Healthcare in the United States

NewYork-Presbyterian Hospital in New York City, a hub for health care and life sciences,[1] is one of the world's busiest hospitals. Pictured is its Weill Cornell Medical Center (white complex at the center).

Healthcare in the United States is largely provided by private sector healthcare facilities, and paid for by a combination of public programs, private insurance, and out-of-pocket payments. The U.S. is the only developed country without a system of universal healthcare, and a significant proportion of its population lacks health insurance.[2][3][4][5] The United States spends more on healthcare than any other country, both in absolute terms and as a percentage of GDP;[2] however, this expenditure does not necessarily translate into better overall health outcomes compared to other developed nations.[6] Coverage varies widely across the population, with certain groups, such as the elderly and low-income individuals, receiving more comprehensive care through government programs such as Medicaid and Medicare.

The U.S. healthcare system has been the subject of significant political debate and reform efforts, particularly in the areas of healthcare costs, insurance coverage, and the quality of care. Legislation such as the Affordable Care Act of 2010 has sought to address some of these issues, though challenges remain. Uninsured rates have fluctuated over time, and disparities in access to care exist based on factors such as income, race, and geographical location.[7][8][9][10] The private insurance model predominates, and employer-sponsored insurance is a common way for individuals to obtain coverage.[2][11][12]

The complex nature of the system, as well as its high costs, has led to ongoing discussions about the future of healthcare in the United States. At the same time, the United States is a global leader in medical innovation, measured either in terms of revenue or the number of new drugs and medical devices introduced.[13][14] The Foundation for Research on Equal Opportunity concluded that the United States dominates science and technology, which "was on full display during the COVID-19 pandemic, as the U.S. government [delivered] coronavirus vaccines far faster than anyone had ever done before", but lags behind in fiscal sustainability, with "[government] spending ... growing at an unsustainable rate".[15]

In the early 20th century, advances in medical technology and a focus on public health contributed to a shift in healthcare.[16] The American Medical Association (AMA) worked to standardize medical education, and the introduction of employer-sponsored insurance plans marked the beginning of the modern health insurance system.[17] More people were starting to get involved in healthcare like state actors, other professionals/practitioners, patients and clients, the judiciary, and business interests and employers.[18] They had interest in medical regulations of professionals to ensure that services were provided by trained and educated people to minimize harm.[19] The post–World War II era saw a significant expansion in healthcare where more opportunities were offered to increase accessibility of services. The passage of the Hill–Burton Act in 1946 provided federal funding for hospital construction, and Medicare and Medicaid were established in 1965 to provide healthcare coverage to the elderly and low-income populations, respectively.[20][21]

  1. ^ "Governor Hochul, Mayor Adams Announce Plan for SPARC Kips Bay, First-of-Its-Kind Job and Education Hub for Health and Life Sciences Innovation". State of New York. October 13, 2022. Retrieved May 29, 2024.
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  3. ^ Vladeck, Bruce (January 2003). "Universal Health Insurance in the United States: Reflections on the Past, the Present, and the Future". American Journal of Public Health. 93 (1): 16–19. doi:10.2105/AJPH.93.1.16. ISSN 0090-0036. PMC 1447684. PMID 12511377.
  4. ^ Fisher M (June 28, 2012). "Here's a Map of the Countries That Provide Universal Health Care (America's Still Not on It)". The Atlantic.
  5. ^ "The U.S. Health Care System: An International Perspective - DPEAFLCIO". dpeaflcio.org. August 15, 2016.
  6. ^ Fullman N, Yearwood J, Abay SM, Abbafati C, Abd-Allah F, Abdela J, et al. (GBD 2016 Healthcare Access and Quality Collaborators) (June 2018). "Measuring performance on the Healthcare Access and Quality Index for 195 countries and territories and selected subnational locations: a systematic analysis from the Global Burden of Disease Study 2016". Lancet. 391 (10136): 2236–2271. doi:10.1016/S0140-6736(18)30994-2. PMC 5986687. PMID 29893224.
  7. ^ Murdock, Christopher J.; Laurencin, Lynne; Christensen, Donna M.; Laurencin, Cato T. (June 2018). "HIV/AIDS and the African-American Community 2018: A Decade Call To Action". Journal of Racial and Ethnic Health Disparities. 5 (3). Springer Nature: 449–458. doi:10.1007/s40615-018-0491-0. ISSN 2196-8837. PMC 8224540. PMID 29869005.
  8. ^ Guilamo-Ramos, V; Thimm-Kaiser, M; Benzekri, A; Chacón, G; Rios, E; Scaccabarrozzi, L (January 2020). "The Invisible US Hispanic/Latino HIV Crisis: Addressing Gaps in the National Response". American Journal of Public Health. 110 (1). American Public Health Association: 27–31. doi:10.2105/AJPH.2019.305309. ISSN 0090-0036. PMC 6893335. PMID 31725313.
  9. ^ Lee, S.; Martinez, G.; Ma, G.; Hsu, C. E.; Robinson, E. S.; Bawa, J.; Juon, H.-S. (January–February 2010). Glover, Elbert D. (ed.). "Barriers to Health Care Access in 13 Asian American Communities". American Journal of Health Behavior. 34 (1). PNG Publications and Scientific Research Limited: 21–30. doi:10.5993/AJHB.34.1.3. ISSN 1945-7359. PMC 6628721. PMID 19663748. S2CID 31669071.
  10. ^ Armstrong, Katrina; Putt, Mary; Halbert, Chanita H.; Grande, David; Schwartz, Jerome Sanford; Liao, Kaijun; Marcus, Noora; Demeter, Mirar B.; Shea, Judy A. (February 2013). "Prior Experiences of Racial Discrimination and Racial Differences in Health Care System Distrust". Medical Care. 51 (2). Lippincott Williams & Wilkins on behalf of the American Public Health Association: 144–150. doi:10.1097/mlr.0b013e31827310a1. ISSN 0025-7079. PMC 3552105. PMID 23222499. S2CID 46125799.
  11. ^ Kliff, Sarah; Katz, Josh (August 22, 2021). "Hospitals and Insurers Didn't Want You to See These Prices. Here's Why". The Upshot. The New York Times. eISSN 1553-8095. ISSN 0362-4331. OCLC 1645522. Archived from the original on December 31, 2021. Retrieved July 18, 2022.
  12. ^ Rosenthal E (December 21, 2013). "News Analysis – Health Care's Road to Ruin". New York Times. Retrieved December 22, 2013.
  13. ^ "Improving Europe's competitiveness". EFPIA. Archived from the original on August 23, 2009. Retrieved November 6, 2016.
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  15. ^ Grant Rigney (March 3, 2023). "United States: #11 in the 2022 World Index of Healthcare Innovation. America's runaway leadership in science and technology is marred by a fiscally unsustainable system of costly health care". freopp.org. Retrieved April 27, 2023.
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  18. ^ Cite error: The named reference Adams 72 was invoked but never defined (see the help page).
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  20. ^ Shi; Singh (2019). Delivering health care in America : a systems approach (7th ed.). Jones & Bartlett Learning.
  21. ^ Raffel, M. W. (1980). The U.S. health system : origins and functions. New York : Wiley.