Health Care System in the United States 1

Running head: HEALTH-CARE SYSTEM IN THE UNITED STATES

Health Care System in the United States

Má rcio Padilha

College of Southern Idaho

ALLH 202 – Janak

Spring/2010
 Health Care System in the United States 2

Health Care System in the United States

Summary and description:

Despite being alone among developed nations in not having a universal health care

system, healthcare in the U.S. does have publicly funded components. Medicare covers the

elderly and disabled with a historical work record, Medicaid is available for some, but not

all of the poor and the State Children's Health Insurance Program covers children of low-

income families. The Veterans Health Administration directly provides health care to U.S.

military veterans through a nationwide network of government hospitals; while active duty

service members, retired service members and their dependents are eligible for benefits

through TRICARE. Together, these tax-financed programs cover 27.8% of the population,

making the government the largest health insurer in the nation.

Roughly, two thirds of urban hospitals in the U.S. are non-profit hospitals and the

balance evenly divided between for-profit hospitals and public hospitals. The urban public

hospitals are often associated with medical schools. For example, the largest public hospital

system in America is the New York City Health and Hospitals Corporation, which is

associated with the New York University School of Medicine.

Although public hospitals constitute the greatest percentage of non-federal hospitals, care

in the U.S. is generally provided by physicians in private practice and private hospitals. Just

over 59% of Americans receive health insurance through an employer, although this

number is declining and the employee's expected contribution to these plans varies widely

and is increasing as costs escalate. A significant number of people cannot obtain health

insurance through their employer or are unable to afford individual coverage. The U.S.

Census Bureau estimated that 15.3% of the U.S. population, or 45.7 million people, were
 Health Care System in the United States 3

uninsured at some time in 2007. More than 38% of the uninsured are in households

earning $50,000 or more per year. A few States have taken serious steps toward universal

health care coverage, most notably Minnesota, Massachusetts and Connecticut, with recent

examples being the Massachusetts 2006 Health Reform Statute and Connecticut's SustiNet

plan to provide quality, affordable health care to state residents. In 2005, the United States

spent 15.2% of GDP on health care, or US$6,347 per capita. Of that, approximately 45% was

government expenditure. The U.S. Congress is currently debating many options for further

reforming the U.S. health care system.

List and description of the major factors driving the cost of health care:

23.3%
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7.6% 7.4%
4.9%
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What are the trends and major issues for healthcare in the next 10 years?

The debate over health care in the United States centers on questions about whether there

is a fundamental right to health care, on who should have access to health care and under what

circumstances, on the quality achieved for the high sums spent, the sustainability of expenditures

that have been rising faster than the level of general inflation and the growth in the economy, the
 Health Care System in the United States 4

role of the federal government in bringing about such change and concerns over unfunded

liabilities.

Explain the importance of patients’ rights:

The American Medical Association outlines fundamental elements of the doctor-

patient relationship in their Code of Medical Ethics. These rights include the following:

 The right to receive information from physicians and to discuss the benefits,

risks, and costs of appropriate treatment alternatives

 The right to make decisions regarding the health care that is recommended by

the physician

 The right to courtesy, respect, dignity, responsiveness, and timely attention to

health needs

 The right to confidentiality

 The right to continuity of health care

 The basic right to have adequate health care

Law and ethics state that the doctor-patient interaction should remain confidential.

The physician should never reveal confidential information unless the patient wants this

information disclosed to others, or unless required to do so by law. If the release of

information is warranted, information should be released in the form of an official signed

document.
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Explain the importance of confidentiality:

Confidentiality is subject to certain exceptions because of legal, ethical and social

considerations.

When patients are at risk of physically harming another person, or if those patients

are at risk of harming themselves, the physician has the legal obligation to protect the

potential victim and notify law enforcement authorities.

All US states require all cases of child abuse to be reported to the district attorney's

office and/or child protective services. This includes suspected and confirmed cases of

child abuse. Failure of health care personnel to report child abuse and neglect may result in

criminal prosecution under the Child Abuse and Prevention Act of 1974. Failure to report

child abuse may also result in civil prosecution for malpractice if the child suffers injury or

death because the abuse was not reported. This is another special case in which patient

confidentiality does not exist.

In addition to child abuse, confidentiality does not apply to cases involving

communicable diseases, gunshot wounds, and knife wounds.

The subject of minors creates a special situation regarding confidentiality. The laws

vary from state to state. Most states regard a person younger than 18 years as a minor.

An exception is made for emancipated minors, who are considered self-reliant

because, for example, they are married or have children themselves. Emancipated minors

are usually regarded as adults in reference to their medical care.

Minors who live with their parents but are self-reliant and independent are

considered mature minors. In some states, a mature minor may be considered an adult

regarding medical treatment. In various states and depending on the situation, minors can
 Health Care System in the United States 6

consent to treatment for contraception, drug and alcohol problems, psychiatric conditions,

pregnancy, abortion, and venereal diseases without the knowledge of their parents

Web site for Health care information:

 ELDIS: http://www.eldis.org/healthsystems

ELDIS is an interesting system which provides 26,000 full text documents

free to download, resource guides, 24 subject-focused guides offer quick access to key

documents, organizations, research themes, discussions and other key resources, country

profiles, email newsletters and newsfeeds. Although this is a United Kingdom based

website, I do appreciate the global perspective it offers.

 http://cthealth.server101.com/the_case_for_universal_health_care_in_the_united_st

ates.htm

The Connecticut Coalition for Universal Health Care discusses the case for

universal health care in the United States.

 http://www.independent.org/pdf/working_papers/29_changing.pdf :

The The Changing United States Health Care System: The Effect of

Competition on Structure and Performance is an academic study presenting aspects of the

United States Health Care System to a foreign audience.

 http://www.pbs.org/newshour/globalhealth/july-dec09/insurance_1006.html :

Comparing International Health Care Systems refers to a PBS documentary

where aspects of the United States Health Care System are addressed and compared to

those of some other nations.

 http://www.whitehouse.gov/issues/health-care/:
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Health Care: The White House id the official website which addresses the

Obama Administration’s take on the health care system.

 http://www.aafp.org/online/en/home/policy/policies/h/healthcare.html

Health Care for All: A Framework for Moving to a Primary Care-Based Health

Care System in the United States addresses the issue that, in the United States, intervention

is emphasized over prevention.

 http://www.hhs.gov/

The United States Department of Health and Human Services provides all US-

policy currently supported issues.

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Bibliography

Bronner, K. (2007, 01 15). Dartmouth Atlas Project Topic Brief. Retrieved 02 17, 2010, from
http://www.dartmouthatlas.org/topics/effective_care.pdf

US Department of Health and Human Services. (2009). National Health Expenditure Projections 2009-
2019. Retrieved 02 17, 2010, from
http://www.cms.hhs.gov/NationalHealthExpendData/downloads/proj2009.pdf

WebMD. (n.d.). Patients' Rights. Retrieved 01 17, 2010, from WebMD:

http://www.emedicinehealth.com/patient_rights/page4_em.htm

Wikipedia. (2010, 01 16). Health care in the United_States. Retrieved 02 17, 2010, from
http://en.wikipedia.org/wiki/Health_care_in_the_United_States

Wikipedia. (2010, 02 16). Health Care Systems. Retrieved 02 17, 2010, from
http://en.wikipedia.org/wiki/Health_care_system