The American health care system is one of the best in the world. Though it is full of positive aspects it also has negative elements. Many Americans themselves cannot understand it completely, especially since amendments are constantly being made to existing medical legislation and new laws are being accepted.
You have to pay quite a lot for medical care in the US. There are no free medical services, no compulsory medical insurance, although certain attempts in this direction have been made by Barack Obama. The government takes care only of the most vulnerable people, but, as a rule, not in a proper manner. Children under 18 years old are eligible for health insurance in many states if they meet the total family income.
US state insurance
Americans are offered 3 types of state health insurance:
- the Veteran Health Administration.
Medicaid insurance, approved in 1965 by President Lyndon B. Johnson, is provided to low-income people and families, children and pregnant women without insurance. It is issued by the state and operates in any state. It is paid by the federal government and state. It is financed by payroll taxes. In the end, this insurance is issued by this or that state. If a person moves to another state, he needs to get Medicaid again at a new place, and this is a very long process (many different documents are required).
The great advantage of Medicaid insurance is that many hospitals accept it. The disadvantage is that private doctors do not accept it. Another disadvantage is that until the pensioners themselves spend a certain amount on medications, insurance is not even activated, and patients cannot afford treatment. Medicaid completely covers short-term hospital treatment, only 80% of visits to doctors.
Medicare health insurance also appeared in 1965. It is intended for pensioners (people over the age of 65) and people with disabilities. In 2004, it had more than 42 million Americans. This program is financed by payroll taxes, contributions, and social security benefits taxation. The insurance covers short-term hospital treatment, as well as most of the cost of visits to doctors.
Veteran Health Administration is military medical insurance. It is granted to servicemen and members of their families, army veterans. Holders of this policy have the right to be treated only in military hospitals or from doctors who have an agreement with the Pentagon.
US private insurance
In America, both an employee and his employer can pay for private medical insurance (students in colleges and universities are also insured). As a rule, medical policies are cheaper for employers because they buy them wholesale. Usually, American employers pay only part of the cost of insurance, and the remaining payments must be provided by the employee.
The disadvantage of such insurance is that at the new place of work you always need to enter into new insurance which does not take into account already diagnosed diseases. The cost of a private medical policy is calculated based on the risk level of the insured. Insurers even take into account heredity, alcohol and tobacco use, and because of this, the cost of the policy increases dramatically.
Outpatient medical assistance
Americans receive outpatient medical care from a family doctor. He examines the patient and, if there is such a need, sends him to a single-discipline specialist. In the US, family medicine was recognized as a separate specialization in 1969. Every family doctor must confirm his qualification after a certain time (7-10 years). Every year, Americans make more than 208 million visits to family doctors.
There is a supposition that there will be a significant shortage of family doctors in the United States by 2020. So, in 2006, there were more than 100 thousand family doctors, and by 2020, there should be more than 139 thousand of them to meet growing demand. But now only about 2,200 new family doctors appear annually (the American Academy of Family Physicians published such statistics at the time).
The main problem in the salary. In America, the family doctor earns well but noticeably less than doctors of other specialties. Graduates of American medical universities have to pay very large loans for a long time, which they took on their education. Therefore, they choose higher paid medical specialties, and therefore there are not enough family doctors in the United States.
Inpatient medical assistance
In the United States, inpatient medical care is provided in public, private, and charitable hospitals. Patients are admitted to them only if they are seriously ill. You may be admitted to the hospital having фт appointment card given by either the family doctor or through emergency departments. More than 40 million people are treated in American hospitals annually, which costs about 390 million dollars. 63% of these costs are covered by Medicare and Medicaid.
Emergency medical assistance
Many US private and municipal hospitals have emergency care departments. Specialists working there provide emergency medical care to Americans. In addition to the driver, in the American ambulance car, there is only a paramedic (a specially trained male nurse) who should give the patient the first help and quickly take him to the hospital. 1-2 weeks after the ambulance call, the patient receives an invoice for the services’ received. Most of the amount is covered by insurance (if, of course, the patient has it).