Tuesday, June 25, 2024

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    The United States Healthcare System

    US citizens must pay large sums of money a year to be able to access medical care, which is why millions of people are excluded from the health system.

    Did you know that the health system in the United States is public but not free, as in Venezuela, Cuba and most European nations? This means that the American people must pay to receive quality medical treatment.

    In 2015, U.S. citizens spent an average of $8,745 a year on independent medical coverage and health services.

    Despite the health reform promoted by the administration of Barack Obama (Obamacare) that allowed around 20 million people to access health insurance, this is not a major change to the health system.

    During his election campaign, the current president of the United States, Donald Trump, promised that he would reform Obamacare as it generated losses to the nation through a less expensive system for the State and more for the citizens.

    Health in the United States

    Currently the United States is the country in the world that invests most in health. It allocates 17.4 percent of its GDP, much more than those who follow it, Sweden, Switzerland and France, which do not reach 12 percent.

    Despite having a population that exceeds 300 million people, the country has the third highest health expenditure per capita, $9,403 a year, just below Switzerland (9,674) and Norway (9,522), which have less than 10 million citizens.

    With these data it is difficult to imagine why citizens complain about the health system. Criticisms include that the US contributes only 48 percent of all that is invested in health, which throws the country to 117th place in comparison with the rest of the world.

    The Government’s contribution makes health expensive for citizens. In a society that has a growing problem of income inequality, this leaves an important part of the population in a precarious and vulnerable situation.

    The Health Business

    In the United States, health has become a business rather than a right. Americans pay more money for a medical treatment or for a medicine than a European patient.

    USA It does not have a body that negotiates between insurers, hospitals and patients, a situation that affects, for example, the cost of medicines. Americans pay much higher prices for medicines than Europeans.

    In the United States, every insurer and hospital go on their own, so there are thousands of negotiators with a very fragmented market. There, distributors can better enforce their law.The director of the Health Program at the University of Virginia, Carolyn Engelhard, explains that there are two causes that make health cost more in the US.

    “The first is that things are worth more. Germany or France, for example, set quotas, a pricing scheme for medical procedures and medicines. In the United States we have market forces, insurers, hospitals… And the prices are higher.”

    “The second reason is that we have a more intense health system,” continues the doctor. “There are fewer hospital beds, but once you enter, we do more things for you. More scanners, more procedures…”


    The health reform promoted by Barack Obama will pass as one of the great achievements of the former US president. Before Obamacare, the healthcare system worked as follows:

    Entrepreneurs had to guarantee the coverage of most Americans while another part of the population had the option of choosing private insurers.

    The terms of almost all health plans included the periodic payment of fees, but sometimes the advance of a certain amount of the cost of medical treatment was required, the amount of which depends on the type of plan agreed upon.

    From the age of 65, citizens could access the Medicare program, managed by the state. In the same way, the health system took care of families with modest salaries, children, pregnant women and people with disabilities.

    The health costs for the individual dramatically increased the fees for systems based on the partial payment of the employer had increased four times faster than the salaries of the employees, generating a million-dollar expense for companies and the State.

    At the time of launching the health reform proposal, Barack Obama formulated three principles to gain Congress support: cost reduction, the guarantee that all Americans will be able to choose their own health plan, including a public plan, and the quality and accessibility of the system.


    The Affordable Health Care Act, popularly called Obamacare, was passed by the United States Congress on March 23, 2010.

    Obamacare forces the vast majority of US citizens to take out medical insurance, under penalty of a tax fine, provides subsidies to those who need it to pay it, prohibits denying coverage to people with a “pre-existing medical condition,” extends the minimum It must cover the medical insurance offered by companies and limits the cost by requiring insurers to publicly justify the price increase.

    Before implementation, there were 48.6 million people without medical insurance in the country, 16 percent of the population. In 2016, the proportion of unprotected citizens fell to 27.3 million, which today represents 8.6 percent.

    Obamacare also did not escape political discussions. One of the biggest difficulties the health program had was that it depended for its success that a greater number of people access Medicaid, but since this is a federal plan, ultimately it is up to the states to decide whether or not to expand it.

    Obama’s health proposal had a high rejection within American society, according to a study by the Kaiser Family Foundation, at the time of approval 46 percent of Americans were in favor, compared to 40% who expressed against. By 2014, 46 percent of citizens opposed Obamacare at 38 percent.

    Since Trump’s victory, and the consequent feeling that Obamacare was coming to an end, the trend reversed. In March, 49 percent of Americans supported the medical program.


    The Donald Trump Administration withdrew before the vote in Congress the proposal to reform the health system, not having the necessary support from Republican legislators. So, health in the US will continue to be governed by Obamacare.

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