For many years it was believed that the American health care system is the best in the world. But now so many shortcomings have been identified. "The 42.6 million people in the US currently without health insurance are acutely aware that our healthcare system is not working for everyone, and there is growing recognition that the major problems of rising cost and lack of access constitute a real crisis".( "The U.S. Health Care System" 1)
The majority of US healthcare are out patient based. The personal primary healthcare physicians, specialist physicians, non-physicians including nurses and pharmacists constitute the healthcare system. There are mainly two types of hospitals the for-profit hospitals and the non-profit hospitals. The former is operated by privet corporations and the later by the government or by some religious or other organizations. The hospitals provide out patient service in emergency room and they also have inpatient section. The payment of healthcare for most of the Americans is through the employer but the cost of which is increasing now a days. The government now subsidizes employer-paid health care.This is done by exempting employer contributions from taxation as income. The government sponsored Medicare and Medicaid covers the uninsured people in the US. The programmes like Tricare and Veterans administration provide insurance coverage to the elderly people in America. But now the number of physicians accepting the Medicaid decreasing due to the increase in the administrative cost as compared to the reimbursement.
The Census Bureau found last year that almost 44 million Americans had gone without health insurance for the previous year. That number has been increasing by roughly 2 million a year. Families USA, a consumer group, says that almost 82 million people, one out of three below age 65, were uninsured at some point during 2002-03, most of them for at least nine months. (Broder, D.S., A21)
III. SYSTEM INEFFICIENCIES AND INEQUITIES
1. Delays in seeking care and increased use of emergency care-Usually American people have a habit of not going to preventive healthcare and regular medical check ups and finally when they reach the hospital for treatment the disease may get advanced and more intensive care is needed. This causes the increase in the amount of reimbursement. The people without the insurance are twice as likely to visit hospital emergency rooms as those with insurance; burdening a system meant for true emergencies with less-urgent care needs. In patients with privet insurance cancer is diagnosed only in the late stage or in the advanced incurable state only and they need more costly procedures than the people who diagnose the disease in the early stage. The people without privet insurance get less chance to attend the cancer screening tests than the others with the privet insurance plans.
2. Shared cost of uninsured- The service providers