What is the U.S. healthcare system

American health system

The American healthcare system is expensive and patchy. The number of citizens without health insurance protection was more than 51 million (16.7 percent) in 2009.

Table of Contents
Health reform | Criticism of the health reform | Obesity

Even those who are insured have to pay from private funds: 10 to 20% of the treatment costs are regularly due for each visit to the doctor. In 2008, US residents spent $ 7,536 per capita on the health system, which is around twice as much as in Germany ($ 3,692 int.). The US healthcare system is by far the most expensive in the world. Every year, 18% of the gross domestic product is spent on health. Most Americans are insured through their employers, but to date they have not been required to offer health insurance to their employees.

Very few Americans have private health insurance. Most of the time, the few citizens who are insured are also underinsured. Benefits and premiums are often based on the health of the policyholder. In addition, insurance companies were allowed to terminate their customers if they fell ill and the treatment was too expensive for the insurance companies. Since 1965, within the framework of the "Social Security Act of 1965"Introduced two state-funded health insurance programs: The program"Medicaid"Was created for people with low incomes and the needy,"Medicare“Was intended for people aged 65 and over, people with disabilities and people suffering from acute kidney failure.

Health reform

In 1993, US President Clinton failed to introduce health insurance similar to the German system. Since then, American policy has done little to counter the skyrocketing costs. Barack Obama is also currently determined to push through the health care reform. In 2009 the US President said in a speech to both Houses of Congress: "I am not the first US president to address health insurance reform, but I am determined to be the last„.

US President Barack Obama took a clear step in the right direction. On March 23, 2010 he signed the "Patient Protection and Affordable Care Act". A law that provides for the reform of the health system. Two days earlier, the reform had been passed in the House of Representatives with 219 to 212 votes. Before that, attempts by American presidents to reform the health systems of the states had failed for decades.

Now every American is gradually getting health insurance. By 2019, 32 million Americans are to be additionally insured. The goal of the state is to insure 95% of the population by then. From 2014, basic insurance will be mandatory for every citizen. If the citizen does not follow this law, there is a risk of a fine of up to 2.5% of the income. Companies that employ more than 50 employees will be obliged to insure their employees from 2014. Failure to comply with this requirement could result in a fine of $ 2,000 per employee. State aid is available to smaller companies and low-income households.

The "Medicaid“Program, approved by the USA, is being expanded further. In addition, the health insurance companies must accept each customer regardless of their previous illnesses. Even in the event of illness, the status and contributions may not change. After a long discussion, the state decided not to introduce a public health insurance scheme to compete with the private ones.

According to estimates "Congressional Budget Office“The new healthcare reform will cost the state $ 940 million over the next 10 years. By reducing the expenditure in the "Medicare“Program and through tax increases for higher earners, the aim is to regulate these costs. Particularly expensive health insurances are also subject to a tax. The US national deficit is expected to be reduced by $ 138 billion by 2020.

Criticism of the health reform

For some critics, the reform does not go far enough, while others criticize the high costs. In addition, the individual's right to self-determination is being attacked. The eternal struggle of American politics with the health system got another shot across the bow in August 2011. An appeals court ruled parts of the plans unconstitutional. Nobody should be forced to take out insurance. In the summer of 2012, US citizens will know more. Because then at the latest he will Supreme Court of the US to make its judgment on the constitutionality of US health care reform. Meanwhile, the implementation of individual elements of the law is progressing.


One of the main reasons why American health care reform is so important is that the American people generally neglect health. In the late 1980s, more than half of Americans were of normal weight. Today almost two thirds have too much bacon on their ribs:

    part of the obese Americans in the US population:
  • 1960: 44,8 %
  • 1970: 47,7 %
  • 1980: 47,4 %
  • 1990: 56,0 %
  • 2000: 64,5 %
  • 2008: 68,0 %