Healthcare is an essential part of the social sphere and has as its goal the preservation and enhancement of the well-being of the population through preventive, therapeutic, and other medical activities. The fundamental role of healthcare as an integral part of society is recognized in the laws of all civilized countries. It is considered an essential factor in national security as a system of public and state socio-economic measures to ensure a high level of protection and improvement of the population’s well-being. The United States is the uncontested leader in many economically developed countries, including in the medical industry.
Healthcare in the United States is one of the largest sectors of the American economy, with enormous resources. This industry accounts for 1/7th of the entire national economy, employing more than 15 million people (Insider Intelligence, 2022). Historically, the U.S. healthcare system has been a self-sustaining market with a very limited public influence, aided in no small part by liberal ideology. The United States is now an example of a private-media model with strong market mechanisms and multiple financing lines, coupled with a strong state support and regulation system.
The organizational structure of health care in the United States is characterized by a decentralized management system with the division of the entire system between the federal center and the states. The U.S. Department of Health and Human Services (HHS) is represented as a federal agency. It is this organization that oversees the activities of well-being programs such as Medicare and Medicaid (U.S. Equal Employment Opportunity Commission, 2020). The practical solution to providing medical treatment to low-income Americans is the responsibility of state governments. In general, HHS has a relatively modest role in state regulation of the healthcare system. Still, its capacity to coordinate and implement strategic and tactical issues cannot be underestimated.
The United States does not have a unified and defined healthcare system. However, its structure can be divided into structural elements in which the state and private medical insurance system is the guarantor of health care:
- State medical insurance programs;
- A network of state well-being centers for military personnel;
- Local, state, and county programs;
- Mandatory private insurance for employed health care workers;
- Self-payment of medical expenses by citizens.
Many Americans without private insurance are subject to government programs like Medicare and Medicaid and other regional programs for low-income populations. The Medicare State Health Insurance Program provides medical insurance to all Americans over 65 years of age with 5-10 years of service and to people who approach that age and have serious health problems (Kaiser Family Foundation, 2019). Essentially, Medicare is a form of medical insurance provided and administered by the federal government. Part of this program covers primary healthcare for seniors and is funded by Social Security taxes (Kaiser Family Foundation, 2019). Another part of the program is paid for directly by the federal government, and the participants’ initial premiums pay for the other part.
Medicaid covers five services: inpatient and outpatient care, consultations with specialists, home visits for the elderly, and laboratory and instrumental diagnostics. This program pays for nursing home visits for the elderly and takes up a large portion of Medicaid funds. Unlike Medicare, Medicaid is funded not only by the federal government but also by state governments (Center on Budget and Policy Priorities, 2020). It is the legislature and state governments that determine the specific categories of low-income people and the conditions under which health benefits are provided. Through the private insurance system, a network of more than 1,500 insurance organizations, consumers in the United States receive a wide variety of medical services (Center on Budget and Policy Priorities, 2020). Some private healthcare companies are nationally important and participate in government programs.
The healthcare structure in the United States can be conceptualized graphically as a three-tiered system made up of family medicine, ambulatory care, and community treatment services. Family medicine is a very developed system that provides primary care and preventive medical care. As a rule, the medical specialty has a wide range of functional responsibilities. When specialized treatment is necessary, and under challenging diagnoses, the family physician’s practice is to examine patients. Ambulatory care in the U.S. accounts for the largest share of medical services to the population. Home treatment is mainly provided by community-based organizations and is usually prescribed and ordered by physicians. Hospital care is costly, and that is why very short hospital stays characterize American hospitals.
Treatment of the population in the U.S. is carried out using the most advanced technology. Equipment and medicines are constantly updated, considering the world’s scientific developments and research. Even in small cities, medical facilities are provided with the most modern medicines and equipment possible. The disadvantage of the U.S. healthcare system is the high cost of treatment. Only the most vulnerable population groups receive treatment at the state’s expense: seniors, people with low income, and children. However, the government in recent years has been making more and more attempts to reform the system, including reducing the cost of health care for the population. Thus, there is a chance that the United States will become a leader in many of the world’s health care indicators soon.
References
Center on Budget and Policy Priorities. (2020). Policy basics: Introduction to Medicaid.
Insider Intelligence. (2022). US healthcare industry in 2022: Analysis of the health sector, healthcare trends, & future of digital health.
Kaiser Family Foundation. (2019). An overview of Medicare.
U.S. Equal Employment Opportunity Commission. (2020). Department of Health and Human Services (HHS).