Health services in the USA
The health service in the United States. The value of insurance for the population. Statistical indicators of the cost of treatment. The amount of offset funds for the maintenance of one patient from the Federal budget. Reform of medical insurance.
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Health services in the USA
In system of public health services of the USA there are six kinds of health services: preventive maintenance of diseases, primary, secondary (in stationary medical institutions of the general type), tertiary (in the specialised centres) the help, medical rehabilitation and послебольничное service. All kinds of health services are guided by population self-maintenance. Medical aid paid for an overwhelming part of the population. Official tariffs are absent.
With a view of simplification of burden of expenses on treatment Americans buy the policies of the insurance companies granting the right to full or partial payment of treatment depending on its cost and the sum of payments. The medical policy serves as a guarantee of reception of medical aid, volume, character and which limits are predetermined by medical insurance conditions.
In 2003 the average inhabitant of the USA has spent for the medical purposes of $5440. Inhabitants of the USA have spent for the medical purposes on 9.3 % more than in 2002. Thus, expenses for purchase of medicines have grown more, than on 15 % (all data of governmental organisation Centers for Medicare and Medicaid Services). For example, cost of visiting of the therapist, on the average on the country, makes $120. On the average on the USA, medical expenses per capita (expenses which the inhabitant of the USA pays from own pocket or the insurance company repays) make $3 759 in a year - according to Ministry of Trade SSHA\US Department of Commerce, cреднестатистический the American in 2000 has earned $28 272.
Annually more than 18 thousand Americans perish only that they do not have medical insurance, and they not in a condition to pay medical aid. According to the research spent Institute of Medicine (not state organisation spending independent expert appraisals in medical sphere for the Congress of the USA), not insured people in whom the breast cancer is found out, have on 50 % of more chances to die, than insured. Also much more chances to leave life at victims of accidents, diabetics and hypertensive persons.
In the end of November, 2003 the Congress has voted for the law on cost indemnification prescriptional medicines under program Medicare (the federal program of medical insurance for older persons). According to the new bill indemnification of cost of medicines not only for patients of hospitals (this service already appeared within the limits of the operating program), but also for the patients who are on treatment out of hospital is provided. The total cost of the law $395 billion Law is one of priority for both parties and the president. It speaks an urgency of reforming of system of the medical insurance existing in the USA.
In 1965 program Medicare has been founded is one of federal programs of medical insurance for advanced age population (is more senior 65th years). Since 1972 the program also serves invalids. It consists of two basic parts:
Part And. Hospital insurance: payment of the hospital services, some forms of home care.
Part B. Additional medical insurance: payment of visitings of the doctor, out-patient services and services of independent laboratories.
In difference from obligatory hospital insurance, additional insurance is made on a voluntary basis. In 2002 34.6 million aged citizens and 6 million invalids have received the help by a part And programs. Part services In have used accordingly 32. The same year the average sum of the compensated means for service of one patient under the program of hospital insurance has made 9 million and 5.2 million $3 689, and under the program of additional insurance - $2 915. Health services in the USA one of the most expensive in the world, therefore program Medicare is not capable to cover 100 % of cost of medical services. In particular, long stay in hospital is not completely paid, stomatologic services, sight check, a glasses making are not paid.
Other federal program - Medicaid - is calculated on medical aid rendering to the needy citizens having the income below level of poverty. In 2000 it is the program served 44.3 million persons. But completely not each American, whose income below poverty level can be included in this program. Medicaid extends on members of families with children, pregnant women, older persons, blind, invalids, and also people suffering some diseases (a tuberculosis, some forms of a cancer). As well as in a case with Medicare, the program does not pay 100 % of expenses on treatment. Besides these two federal programs there is also a market of private insurance on health and various local, municipal and district programs.
However out of sphere of attention of all these kinds of medical insurance there is a most part of the population of the country. Approximately 44 million Americans has no medical insurance, and 77 million have so-called "прерывную the insurance", i.e. during the certain periods have no (for example, in case of work loss).
Imperfection of system of medical insurance directly and indirectly concerns all inhabitants of the country. And business not only in social vulnerability of the most part of the population. For example, if in hospital the patient who does not have the medical insurance arrives, the hospital has no right to refuse to it in service. Expenses on treatment of such patient in the latent kind are redistributed between the patients having the insurance. It, in turn, conducts to growth of cost of the insurance. Annually authorities of various level are compelled to spend to $30 billion for a covering of expenses deprived, about $5 billion, physicians who often agree to render medical aid free of charge "give" to them. However it does not reduce a problem sharpness.
At a consensus that the system of medical insurance needs considerable changes, at democrats and republicans different claims to program Medicare, as well as as a whole to system of medical protection in the country. In general, democrats aspire to creation of a government program of medical protection which would guarantee to everyone needing certain level of medical aid, and republicans suggest to release as much as possible system of medical insurance upon state financing and to assign to its market. Bills of cost indemnification рецептурных medicines under program Medicare were already repeatedly considered in the Congress. In 2000 and 2002 the Congress lower chamber accepted "a republican" variant of the law, however both times bills did not find support in the Senate where the majority belonged to democrats. This time, the republicans having control over both chambers, have managed to spend the law.
Republicans insisted, that indemnification of expenses on рецептурные medicines was paid to clients Medicare through the private insurance companies already since 2006, and in the long term all services Medicare should be transferred in private hands. While the majority of democrats suggested to use a traditional way - government program Medicare. The republican project, according to opponents, not only undermines developed system Medicare, but also is more expensive, as administrative expenses in the private insurance companies considerably above than in Medicare: 15 % from the general budget against 1 %. Democrats have offered the compromise. Of mechanisms of financing of expenses on medicines the following model has been offered: If in region one private insurance company operates only, the client can choose between state (Medicare) and private insurance services if it is some of them, financing of expenses is carried out through the private companies. As to "privatisation" of the state insurance medicine, opponents have converged that since 2010 in six regions of the country experiment which will show what of systems of medical maintenance - private will be made or state - is more effective.
health insurance budget medical
Polls have shown that a considerable part of the population of the USA do not approve this way of the decision of problems of public health services. For example, poll Pew Center for People and Prеss, spent in the end of December, has shown that these measures do not cause delight in 27 % interrogated. Service Gallup poll has shown that against similar decisions 36 % of Americans act. Research of broadcasting company ABC and The Washington Post newspapers has yielded even more discouraging result: pro similar reforms have expressed 32 %, contra - 38 % (other respondents did not have a certain opinion in this respect).
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