It is impossible to understand the US health system without considering America’s ideological and political context. Individualism, less regulation, more gaps Overall, the US health system is very expensive and costs roughly twice as much as the Australian health system per person.ĭespite this, Americans have lower life expectancy than Australians. Some hospitals and health services in the US provide the best care in the world, albeit at very high cost. If you go to an uncovered provider, you pay the whole bill yourself. Health insurers control their costs by charging customers out-of-pocket fees, and by limiting the number of service providers covered by the plan. More than half of US hospitals are not-for-profit, and they negotiate contracts with multiple insurers for their income. Unlike Australia, the US has no network of public hospitals to be coordinated and mobilised during the COVID pandemic. That number is projected to rise in the short term because outgoing President Donald Trump wound back some of the Obamacare provisions. But there are many challenges aheadĭespite these reforms, almost 15% of adults aged 18-64 have no insurance coverage at all. These marketplaces enabled people to avoid the very high premiums that was the norm for individually-negotiated private insurance, by sharing risks across the insured in a bulk-buy arrangement.īiden has announced a COVID taskforce to guide him through the crisis. The “Obamacare” reforms added an option, for those without other coverage, of insuring through federal and state “ marketplaces”. The types of insurers on offer normally include those operating a fee-for-service model like Australian private health insurance, and those offering a whole-of-care experience where the insurer is also the provider, or is closely linked to the provider, and covers all care for a fixed sum each year. If you are employed, your employment package may include health insurance coverage and you generally get to choose - from a panel selected by your employer - which insurer will cover you in the forthcoming year.
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