The US Healthcare System – Features, Advantages, Disadvantages, Types

healthcare insurance

The US healthcare system has been a leader in many ratings for many years in a row, both in terms of the scale of resources concentrated in it and in terms of the effectiveness of scientific research.

The development of the healthcare system is one of the priorities of the US government. In 2016, America’s expenditures in this direction amounted to $3.3 trillion, which amounted to $10,348 per person – this significantly exceeds the expenditures of other developed countries. And if we analyze the market of today’s US pharmacology, we can see that half of all medical products created recently fall on the USA. But it is important to make a remark here – a lot of doctors and scientists who have succeeded in this business in America are not always Americans. This country attracts the best foreigners to study and work thanks to numerous programs, grants, as well as wages, the level of which significantly exceeds the earnings of doctors from other countries.

Features of the US healthcare system

US medicine is perfect for those for whom comfortable interaction between a patient and a doctor takes the first place. The country occupies a leading global position in terms of confidentiality and respect for patients, as well as in the timeliness of care and meeting the needs of patients. In addition, US medicine has a well–established system of quality control of services – the rights of the patient and his relationship with the doctor are constantly monitored here. If it so happens that the doctor is mistaken, then the services of special lawyers are immediately provided to the undergoing treatment, which will help to achieve large material compensations.

Advantages and disadvantages of medical care and services in the USA

There are the following advantages:

  • Priority for the governmentThe development of healthcare is one of the US government’s priorities. In 2016, the expenses of the United States in this area amounted to $ 3.3 trillion. It is amounted $ 10,348 per person, which significantly exceeds the expenses of other developed countries.
  • High positions in the field of medical tourismThe USA has achieved high rates in the field of neurology, transplantation and oncology, heart surgery and plastic surgery, and that is why America is one of the countries with highly developed medical tourism.

    According to the rating of the International Patient Support Center, the USA, namely the American Johns Hopkins Hospital, is among the top 10 cancer centers in the world. The Center is the largest research base that sets the direction for the development of new methods in the treatment of oncological diseases for many years.

  • The latest technologies for all US residentsThe treatment of the population is carried out with the help of the most advanced technologies. Equipment and medicines are constantly updated, taking into account world scientific developments and research. And even in small towns, medical institutions are supplied with modern medicines and equipment as much as possible.
  • The value of a doctor’s professional ethicsIn addition to the fact that doctors here have a high social status, high wages and a prestigious education, thanks to the multi-stage educational structure, the ethics of the profession differs significantly from other countries.

    In the USA, you are unlikely to encounter indifference or neglect on the part of a medical professional. Here, much attention is paid to the specialist’s communication skills, which are evaluated during the “Clinical Skills” exam. The exam reveals, among other things, the ability to empathize with the patient, up to the intonation of the voice and the ability to support.

Disadvantages of US healthcare are the following:

  • High costThere is practically no free medicine in the USA. Only the most vulnerable segments of the population receive treatment at the expense of the state: pensioners, low-income people, children, etc. For the average working citizen of the United States, the cost of a health insurance policy costs, on average, from $250 to $400 per month.

    Some part of the insurance may be covered by the employer. However, for an appointment with a doctor with a medical policy, you still need to pay an average of $50 to $100. Insurance in the USA does not cover 100% of the patient’s treatment.

  • Medications are only prescribed by a doctorIt will not work to save on medications even in the case of light disorder. When buying even the cold medicine, you will be asked for a prescription written down by a healthcare specialist. You will first have to visit the doctor, pay for an examination, and then attend the drugstore. In addition, the prices of medicines in the United States are high, but medical insurance can cover most of the costs of drugs.

Types of healthcare insurance

In the USA, mainly private healthcare organizations work, and the share of public ones is only 20%. There are several options in the country for how medical insurance is issued:

  • self-purchase;
  • if a person works officially, then some of the costs are covered by the state;
  • the state fully assumes the payment of the insurance policy (pensioners, low-income people, children, etc.);
  • option when the employer is engaged in paying for the insurance policy, in whole or in part.

In the USA, you can purchase two health insurance options: the first is HMO (Health maintenance organizations) with a low cost, but this option provides treatment only in certain healthcare organizations of a single network and only from one therapist, who decides on the need and possibility of visiting the patient with other specialists. Without insurance, an appointment with a specialist costs about $150, but on average, even with a medical policy, you still have to pay from $50 to $100, because insurance in the United States does not cover 100% of the patient’s treatment.

In cases of emergency, an ambulance in other hospitals will still be provided to the patient with HMO insurance. The lower limit of the minimum insurance is approximately $160 per month. By the way, you also need to know that in the United States, the penalty for not having an insurance policy is about $100 per year.

The second option of medical insurance in the USA is PPO (Preferred provider organizations). It will cost more, but, in this case, you can use services on favorable terms in a certain health network. Such insurance guarantees a free and independent visit to the right specialist. PPO implies special tariffs that depend on the amount of compensation for services:

  • Platinum – insurance company 90% contribution;
  • Gold – insurance company 80% contribution;
  • Silver – insurance company 70% contribution;
  • Bronze – insurance company 60% contribution;
  • Minimum – emergency cases, persons only under the age of 30 or with a difficult financial situation.

But even with the option of expensive insurance (its cost will depend on income, region and the chosen insurance plan in the range of $150-$300), you usually have to pay separately for all services related to dentistry, ophthalmology and psychiatric care, because the services are quite expensive. The cost of one filling without nerve removal and additional manipulations will cost $250. As for traditional examinations, a series of general tests and check-up examinations will cost $700, whereas a person pays about $250 for insurance. The cost of operations starts at $25,000, whereas with insurance it will be $2,500.

Therefore, most specialists of American medicine advise: in the USA it is better to live either with insurance or not to live. You also need to know that in America, medicines can only be bought by prescription, even a simple antipyretic or headache remedy, and for this you will need to go to a doctor’s appointment.