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U.S. Medical System Healthcare, Insurance and Hospitals in the United States


Vocabulary and Questions to Think About

 Privately owned: owned by one person or a group of people, not the government.  Insurance company: a company that helps its members pay for medical care.  Employer: the person or company that you work for.  Debt: an amount of money that you owe to someone else  Inflate: to make something bigger unnecessarily  What is the difference between healthcare in the U.S. and Spain?  Do you think people have a right to healthcare?


How it Works…  Healthcare in the U.S. is primarily provided by privately owned doctor’s offices and hospitals.  Doctors and hospitals are paid by patients and insurance companies.  U.S. citizens receive health insurance through their employer, a family member’s employer or they buy it on their own.

 About 84.7% of Americans have some form of insurance.  59.3% receive insurance through work  8.9% purchase it individually.  27.8% receive insurance through a government program. This includes the elderly, disabled people, children, veterans and some of the poor.  15.3% of Americans have no insurance at all.


Controversy  Even with insurance, patients often have to pay part of their medical costs.  The company (employer) chooses the insurance plan and some doctors, hospitals or medical services may not be included.

 Because of a “dishonest and inefficient system” that sometimes inflates bills to ten times the actual cost, even people with insurance can be charged more than the actual cost of their care.


Debate and Controversy  There is no government funded healthcare insurance company which covers all Americans.  Many people in the US think that healthcare should be a basic right and the current system is not fair or efficient and the cost does not reflect the quality.  Medical debt is the reason for almost half of personal bankruptcies in the U.S.  Healthcare spending in the U.S. is the highest in the world.


What to do if you get ill:  If you wake up one morning and you have a cold, the flu or a sore throat you must call your primary care doctor(or general practitioner) and request an appointment. Depending on your insurance plan, your doctors office and your complaint or illness you may be able to get an appointment for the same day or you may have to wait several days. Also, if your complaint is not severe and your doctor is very busy, you may be scheduled to see a nurse practitioner or physicians assistant.  At your appointment, you must always bring your insurance card and ID.  At your appointment, the doctor or nurse will take your temperature, take a swab of your throat and check for fluid in yoru ears and lungs with a stethoscope.  Then, they may do some tests in the office or in a lab to determine if you have an infection or a virus.  Finally, the doctor will write you a prescription for some medication which you must then take to a pharmacy


At the Pharmacy…  In the United States you cannot get any medication at a pharmacy without a written prescription from your doctor.  The medication may be available immediately or you may have to wait for the pharmacist to make it for you.  Depending on your insurance plan and the type of medication you need, it may be free or you may have to pay part or all of the cost of the medication.


If you are seriously ill…  If you have something more serious than a cold or the flu, the doctor may refer you to a specialist.  The doctors office will call or send a message to your insurance company explaining why you need to see a specialist and the insurance company will send a list of approved specialists. Again, depending on your insurance plan, some specialist and services may not be allowed or you may have to pay for them.  You must then call the specialist´s office and request an appointment.


The Emergency Room  If you are too serioulsy ill or injured to wait for an appointment you can go to the Emergency Room at the hospital.  You do not need an appointment and you can go 24 hours per day.  No one is turned away from the ER even if they do not have insurance. Becasue of this some people without insurance always go to the ER but sometimes you must wait several hours to get care if your illness is not very serious.  The ER is always very crowded, the doctors are overworked and sometimes the care is not as good as it could be because doctors are forced to make decisions very quickly and can sometimes make mistakes about how serious your condition is.


You get what you pay for…  Because it is private, healthcare in the US varies hugely.  The more money you have or the better your insurance, the better your healthcare.  What do you think of this?


Health Care United States