, persons insured are likely to pay less money on healthcare services than out-of pocket individuals who meet all costs alone. This is because; insurance companies have a network structure to service provides, that is, doctors and hospitals under two systems. The first one is health maintenance organizations (HMOs) where, insurance companies sign a contract with healthcare service providers. The second one is preferred provider organizations (PPO), which comprise of in-network and out-of-network modes. Habitually, out-of network mode is more expensive than in-network and lately; PPO has attracted many Americans depending on the cost of enrollment. (Hurley, Strunk, & White, 2004, pp. 56-58).

Public Insurance Cover

Under this insurance cover, the government covers a section of Americans like children, veterans, physically and mentally challenged persons, the old and in some cases, the poor. Whether able or unable to pay, these persons can access insurance premiums. Every year, the American government spends about half of healthcare allocation on these programs making it to be one of the highest GDP consumers. Some of the programs include Medicare for covering persons aged 65 and above. Another category is Medicaid, which insures children, expectant mothers and the challenged. The government, through counties runs community clinics, which offer treatment to poor Americans. Additionally, low-income children can receive treatment via the State Children’s Health Insurance Program, and on the other hand, Veteran Administration covers medical costs of American veterans. Lastly, there is a program for people serving in the military called TRICARE. However, persons with employer-paid healthcare insurance cover do not pay federal taxes leading to a distorted market hence; the government loses millions of taxes. Further, this exemption is disadvantageous to out-of-pocket persons who incur taxes in addition to huge medical costs. Nevertheless, many hospitals and particularly doctors are not willing to work on government programs like Medicaid due to low wages. Thus, the best way to cover all Americans is through a single-payer healthcare for a consumer healthcare. (Herzlinger & Parsa-Pasi, 2004, pp. 1213-1220).

The Uninsured Americans

About 46 million Americans do not have any healthcare insurance cover. This is because; they do not meet government insurance cover requirements, are not employed, cannot afford the cost of insurance premiums or, they willingly decline to have healthcare insurance covers. Most of the uninsured persons are young adults, unemployed or working part-time. There are also families who cannot afford healthcare insurance cover due to poverty. The issue is now trivialized politically and for the past one year, Obama administration has tried successively to make new historical changes in United States healthcare system. (Wilhelmie, Vidgor & Williams, 2004, Para. 1-16).

Many people believe that, government programs like Medicare and Medicaid destroy the healthcare market. Most people, especially republicans, do not believe in a market where a single player dominates. They strongly believe that, healthcare system should be liberalized to allow competition hence, lead to the reduction of medical costs. Nevertheless, a universal healthcare will give every American an opportunity to access healthcare services without fear. The system will not render private companies powerless since; some people can chose to have private treatment instead. Nevertheless, some private companies selling medical equipments and pharmaceuticals have also been monopolistic in the market. Thus, a universal healthcare system will enable the government to track economy of scale, and reduce public expenditure on healthcare. The government has also developed a policy to control the cost of drugs and save consumers from subsidizing to aggressive companies out to exploit them. In dealing with the whole issue, the government can decide to impose taxes on manufacturing companies or make pharmaceutical sales liberal hence, creating a liberal market. (McWilliams, 2007, pp.2886-2894).

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Debate on Healthcare Reform

From the ongoing debate on healthcare reform in America, it is clear; the public is divided over the issue. Though instigated by the politics of republicans and democrats, America needs healthcare reform. The opponents of healthcare reform believe that, if America adopts a universal healthcare system like the one in Canada, Americans will be forced to pay more taxes. However, the Congressional Budget Office has reiterated that, a universal healthcare system will save billions of dollars, which can be pumped elsewhere. (Christopher, 2004, pp, 8-32). The truth of the matter is, not all Americans have insurance cover. Millions of people die each year because; they do not afford medical costs. However, republicans believe that, if a universal healthcare system is adopted, less industrious Americans will be spoon fed, instead of making them strive to have personal healthcare insurance cover. Nevertheless, neither single player healthcare system nor many-player healthcare system seem to benefit private companies. The biggest gainers of healthcare reform will be lobbyists and insurance companies in their campaign of multiple-player healthcare. (Steinbrook, 2006, pp.1661-1664).


The passing of healthcare reform bill marked a historical moment in America’s healthcare. It is believed by many Americans that, the system will cover all healthcare insurance to all Americans. Many Americas would want to see a system that cares for the elderly, disabled and children. Additionally, the system should guarantee safety, accessibility, equality and consistency to all Americans whether employed or unemployed. No single American will accept a healthcare system whose costs soar every time. Should another system promise lower costs, offer diverse choices, and guarantee better service delivery; many Americans could be willing to adopt it even immediately.

Reference List

Andersen, R. (1995).Revisiting the behavioral model and access to medical care: Does it matter? Journal Health Social Behavior, 36, 1–10.

Christopher, J. (2004). Health Care Regulation: A $ 160 Billion Hidden Tax. Cato Policy Analysis, 527, 1–32.

Heffler, S., Levit, K. & Smith, S. (2001). Health spending growth up in 1999; Faster growth expected in the future. Health Affairs, 20(2), 193–203.

Herzlinger, R., Parsa-Parsi R. (2004). Consumer-driven health care: lessons from Switzerland. The journal of the American Medical Association, 292 (10): 1213–1220.

Hurley, R., Strunk. B. & White, J. (2004). The Puzzling popularity of the PPO. Health Affairs, 23 (2), 56–68

Kronenfeld, J. & Kronenfeld, M. (2004). Healthcare reform in America: a reference handbook. California: ABC-CLIO Publishers.

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Leiyu, S. & Singh, D. (2005). Essentials of the United States health care system. London: Jones and Bartlett Publishers.

McWilliams, M., Meara, E., Zaslavsky, A. & Ayanian, J. (2007). Health of Previously Uninsured Adults after Acquiring Medicare Coverage. Journal of American medical association, 298(24), 2886 – 2894.

Lumsdon K. (1992).New surgical technologies reshape hospital strategies. Hospitals, 66(9), 30–33.

Steinbrook, R. (2006). Private health care in Canada. The New England journal of medicine, 354 (16), 1661–1664

U.S. Census Bureau. (2008). Income, Poverty, and Health Insurance Coverage in the United States: 2007. Web.

Wilhelmine, M., Vigdor, E. & Willard, G. (2004). Covering the Uninsured: What Is It Worth? Health Affairs Web Exclusive. Web. 

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