Health Care Reform

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The debate over healthcare reform in the United States centers around questions of a right to health care, access, fairness, sustainability, and quality purchased by the high sums spent. The mixed public-private health care system in the United States is the most expensive in the world, with health care costing more per person than in any other nation, and a greater portion of gross domestic product (GDP) is spent on it than in any other United Nations member state except for East Timor (Timor-Leste). A study of international health care spending levels in the year 2000, published in the health policy journal Health Affairs, found that while the U.S. spends more on health care than other countries in the Organisation for Economic Co-operation and Development (OECD), the use of health care services in the U.S. is below the OECD median by most measures. The authors of the study concluded that the prices paid for health care services are much higher in the U.S.

The U.S. is the only wealthy, industrialized nation that does not have a universal health care system, according to the Institute of Medicine of the National Academy of Sciences and others. The number of people in America without health insurance coverage at some time during 2006 totaled about 16% of the population, or 47 million people. Of these 47 million uninsured people, nine million or roughly twenty percent, reside in households whose income totals greater than $75,000 In addition, many or most of those with insurance are not sufficiently insured, with high-deductible policies, policies that do have limits on what they will pay for or policies that cost a significant percentage of their income.

In spite of the amount spent on health care in the US, according to a 2008 report, the United States ranks last in the quality of health care among developed countries. The World Health Organization (WHO), in 2000, ranked the US health care system 37th in overall performance and 72nd by overall level of health (among 191 member nations included in the study). International comparisons that could lead to conclusions about the quality of the health care received by Americans are subject to debate. The US pays twice as much yet lags other wealthy nations in such measures as infant mortality and life expectancy, which are among the most widely collected, hence useful, international comparative statistics.