The health system in the United States is radically different from the existing one in France, it is also one of the most difficult, because there are many actors at play. Explanations of this system, main players, size of the whole system, mode of operation.
The American health care system: definition
The health system in the United States is much more complex than the one found in France. It is the set of organizations and processes that are intended to care for the American population.
The American system is in no way financed by the state, it is based on a relatively complex system of private and public insurance but also works with direct payments. It is essentially a hybrid market, which operates in two forms, on the one hand with government intervention and on the other hand with a freer market.
The main characteristics of the American health care system
There is no coverage that is said to be universal in the United States, unlike in France, where everyone can be treated easily. Health insurance is not mandatorily guaranteed for all Americans, but it is most often provided by employers. American citizens can also buy insurance individually, with different formulas depending on the population category.
Getting treatment in the United States is almost like buying something in a supermarket. These two concepts are often compared and this leads, as in the case of mass distribution, to fierce competition between hospitals, nurses and doctors or more generally insurers.
It should also be noted that healthcare is expensive in the United States, about 17% of GDP, one of the highest in the world. These costs include hospital fees, medications, and insurance.
Therefore, a high income to access health care also means many inequalities according to citizens' incomes. However, public programs have been put in place such as Medicaid or Medicare, which can be a help for some citizens.
The main players in the American health care system
We were talking earlier about the public programs that have been put in place, such as Medicare and Medicaid. There are also some for veterans of the Veterans Health Administration type.
Medicare, for example, is a system that includes coverage for citizens over the age of 65, while the Medicaid system is for people who don't earn a lot of money.
As far as the private sector is concerned, it is private insurance that will insure a large part of the population, which leads to a war between insurers, who are waging a real battle over prices and services to seduce citizens.
There are also two types of hospitals in the United States, those that operate for profit, i.e. private hospitals, and those that operate on a non-profit basis, with care that appears to be more affordable.
It is the state and federal governments that regulate health policies and public programs. They are also the ones who will help with adequate funding.
The size of the system
In addition to being particularly complex, the American health care system is particularly large. It represents more than 4300 billion dollars in spending per year, with a percentage that continues to increase over time.
This is one of the sectors that is the most promising for employment along with the retail sector. In the United States, there are more than 6000 hospitals and thousands of private and/or public clinics, not to mention laboratories and research centers.
The way the health care system works in the United States
The payment of care is, as we said above, most often the responsibility of the citizens themselves, since there is no care as in France in particular, or in other countries.
Thus, to have access to care, American citizens pay for insurance packages, which are often directly related to their job. Deductibles are also considered depending on the case and the costs that they must pay directly for certain types of care.
Earlier, we also talked about public programs, which are partly financed by taxes.
Insurance companies are in a way partners with hospitals, access to these hospitals is subject to the formulas present in the insurance. Those who cannot purchase health insurance privately can access clinics that offer more affordable care, called community clinics. Otherwise, they must finance their care in full, since they have not taken out insurance.
As far as technology is concerned, the United States is one of the world's leading leaders in the field of innovations related to the health sector. Medical research, but also medical equipment, has the latest technologies.
It should be noted today that the American health care system is facing a significant number of challenges, which will continue to increase over time. These challenges are both economic, but also social and organizational. There are many Americans who would like to be able to benefit from universal coverage; others find the current system much more advantageous.
However, the system is focused on greatly increased inequalities of access. There are currently more than 27 million Americans who do not have insurance. In addition, health spending is constantly increasing, and this is the case in many countries. They are about $13,000 per person, and even companies are somehow threatened by this system, because some can't keep up. The population is aging, and health professionals are increasingly difficult to find, especially in the least developed areas.
Conclusion
The American health system is, as we have seen, very complex and above all very different from the French system and the majority of systems in Europe. It is both a strength because it benefits from very advanced technologies that make care more adapted to the needs of patients, but also a weakness, because inequalities are increasingly pronounced between citizens who can afford to treat themselves, and those for whom access is much more difficult.
Reforms like the Affordable Care Act have tried to reduce these inequalities, and there are still many challenges to overcome. Today, the health system in the United States tends to appear more like a commercial service, where the actors try to convince citizens to choose them, but we must not forget that health remains above all a fundamental right.
https://www.commonwealthfund.org/sites/default/files/2020-12/2020_IntlOverview_USA.pdf
https://healthsystemsfacts.org/the-us-health-system/us-health-system-overview/