The health care system in the US differs from that of other republics because of the country’s long-standing beliefs in capitalism as opposed to socialism. This difference can be observed with other national health care systems in countries like France, Canada, and the United Kingdom. Therefore, the US is one of the few developed countries that lack a universal health care system for its citizens. The health care system in this country started taking shape in the late 1800s when workers in the steel mills formed unions to protect themselves against injuries in the workplace (Shalowitz, 2019). The evolution of the efforts by different stakeholders to formulate some universal health care system makes for an interesting lesson in the history and ideology of America.
Whereas other developed nations have had their own forms of social insurance that later transformed into national insurance, the United States has been trying to figure out its own system. In some European nations, for example, mandatory sickness insurance was introduced in the late 1800s. During the same time, Switzerland, France, Sweden, and Denmark offered subsidies to workers who formed welfare societies to deal with health care problems. The benefit of these initial programs was the resulting protection against loss of wages due to sickness in place of direct payments for medical expenses. However, these programs were not universal because they were meant to buy the allegiance of workers by maintaining their incomes.
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When other countries were experiencing the proliferation of health care systems among workers’ unions between the late 1800s and early 1900s, the United States did not take any actions towards that effect (Jonas, Goldsteen, Goldsteen & Jonas, 2013). This country did not have any compulsory sick insurance system or a subsidized fund for voluntary contributions. Instead, the federal government left those matters in the concern of the states and the states, in turn, left them to private organizations and voluntary programs. The labor association led the initial campaign for health care in the US through the AALL Bill of 1915.
The mandate of this group was to reform capitalism through the introduction of necessary social welfare programs. The formulated bill, which sought to frontier coverage to the salaried group, was backed by the American Medical Association (AMA). However, the idea was opposed by the American Federation of Labor (AFL) as well as the private insurance industry (Shalowitz, 2019). This opposition eventually led to the failure of efforts to achieve a national health insurance program, as well as the subsequent formation of the 1935 Social Security Act (SSA) which created room for different states to develop their own programs.
In the 1940s, the inability of many businesses to afford high salaries for workers led to the introduction of employer-sponsored health insurance as a benefit for the recruited workers. However, many individuals did not subscribe to the idea of a national health care insurance plan but instead opted to purchase health insurance from private organizations (Shalowitz, 2019). The increase in the national expenditure on health care services in the 1960s triggered proposals to extend the 1935 SSA, hence laying the foundation for Medicaid and Medicare which are the central systems of health care used today.
The state of health care insurance in the United States is unique because of the lack of a uniform or a universal system. Instead of having a single-payer health insurance arrangement for the entire population, this country has a hybrid system with both public and private programs. The public financing for health care insurance seeks to support programs that benefit specific categories of people. For example, the Medicare program supports individuals who are sixty-five years old or older, the persons living with disabilities and entitled to social security, as well as those with end-stage renal disease. Federal employees, members of Congress, and veterans are also covered under this program, whereas state-run insurance programs cover other public employees. Medicare was initiated under Title 18 Social Security Act benefits.
The Medicaid program, which was established under Title 19 of the Social Security Act, finances health care for the poor in America. The eligibility into this taxpayer-financed program is dependent on the financial resources of an individual. The Children’s Health Insurance Program (CHIP), which was founded under Title 21 of Social Security Act, is a partnership package that is mutually financed by the federal and states government to offer health care insurance to qualified children. This program covers children up to the age of nineteen and is administered by the states according to the requirements of the federal government. In 2010, reforms in health care insurance led to the institution of the Affordable Care Act (ACA) that brought about significant changes (Shalowitz, 2019). The provisions in the ACA sought to expand coverage and access to health care for an increased number of Americans.
The health coverage systems in the United States have various strengths and weaknesses. The publicly- and privately-funded insurance plans are beneficial to individuals with jobs or the financial ability to afford them, as well as the poor and the elderly. One of the benefits is that these insurance plans are some of the best in the world for coverage and provision of other related services. This factor is largely supported by the presence of world-renown institutions such as the Cleveland Clinic and Harvard Medical School, among others that have state-of-the-art medical research systems. Another benefit of the publicly-funded insurance plans in America is the fact that taxpayers are not burdened with the cost of providing medical insurance services to every citizen. Currently, the cost of health care in the United States is higher than in any other place in the universe (Woolf et al., 2013). Therefore, the existence of a universal health care system would translate to an increase in the taxpayer expenses.
The biggest weakness of the health insurance plans in the US is the fact that the high cost for health care is not reflected in the general health of the nation. Although this country appends more on health care compared to any other nation on the universe, Americans cannot be said to be the healthiest population around. Another weakness in this system is that many Americans remain uninsured or underinsured under the current insurance plans.
In conclusion, the American health care system has undergone various reforms and changes within the past century. This system is different from many others around the world because its foundation was built on capitalism as opposed to socialism. Throughout the years, America has initiated various efforts to cover most, if not all, of its citizens under an effective and sustainable health insurance system. However, this country remains the only one among the developed nations to lack a universal health insurance system. Currently, the United States has a hybrid system that consists of both public and private health insurance plans. The programs that stand out include Medicare, Medicaid, as well as CHIP, under which the poor, elderly, and children are covered. Although this country has the world’s best health care services provided by well-trained specialists, there are issues of incomplete coverage of the population, with the spending on health care exceeding all the other countries.
References
Jonas, S., Goldsteen, R. L., Goldsteen, K., & Jonas, S. (2013). Jonas' introduction to the U.S. health care system . New York: Springer Publishing Company.
Shalowitz, J. (2019). The US healthcare system: Origins, organization and opportunities . Hoboken, NJ: Jossey-Bass.
Woolf, S. H., Aron, L. Y., National Academies (U.S.) & Institute of Medicine (U.S.). (2013). U.S. health in international perspective: Shorter lives, poorer health . Washington, D.C: The National Academies Press.
