The current health delivery system in the United States exhibits many problems with equity and distribution. A definite relationship exists between poverty and lack of access to quality medical care. Impoverished patients are treated in the framework of welfare medicine, where they are forced to rely on public hospitals and clinics. While the poor are relegated to the public welfare track, well-to-do Americans have access to private hospitals and practitioners. In addition, many citizens meet the economic standards of poverty yet are not eligible for the U.S. government-sponsored health insurance programs (Medicaid and Medicare). Thus, a significant percentage of the American population has no health insurance coverage.
The multibillion dollar health care industry in the United States represents a patchwork of successes and failures in improving the health status of the population. Given its enormous expenditures on health care, America should rank number one in terms of low mortality and morbidity rates compared with other countries: "Americans will spend close to $1 trillion on health care this year [1995]--a staggering one-seventh of the nation's economy." Surprising, despite these expenditures, America is not the leading country in terms of its population's health; major improvements are needed.
The major failures of the American health care system are evident in five areas: high blood pressure control, pregnancy and infant health, smoking, alcohol and drug abuse, and sexually transmitted diseases. In addition, income plays a significant role in the maintenance of health. America has also experienced distinct successes in its health care system: expansion of hospital facilities, increased number of physicians, expansion of health care coverage, and growth in technology. Unfortunately, these successes have led to spiraling health care costs.
A criticism of the American health care system is that it is mark...