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  • The health care system in the United States of America is considered to be one of the most complex and expensive in the world. Being a distinctive model of planning and management, it delivers medical services for all social groups. Unlike other countries, where health care is basically offered by government institutions only, the United States of America decides the question differently.
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    American medical establishments, such as hospitals and clinics, are normally operated by business structures of the private sector. People receive their health insurance either directly from the government or through social insurance programs, such as Medicare and Medicaid, which are developed by the U.S. federal government. Such a system has created all necessary conditions for medical services to be of exceptional quality, but on the other side it has made them too expensive for many Americans. Another issue, presented in health service, lies in health care spending.
    Over the past years, the level of health care spending in the U.S. has been reduced. In 2010, over $2.4 trillion was spent on health care as opposed to $726 billion spent in 1990 (National Health Statistics Group, 2012). However, despite such an obvious reduction, health care expenditures are expected to grow as the economic situation in the country will be unstable for the next years.
    At these days, the level of national health care expenditures continues to grow slowly. More than 32 percent of money is spent on the hospital care. 21 percent is spent on physician and clinical services. 13 percent is spent on the health care administration, 9 percent on the drugs retail, 5 percent on investment, and 20 percent is expended on other services. The statistical data have shown that there are three major segments which all together cover more than 50 percent of total health care expenditures. They are hospital care, physician and clinical services and health care administration. Analyzing each of them in particular, it can be defined whether the spending on them is reasoned or not, and whether the nation should cut any costs in order to stabilize the situation.
    In 2012, 64 percent of American hospitals have significantly increased their spending on the information technology, and they are expected to continue this tendency in 2013. The major reasons for this are the transition to electronic health records, and the necessity to switch to ICD-10 codes. Many hospitals have upgraded their medical equipment. Many of them spent much on disposable products which prevent infections etc. Therefore, the nation should cut spending on the hospital care as a lot of funds are spent on needless things. For instance, there is no need to buy more new expensive medical devices because every hospital is already equipped quite well.
    Another health care segment with a high level of spending is physician and clinical services. In 2011, the level of spending was over $541 billion. 81 percent of the total spending for physician and clinical services was accounted for physician services, and this percent keeps increasing (National health expenditures, 2012). The reason lies in a large number of employed physicians, and different diagnostic procedures and tests as well as defensive medicine that they do not always prescribe due to an actual necessity. It shows wasteful spending which, on the basis of the data provided, should be cut.
    Administrative expenses are estimated at the level of 13 percent, which is 7 percent more than it was in 2010. There are the costs of private insurance, such as reserves, profits and losses, taxes, administrative costs, and the costs of national social health insurance. Many American analysts believe that the problem lies in the concept of a mixed health care system, which is basically public and private at the same time. Such a mixed system establishes conditions for additional health care spending. That is why there is a necessity to reconsider administrative expenditures and cut them where it could be possible.
    The health care system of the United States is fundamentally different from those which are established in other countries because the U.S. health care does not have a national health insurance plan. It is the very reason why public health care needs are generally covered by various payers. There are social insurance programs, such as Medicaid which was created for people who have low incomes, or Medicare that has been established for those who are 65 and older, and people who are with disabilities; provider sponsor organizations, insurance companies and patients themselves (out-of-pocket payments). In such a manner, almost 25 percent of public health care expenditures are paid directly by people who use medical services. The other 75 percent are covered by the payers. Further, they pay more than 95 percent of hospital health care and only 60 percent for drugs and other services (Feldstein, 2011). Therefore, it is obvious that more than a half of medical services are paid by different governmental programs and insurance companies, but still there are 25 percent of health expenditures which are paid by patients. They mostly pay inpatient hospital costs and outpatient clinic costs.
    The future of the health care system in the United States is foreseen as full of brand new innovations, and along with them, it will bring out more increases of expenditures. There are several economical needs of the health care system. Two of them are changes in insurance coverage, which is moving more towards national health insurance cover, and new ways of improving control of spending on different segments of the health care system. As it was analyzed above, these two are urgently in need of reconsideration and improvement.
    Therefore, in order to reform the health care system and satisfy its economic needs, many steps must be taken. One of these steps is to create and establish an absolutely new health care insurance plan which will be appropriated by the U.S. government as well as by the people. Another question is a potential source of financing for this purpose. Basically, it could be financed by the government if its spending on health care were reduced.



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