Others, citing the national health care models implemented in various European countries and Canada (Reinhardt, 1985: 23), have advocated changes ranging from selective involvement in prescription drugs to larger wholesale changes to the philosophical and structural underpinnings of the American health care system. In short, there are problems. There are shortcomings and areas where improvement is both necessary and possible. The question is how these improvements might be best achieved.
This essay will identify some of the most common weaknesses in the American health care system. It will begin by characterizing the health care system in the United States, a system distinctly different from that employed in other industrialized countries, and follow with an overview of the issues of concern to both scholars and health consumers alike. The essay will conclude with some proposals for alleviating the severity of these problems.
As a preliminary matter, it is necessary to place the American health care system in context; more specifically, it is necessary to state rather clearly that America is unique in its approach to health care. America diverges from common practices among advanced industrialized countries in its approach to health care. ...
Governmental support, in terms of generating revenue and funding, is limited to very specific and narrowly-conceived programs such as Medicaid and Medicare. These programs are further limited to people whom are defined as eligible people, mostly comprising people categorized as senior citizens, very poor, or disabled in a very particular way. Outside of these special programs, the health care system both demands and encourages that health care must be paid for with private funds. These private funds come from individuals and, in many cases, an individual's employer. Thus, the American health care system must be primarily characterized as a privately funded health care system with certain publicly funded health care functions. It is within this privately-funded context in which the system must be analyzed in terms of goal-fulfillment, weaknesses, and proposals for improvement.
1.2 Substantial Gaps in Health Care Coverage
Because there is no constitutional or legislative guarantee of universal health insurance coverage, the private market system is left to fill the gap. The effectiveness of the private market, lauded by some, is highly suspect; to be sure, even a cursory examination of health insurance coverage statistics in the United States demonstrates quite clearly that a significant portion of the population is not covered by health insurance. A recent study commissioned by the U.S Census Bureau found that 45.8 million Americans were without health insurance coverage (Helms, 2001: np). Some of these people were deemed as being in-between jobs, and therefore there was a theoretical possibility that they would become covered by their employer when they found