Medicaid / State Health Insurance Assistance Program (SHIP)
Medicare
Prescription Assistance (SPAP)
Military Health System (MHS) / Tricare
Children's Health Insurance Program (CHIP)
Program of All-Inclusive Care for the Elderly (PACE)
Veterans Health Administration (VHA)
Private health coverage
Consumer-driven healthcare
Flexible spending account (FSA)
Health reimbursement account (HRA)
Health savings account (HSA)
High-deductible health plan (HDHP)
Medical savings account (MSA)
Private Fee-For-Service (PFFS)
Health insurance in the United States
Health insurance marketplaces
Premium tax credit
Managed care (CCP)
Exclusive provider organization (EPO)
Health maintenance organization (HMO)
Preferred provider organization (PPO)
Medical underwriting
Health care reform law
Emergency Medical Treatment and Active Labor Act (1986)
Health Insurance Portability and Accountability Act (1996)
Medicare Prescription Drug, Improvement, and Modernization Act (2003)
Patient Safety and Quality Improvement Act (2005)
Health Information Technology for Economic and Clinical Health Act (2009)
Patient Protection and Affordable Care Act (2010)
State level reform
Dirigo Health (Maine)
Massachusetts health care reform
Oregon Health Plan
SustiNet (Connecticut)
Vermont health care reform
Municipal health coverage
Healthcare in California
Healthy San Francisco
Healthy Way LA
My Health LA
Fair Share Health Care Act (Maryland)
Healthy Howard (Howard Co., Maryland)
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This article is part of a series on
Healthcare reform in the United States
History
Debate
Legislation
Preceding
Social Security Amendments of 1965
EMTALA (1986)
HIPAA (1996)
Medicare Modernization Act (2003)
PSQIA (2005)
Superseded
Affordable Health Care for America (H.R. 3962)
America's Affordable Health Choices (H.R. 3200)
Baucus Health Bill (S. 1796)
Proposed
American Health Care Act (2017)
Medicare for All Act (2021, H.R. 1976)
Healthy Americans Act (2007, 2009)
Health Security Act (H.R. 3600)
Latest enacted
Affordable Care Act (H.R. 3590)
Health Care and Education Reconciliation Act (H.R. 4872)
Reforms
Obama administration proposals
Public opinion
Reform advocacy groups
Rationing
Insurance coverage
Systems
Free market
Health insurance exchange
Nationalized insurance
Publicly-funded
Single-payer
Canadian vs. American
Two-tier
Universal
Third-party payment models
All-payer rate setting
Capitation
Fee-for-service
Global payment
United States portal Health care portal
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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.[1][2][3][4]
The United States spends more on healthcare than any other country, both in absolute terms and as a percentage of GDP.[1] However, this expenditure does not necessarily translate into better overall health outcomes compared to other developed nations.[5] 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.[6][7][8][9] The private insurance model predominates, and employer-sponsored insurance is a common way for individuals to obtain coverage.[1][10][11] 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 devices introduced.[12][13] The Foundation for Research on Equal Opportunity concluded that the United States dominates science & 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."[14]
^ abc"How to Improve Access to Health Care: Issues & Potential Solutions". healthadministrationdegree.usc.edu. Los Angeles and Sacramento, California: USC Price School of Public Policy, University of Southern California. 2023. Archived from the original on April 21, 2023. Retrieved May 12, 2023.
^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.
^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.
^"The U.S. Health Care System: An International Perspective - DPEAFLCIO". dpeaflcio.org. August 15, 2016.
^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.
^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.
^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.
^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.
^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.
^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.
^Rosenthal E (December 21, 2013). "News Analysis – Health Care's Road to Ruin". New York Times. Retrieved December 22, 2013.
^"Improving Europe's competitiveness". EFPIA. Archived from the original on August 23, 2009. Retrieved November 6, 2016.
^Stats from 2007 Europ.Fed.of Pharm.Indust.and Assoc. Retrieved June 17, 2009, from [1][permanent dead link]
^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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