health care in the united states

Health care in the United States is provided by many separate legal entities. The U.S. spends more on health care, both as a proportion of gross domestic product (GDP) and on a per-capita basis, than any other nation in the world. Current estimates put U.S. healthcare spending at approximately 15% of GDP, the world's highest. ^{[http://www.who.int/whr/2006/whr06_en.pdf} The health share of GDP is expected to continue its historical upward trend, reaching 19.6 percent of GDP by 2016. ^{"The Not So Short Introduction to Health Care in US"}

In the United States, around 84% of citizens have health insurance, either through their employer (60%), purchased individually (9%), or provided by government programs (27%; there is some overlap in these figures). ^{"Census 2005"} The federal government does not guarantee universal health care to all its citizens, but certain publicly-funded health care programs help to provide for the elderly, disabled, children, and the poor, ^{[http://www.cms.hhs.gov/home/medicare.asp} ^{[http://www.cms.hhs.gov/home/medicaid.asp} and federal law ensures public access to emergency services regardless of ability to pay. ^{[http://www.cms.hhs.gov/EMTALA/} In 2001, only the governments of Iceland and Norway spent more per capita on health care. ¹ U.S. government programs accounted for over 44% of health care expenditures, making the U.S. government the largest insurer in the nation. When public and private spending are added together, the U.S. spends more per capita than any other nation. ^{[http://www.who.int/whosis/database/core/core_select_process.cfm?countries=all&indicators=nha} Americans without health insurance coverage, currently about 16% of the population, or 46 million people, are expected to pay privately for medical services. Health insurance is expensive, and medical bills are overwhelmingly the most common reason for personal bankruptcy in the United States. ^{"Illness And Injury As Contributors To Bankruptcy"}

The debate about U.S. health care concerns questions of access, efficiency, and quality purchased by the high sums spent. The overall performance of the United States health care system was ranked 37th by the World Health Organization (WHO) in 2000, but the same report assessed Americans' overall health at 72nd among 191 member nations included in the study. ^{World Health Organization} ^{[http://www.who.int/whr/2000/en/annex01_en.pdf Health system attainment and performance in all Member States}
However, most Americans rate their own health as "excellent" or "very good". The National Health Interview Survey, released annually by the Centers for Disease Control's National Center for Health Statistics reported that approximately 66% of survey respondents said they were in "excellent" or "very good" health in 2006. This percentage has been declining since 1998. ^{Early Release of Selected Estimates Based on Data From the 2006 National Health Interview Survey Released June 25}