The US Health-Care System: A Proposal for Reform

Abstract

The US health system is a prime example of a market-based health-care system in need of reform. Compared to systems of major European countries, the US system generally has lower quality care despite higher costs and covers a smaller percentage of the population. Unlike European models, which provide governmentally centralized care, the US system is decentralized and primarily operates on a contract basis between private actors (private insurance companies, health-care institutions and health-care professionals and clients seeking care). The majority of funding is provided by labour income generated in the private sector. As a result, the global economic crisis has detrimentally affected the US health-care system to a larger degree than European models. The increase in unemployment in the United States decreases the number of insured people, and the economic crisis puts additional financial pressure on employers to reduce health coverage of retained employees. But even before the economic crisis, the US health-care system ranked lower than systems of major European countries. Recognizing these inefficiencies, former Presidents Clinton and G. W. Bush, along with the current President Barack Obama, have sought to reform the US health system. However, lobbyists representing private insurance companies, health professionals or the pharmaceutical industry have managed to thwart all attempts at major reform. Hence, the challenge before the United States remains: How in these conditions can a reform be proposed that would decrease costs, increase quality and expand coverage to include as many people as possible?