National Information Center on Health Services Research and Health Care Technology (NICHSR)
Health Economics Information Resources: A Self-Study Course
Module 2 - Sources and Characteristics of Information Relating to Health Care Financing in the US
The U.S. health care financing systemIn this section we will be looking at a snapshot of the current health care situation. We will ask whether the U.S. health care system is really a system and will investigate how the money is spent, what are the health outcomes and how individuals access the system.
In the U.S. health care is financed, or paid for, in a variety of ways. Individuals may pay directly for services received. Others may have health insurance coverage as a tax free benefit from their employment. Military personnel and their dependents, as well as veterans, are provided health care coverage through the federal government. Older Americans depend upon Medicare and low income mothers and children, as well as some disabled persons in the U.S., receive health care assistance through Medicaid. Children who might not otherwise receive medical attention may do so through the State Children’s Health Insurance Program (SCHIP).
From this brief description, however, one point is very clear. The health care financing system is not so much a system as it is a crazy-quilt of programs that, when pieced together, cover to some degree, the majority--but clearly not all—of the American people.
Because there is such a wide variety of public and private insurance programs in the US, there is also great opportunity for researchers to study the tradeoffs between key issues. Most notable are issues related to spending, outcomes, and access.