Health care reform debate in the United States
The healthcare reform debate in the United States has been a political issue focusing upon increasing medical coverage, decreasing costs, insurance reform, and the philosophy of its provision, funding, and government involvement. Following the election of Barack Obama as president, who campaigned heavily on accomplishing health care reform, the Patient Protection and Affordable Care Act (PPACA) was enacted in March 2010.
In 2009, the U.S. had the highest healthcare costs relative to the size of the economy (GDP) in the world, with an estimated 50.2 million citizens (approximately 16% of the September 2011 estimated population of 312 million) without insurance coverage. Some critics of reform counter that almost four out of ten of these uninsured come from a household with over $50,000 income per year, and thus might be uninsured voluntarily, or opting to pay for health care services on a "pay-as-you-go" basis.
Further, an estimated 77 million Baby Boomers are reaching retirement age, which combined with significant annual increases in healthcare costs per person will place enormous budgetary strain on U.S. state and federal governments. Maintaining the long-term fiscal health of the U.S. federal government is significantly dependent on healthcare costs being controlled.
There is significant debate regarding the quality of the U.S. healthcare system relative to those of other countries. Physicians for a National Health Program, a political advocacy group, has claimed that a free market solution to healthcare provides a lower quality of care, with higher mortality rates, than publicly funded systems. The quality of health maintenance organizations and managed care have also been criticized by this same group.
According to a 2015 report from The Commonwealth Fund, although the United States pays almost twice as much per capita towards healthcare as other wealthy countries with universal healthcare, patient outcomes are poorer. The United States has the lowest life expectancy overall and the infant mortality rate is the highest and in some cases twice as high when compared with other Organisation for Economic Co-operation and Development (OECD) countries. Also highlighted in this report is data that shows that although Americans have one of the lowest percentages of daily smokers, they have the highest mortality rate for heart disease, a significantly higher obesity rate and more amputations due to diabetes. Other health related issues highlighted were that Americans over the age of 65 have a higher percentage of the population with two or more chronic conditions and the lowest percentage of that age group living.
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