Health care in the United States

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 now primarily provided by the government in the public sector, with 60-65% of healthcare provision and spending coming from programs such as Medicare, Medicaid, TRICARE, the Children's Health Insurance Program, and the Veterans Health Administration.
The U.S. Census Bureau reported that a record 50.7 million residents (which includes 9.9 million non-citizens) or 16.7% of the population were uninsured in 2009. More money per person is spent on health care in the USA 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 USA than in any United Nations member state except for East Timor. Although not all people are insured, the USA has the third highest public healthcare expenditure per capita, because of the high cost of medical care in the country. A 2001 study in five states found that medical debt contributed to 46.2% of all personal bankruptcies and in 2007, 62.1% of filers for bankruptcies claimed high medical expenses. 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, choice, value, and quality. Some have argued that the system does not deliver equivalent value for the money spent. The USA 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 USA has a higher infant mortality rate than most of the world's industrialized nations. In the United States life expectancy is 42nd in the world, after some other industrialized nations, lagging the other nations of the G5 (Japan, France, Germany, UK, USA) and just after Chile (35th) and Cuba (37th).
Life expectancy in the USA is 42nd in the world, below most developed nations and some developing nations. It is below the average life expectancy for the European Union. 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). The Commonwealth Fund ranked the United States last in the quality of health care among similar countries, and notes U.S. care costs the most.
The USA is the "only wealthy, industrialized nation that does not ensure that all citizens have coverage" (i.e., some kind of private or public health insurance). In 2004, the Institute of Medicine report observed "lack of health insurance causes roughly 18,000 unnecessary deaths every year in the United States." while a 2009 Harvard study estimated that 44,800 excess deaths occurred annually due to lack of health insurance.
On March 23, 2010, the Patient Protection and Affordable Care Act (PPACA) became law, providing for major changes in health insurance.

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