The Structure and Financing of the Health-Care System: Reality and Consequences

Abstract

Abstract A health-care system has two basic components—the delivery of health and medical services to those who need them and the payment for those delivered services. The current health-care system in the United States is a by-product of several factors. First, access to and payment for health care in the United States has never been recognized of0cially as a right of citizenship and a responsibility of the government, as it has in virtually every other industrialized country. Therefore, health care in the United States is appropriately viewed as a consumer good/service in a capitalistic society. Second, health insurance, the dominant form of payment for health-care services, is generally a bene0t for the worker and his or her family as a result of participating in the labor force. Third, federal and state governments have legislated responsibility for access and payment for health care of those retired from the labor force (via Medicare, a responsibility of the federal government alone but limited), the poor (working or not, Medicaid, a joint responsibility of the federal and state governments), and children (Children’s Health Insurance Program [CHIP], a joint responsibility of the federal and state governments).