Health Coverage in the United States


The term health coverage or health insurance is used commonly in the USA to describe a program that assist one in bearing his medical expenses.

Individuals can purchase such programs privately from specialized agents or purchase these insurances through the social welfare systems being funded by the local government. These programs are also referred as health benefits, health coverage and health care coverage.

These facilities are being provided by both government and the privately owned organizations to offer protection against the growing cost of different medical services. Medicare, Medicaid, and Children Healthcare Coverage are some of the health care programs that provide help to people who are unable to afford the expenses.

Recent Development in Public Sector Health Programs

In the year 2009, the U.S government spent 2.5 trillion dollars and 18% of the total investment was on two most popular healthcare programs of the country which are – Medicaid and Medicare. Both the health programs were introduced in the year 1965. Lyndon Johnson was the president then when these two health coverage programs were introduced. The Federal Department of Human and Health in US takes responsibility to run these programs.

Medicare is the health care coverage program being provided to Americans who are over 65 and Medicaid is a joint program (state and federal government together run the program) that has been designed principally to back health care for the poor people. Both the programs provide financial aid to disabled Americans and together these programs cover nearly 87 million U.S people.

Medicaid Program in Brief

Medicaid is one of the two mentioned private health coverage programs that have been organized to provide aid to the people with low income and fewer assets. According to an ACA report, the health coverage program includes almost all the Americans who are under 65 and with the least earning (less than 30% of states federal property).

According to a 2009 record, the total Medicaid cost for the year was $359 billion that split within federal payments and state payment that were $234 billion and $125 billion respectively. Throughout the country, several variations are noticed on this program that include certain services like choosing eligible people, claims that would be covered or not, and the payment facilities for hospitals and doctors treating their Medicaid patients.

Medicare Program in Brief

In the year 2004, 42 million beneficiaries were availing this health cover facility and the total expense for this program rose to $297 in the same year. Unlike the private health insurance owners, beneficiaries of Medicare have the facility to demand medical care wherever they choose. Like for a 3 week diet plan review, most people have to tighten their belt while waiting for health coverage.

Thus, this program is often referred as a Free-For-The service model. A majority of the Medicare beneficiaries pay taxes in the programming until they retire from work and this facilitate them to participate in the Medicare hospitalization programs when they are 65 years old. At this time, beneficiaries can also decide to opt for Part B Medicare programs providing only $96.40. The health programs benefits through multiple personal health plans that include HMOs or health maintenance organizations as well.

Health Coverage- An Important Part OF U.S Healthcare System

Health coverage programs provided by both the federal government and the private organizations are regarded as an important part of the country’s health care system. Some of the most-required health care services are being covered by the insurance policies planned by the companies.

People, who don’t have either a private or federal government insurance plans, often fail to avail the best treatment methods. Actually, the plan is that the revenue being earned from the insurance policies will be invested to modify the health care system and thus it is a must for the people of the country to purchase at least a small-amount of policy, if he or she wants to enjoy the facilities.

Reformation of Health Coverage Programs

In the year 1990, the U.S government has reformed one of the country’s best-known health coverage programs, which is the Veteran Health Administration. The mentionable reforms done to this program are:

  • Focus on primary care and more-increased fund for it
  • Implementation of extended pharmaceutical treatment
  • Establishment of a national center keeping patients safety in mind
  • Eligibility criteria was extended for majority of the US veterans

Employer Offered Health Cover Program

This is another popular health coverage program in the USA where the employers offer health care assistance to their employees. This program was introduced shortly after the Second World War. In this program, employers often pay a major portion of the insurance amount and ask the employees to provide a share only. This amount is deducted from the salary amount being paid to the employee. Some employers don’t even ask the employees to bear a portion of the insurance whereas others do.