From the first person. How the US cares about the health of its citizens

Medicaid and Medicare are helping people in the United States to get medical care. Photo: depositphotos.com

In many ways, the United States is the world leader in health innovation and research. 18 of the last 25 Nobel Prize winners in medicine are either American citizens or scientists from other countries working in the United States. Half of all new drugs developed worldwide over the past 20 years have come from American pharmaceutical companies. In fact, Americans have contributed significantly to 80% of the most important medical inventions over the past three decades.

The American health care system undoubtedly has its problems. The costs of it grow and are distributed in such a way that some people cannot afford the medical services they need. Moreover, although the number of Americans who do not have health insurance is often exaggerated, there are indeed very many such people in our country. Despite the fact that the United States provides the highest quality medical services in the world, this quality is unequal throughout the country, and too often Americans cannot get medical care that meets proper standards. However, the experience of other countries, where health care is built on a state basis, shows that the way out of the situation should be sought in market reforms, and not in strengthening state control.

According to the Institute of Medicine of the National Academy of Sciences of the USA, America is the only developed industrial country in the world that does not have a universal health care system.

In the US, about 86% of citizens have medical insurance. 44% of them received it from the employer, 20% acquired it independently, 22% of citizens were provided with insurance under state programs.

Certain government programs allow people with disabilities, the elderly, children, veterans, and low-income people to receive medical care, and also provide emergency care to all residents of the country, regardless of their ability to pay for it. More than 45% of the country's health care spending goes to finance such government programs, making the US government the nation's largest insurer. However, back in 2010, 16% of the population in the United States did not have health insurance, which is 47 million people! This is due to the high cost of insurance, which rises faster than wages or inflation.

Many of the Americans who do not have private insurance are covered by such government programs as Medicare and Medicaid, as well as other programs of various states and local authorities for low-income people (for example, the TRICARE program exists for veterans and their families).

Expenditure on health through two major programs - Medicaid and Medicare covers the US government. These programs provide medical services to poor and needy people in the country for free or at low cost.

Photo: depositphotos.com

Medicare is a well-known state insurance program for people older than 65 years, implemented in 1967. Until this time, most (more than 50%) senior citizens in the United States did not receive the appropriate amount of medical care. In accordance with this program, insurance is provided for all Americans older than 65 years, as well as those who are close to this age and have serious deviations in their state of health. Thus, at present, more than 97% of elderly people, as well as 90% of people with severe kidney disease and 3,6 million people with disabilities are insured under this program.

This insurance program covers acute medical conditions, including inpatient treatment, various diagnostic procedures, home health services, and a short stay in nursing homes. In addition, patients may be provided with some preventive services, for example, vaccination against hepatitis B, influenza, pneumococcus, and mammography. Services such as prolonged hospitalization, nursing home care, the provision of hearing aids and prescription drugs are not covered by this program.

Medicare is a fairly effective program. It is partly funded by a special tax on workers, of which they pay a part, the part - the employer. In general, this tax is about 15% of the income of employed Americans. Another part of Medicare is funded from general income tax revenue.

The state Medicaid program was introduced in 1966 year and provides insurance for Americans from poor families. This program also covers the elderly, people with disabilities, disabled people, pregnant women and children. So, this program covered 33% of newborns, 25% of children of all age groups, 40% of HIV patients.

Medicaid affects basic services 5: inpatient and outpatient treatment, consultations of various specialists, stay in nursing homes, laboratory diagnostics and x-ray methods of research.

Photo: depositphotos.com

This program pays for staying in nursing homes that require constant care and cannot do without help. Staying in such institutions is very expensive - up to $ 100 per day. Therefore, most people do not have enough of their savings for this. Nursing home patients spend most of the money allocated to Medicaid.

Medicaid is funded by both the federal government and state governments. The federal government pays its share of Medicaid expenses from general tax revenues, which is about half of all expenses. The rest is paid by the government of each state.

In 1966, the US Congress passed a law reforming the social security system in the country. Since then, every state in the country has been submitting to the federal government a plan for providing medical services to groups covered by Medicaid. After the approval of this plan, the states began to use federal money for financing medical services, as well as their own revenues. Therefore, each state has its own Medicaid program, which makes it very difficult to manage.

Most likely, the problem of the American health care system is the unresolved form of interaction between the public and private sectors of the economy. The state, allocating enormous funds to finance federal health programs, does not have effective levers to control and regulate prices in the market of medical services and pharmaceuticals. The cost of medical care is growing rapidly and unreasonably. According to estimates by analysts from the US Department of Health and Human Services, the average annual increase in the growth rate of medical expenses in the country from 1960 to 2015 (by 10%) was due to inflation at 56%, population growth by 11% and only by 33% was the result scientific and technical progress and improvement of the quality of medical services and drugs provided.

Although the topic of health care reform does not leave the mouth of every politician in the United States, so far no one has come up with a consensus and decision. The Obamacare Health Care Reform Program has been constantly criticized since its entry into force. Many residents of the country do not like the current state of medicine: according to a recent survey conducted by the Commonwealth Fund, 82% of US citizens believe that this system requires either fundamental reform or a complete restructuring.

It is not surprising that people consider the issue of medical reform to be the most important internal political topic of the presidential election campaign. At the same time, the aforementioned study by the Commonwealth Fund showed that in every country the majority of the population supports fundamental reforms or a complete revision of their health care systems. The mood of the public in other countries is perhaps not as radical as in the United States, but these results cannot be called the endorsement of the existing state of affairs. And in this criticism there is certainly a definite meaning, but this is the topic of the next big article.

Original article published on the site "Our Texas". Republishing done with permission of the publisher.

See also:

Personal experience: a Russian doctor about pregnancy and childbirth in the United States

Personal experience: Russian woman on the work of children's doctors in the United States

How to plan for childbirth in America: step by step instructions

Medical insurance in the USA: how to start a choice

Who can get Medicare and Medicaid

How to reduce the bill for treatment in an American hospital

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