1. The Federal Government Health System: this includes Medicare (the health care system for people over 65), the Veterans Administration Service for veterans, the Indian Health Service which covers Native Americans, and various insurance systems that contract with other systems, providing coverage for government employees and helping the individual states.
2. The State Government Health System: each state has its own "Medicaid" system to cover the poor and uninsured, funded by both the federal government and the state. States also fund some state-run and county-run facilities for the uninsured. Some states are getting into the business of providing insurance to cover more people (Massachusetts is the primary example).
3. The Private, For-Profit Health System: this system is run by for-profit, large insurers, who sell health insurance to employers. This system is probably the system you're familiar with, if you have health insurance. Your employer pays a premium for you every month to an insurance provider, such as Aetna, Cignal, or United Health, and that insurer in turn contracts with groups of doctors and hospitals to provide you with health care. You pay a small part of the cost via "copays" for various services. You probably notice that these "copays" are getting higher, but you have no idea what a tiny fraction of the health care cost you're paying. You can purchase this kind of insurance yourself, if you don't have an employer. You will be surprised how expensive it is.
4. The Private, Non-Profit Health System: this system is one of the options for some employers, and it works very much like the For-Profit Private System. It's just that the insurance provider is a non-profit, so they don't have to pay money to company shareholders. Geisenger Healthcare in the East and Kaiser Permanente in the West are two examples of non-profit insurance providers. Like for-profit insurance, you can buy this kind of insurance yourself if you don't have an employer buying it for you. But it's not cheap.
Most people have government health insurance, employer based for- or non-profit private insurance, or no health insurance. There are more complicated hybrid products, "catastrophic" plans, and various charity-funded insurance-like plans. But they aren't as common. Chances are, you're familiar with one or more of the above systems. If you've ever had a decent job, you've probably had private for-profit, or non-profit, health insurance that your employer paid for. If you're over 65, you probably have Medicare. If you've served in the military, you might have insurance and health care through the VA system. If your family was or is low-income, you might have gotten some of your childhood immunizations or medications through state-funded Medicaid. And if you're uninsured, you might need to seek treatment at some point in a state-funded county hospital or clinic.
One way or another, these various health-care "systems" supply some degree of health insurance and health care to a majority of Americans, the exception being the 50-60 million "uninsured Americans." Yes, there are a lot of uninsured Americans- but they still make up only 1/6 of the population. That might be why not much has been accomplished when it comes to dealing with their health-care situation.
MAJOR PROBLEMS WITH HEALTH CARE IN AMERICA:
1. It's expensive.
2. There is NOT ENOUGH MONEY even to keep providing the current level of health care to the current population of people who have insurance.
3. There are a lot of uninsured Americans. Providing them health care = more money.
4. There aren't enough doctors, especially in "primary care," the first line of care for most Americans.
5. People are living longer. That's good for them, but bad for health care, because more years = more health care needs = more money.
6. The quality is not as good as it should be, for the amount of money it costs in America.
IN SHORT:
What you can expect over the coming years is the following: you may have a harder time finding health insurance, and when you do have it you will have a hard time finding a primary care doctor, and you will wait longer to see that doctor. Your share of the cost of doctor's visits, medications, and hospitalizations will continue to increase. And when you are older and retired, you will spend much more of your retirement savings than you ever dreamed of. We'll probably see quite a few changes in how people get health care in the next few years. Some of these changes ain't going to be pretty.
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