Episode 40: The complexity of the American healthcare system

The healthcare system in the United States is complex, with the government, private insurers, and various providers all playing a role. The most common types of healthcare system in the US are single-payer, universal, and socialized medicine.

Healthcare insurance plans and government subsidies exist because even the rich can’t pay in full for their medical bills.

In today’s conversation, I provide a brief overview of the different types of healthcare systems in the United States. I describe government implications in them to make healthcare available and affordable to all Americans.

The American healthcare system is a complex medical platform that involves the government, private insurers, and various providers. The most common types are Single-payer health care, which is a system in which the government is the sole provider of healthcare services, Universal health care, in which the government makes healthcare available and affordable for all citizens, and Socialized medicine, in which the government owns and operates the healthcare system. 

To make you understand better, I will consider Medicare, Medicaid, Obamacare, Tricare, and Veterans Benefits as prime examples. Let’s begin, shall we? 

Let’s start with Medicare. The federal government runs Medicare, but it does not employ the doctors nor does it own and operate the hospitals or the clinics. Medicare is available to Americans who are at least 65 years old. Based on the info I provided, mainly that the federal government runs Medicare, I am telling you that Medicare is a single-payer healthcare system. Therefore, a single-payer healthcare system is a medical plan for which a federal or central government is fully responsible. 

Now, let’s talk about Medicaid. The federal and state governments jointly fund Medicaid to provide public coverage to low-income or very low-income individuals. In the Medicaid coverage, private hospitals employ most doctors and run the medical facilities. Based on the info I provided, primarily that federal and state governments jointly fund Medicaid, I am telling you that Medicaid is not a single-payer healthcare system but a universal healthcare system. Therefore, universal health care refers to a system in which everyone can access health coverage and affordable medical care.

The definition of a universal healthcare system brings me to the Affordable Care Act, commonly known as Obamacare. Obamacare is a system of medical plans offered to the public by different private health insurers. Same as in Medicare and Medicaid, the doctors and private hospitals sign insurance contracts with the government to provide affordable care to all. Making healthcare available and affordable to all makes Obamacare a universal healthcare system. Obamacare also provides subsidies to eligible enrollees. 

Let’s now talk about Tricare and Veteran’s Benefits known as VA. Active duty and Retired Soldiers are eligible for such plans. The military, through the department of defense, owns and operates the hospitals and employs the doctors. All service members are eligible for the same benefits regardless of age, grade, time in service, or family size. Based on the info I provided, mainly that the federal government runs Tricare and the VA through the Department of Defense, I am telling you that Tricare and the VA are both a single-payer healthcare system and socialized medicine. Therefore, socialized medicine is a healthcare system in which the federal government or a government agency owns and operates all the healthcare facilities and employs all the healthcare professionals, thus also paying for all healthcare services.

As you can see, the single-payer healthcare and the universal public coverage systems are a mix of public and private coverage and medical facilities. In contrast, socialized medicine is a single-payer approach healthcare system that does not involve private insurers.  

As a recap, healthcare is so expensive that federal and state governments provide it free or at low cost, to specific individuals. Employers partner with private insurers to alleviate individual costs for their employees. Healthcare is so expensive that even the wealthiest enroll in plans to cover certain services for them. The single-payer and universal healthcare systems could also be provided through socialized medicine if the federal government decides to employ all the doctors and take ownership and operations of all the medical facilities.