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DISCUSSION: Health Care in the U.S.
The U.S. has what we call a hybrid health care system. Almost 60% of our system is funded by private businesses and organizations, 30% is government funded, and around 10% or 28 million people do not have any health insurance at all.
Here are some things to keep in mind….
Approximately half of Americans get their health care from a private employer. The rest of the “private” health insurance is purchased mostly by individuals who are not getting it anywhere else.
Medicare is the federal health insurance program for more than 60 million people ages 65 and over and younger people with long-term disabilities. Approximately 15% of our annual finding goes to Medicare.
Medicaid is a health care program run jointly by the federal AND state governments. In Tennessee we call it TennCare, but it is Medicaid. Medicaid covers another 60 million people in the U.S. including eligible low-income adults (if they are in certain states), children, pregnant women, elderly adults, and people with disabilities.
Before the Affordable Care Act (aka Obamacare) went into full implementation between 2010-2014, the uninsured rate in the U.S. hovered around 17%. In 2019 (latest data), the uninsured rate was around 9% (an increase from 7.9% in 2017) and included around 28 million people. The Affordable Care Act has allowed many disadvantaged groups, such as lower income adults and racial and ethnic minorities, to have more affordable access to health care. However, even with this “statistical success,” many still consider this program a failure, particularly as premiums have increased in the for-profit marketplace and as many opt out of heath care coverage completely. After all, we still have 10% of the population without health insurance which impacts hospital and clinic funding. In addition, many states, including Tennessee, did not expand their health care coverage under the ACA leaving many still uninsured in the state. Health care costs remain very high in the U.S. while the American population is ranked one of the least healthy in the world.
And….all of this was even BEFORE the impact of the current 2020 COVID-19 pandemic.
Since the onset of COVID-19, more health care disparities are apparent. Our health care workers–doctors, nurses, aids, staff, janitors–all those that keep hospitals, clinics, and nursing homes open, are working tirelessly right now to heal and serve those affected by COVID-19 so this discussion is not a reflection of their work, but the policies and structure of the U.S. health care system.
The U.S. has one of the highest death rates of COVID-19 in the world, and African Americans are dying at higher rates, further exposing many health, economic, and racial disparities within the U.S. health care system. For the latest data on COVID-19 confirmed cases and deaths, the CDC is updating information daily.
Health Care Lecture Handout
U.S. Has the Most Expensive Health Care System in the World
COVID-19’s Devastating Impact On African Americans
As governments fumbled their coronavirus response, these four got it right. Here’s how. April 16.2020-PDF.pdf
Health Care Video Lecture
Sick Around the World or Sick Around the World (YouTube version)
*If one link does not work, try the other or do an Internet search for the title under PBS/Frontline). This is a free video.
You are traveling to another country. Someone asks you to describe the U.S. health care system. How do you describe it? How do you understand the U.S. health care system? If someone asked you to highlight what’s working, what’s not, how it’s structured….what would you say?
How have other countries balanced keeping a population healthy while sustaining affordable health care coverage?
What are some of the financial (increased health care costs) and demographic (think: aging population) challenges facing all countries? How will this affect long term health care availability and options?
With over 17 million Americans (at this writing) having lost their jobs and with many losing health care insurance, how do you think this will impact our future health care policy decisions?
Outline the major components of THREE different countries’ health care systems from the Sick Around the World video. If you were a policy maker, which of these practices do you feel would most benefit the U.S. and gain the support of the U.S. population? Describe at least three of these policies (can be from varying countries) and how they might enhance our health care system in the U.S.
Based on what you have learned about health care in the U.S. and globally, what are some lessons learned from the COVID-19 experience?
*Remember: Show evidence in your discussion responses that you have reviewed and processed the above information/links about the current state of health care in the United States.

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