Health Care System in the USA

As for the health care system in the USA, it is organized in three levels: family doctor, the medical institution or hospital and the United States Public Health Service

A private doctor, they call him a family doctor, gives his patients regular examinations and inoculations. In case professional care is needed the family doctor arranges for the patient to see a specialist or to go to a hospital. The family doctor receives pay directly from the patient. Most physicians have private practices. They make use of the hospital's facilities whenever necessary. A family doctor either has his own private office or works with several other doctors in a so-called group practice.

Many Americans have no family doctor and they come directly to hospital for all their medical needs. The hospital provides health care to the sick and injured. They have government-financed and private hospitals. The patients are admitted to hospitals or clinics staffed by consulting physicians, residents, interns and highly skilled nurses. The nursing staff is very important. Nurses and patients are in close contact throughout the patient’s stay in the hospital. Social services are available to the patients and families regarding personal, emotional, financial problems that may arise from continued illness or disabilities. In some hospitals, for instance in Toledo, Ohio Hospital, pastoral care is available, and pastors visit their parishioners at any time.

Most hospitals have at least the following major medical departments or units: surgery, obstetrics and gynecology, pediatrics and general medicine. They may also have trauma and intensive care unit, neurosurgical, renal care unit and psychiatric unit. The emergency room (unit) is a very special area in the hospital. The emergency patients receive immediate attention.

Cost of medical care is high in the USA. Most of people have private health insurance. Some people have health insurance, life insurance (financial assistance for the relatives in case of death), disability insurance and retirement benefits at their place of employment. Most employers and their families now pay more than 50 per cent of the costs of health insurance. The great cost of medical care in the country and the great number of people who could not pay for it forced the federal government to develop two health insurance programs - Medicaid and Medicare. Medicaid, started in 1966, is a federal program, providing free medical care for low –income people, the aged, and the blind and for dependent children.

Medicare, started in 1967, is a federal program providing free medical care for aged Americans over 65, for those who in the past had the greatest medical expenses.

The chief scientific problems facing American medicine are the same as those facing the Russian medicine; they are heart diseases and cancer. The chief causes of suffering and death today are cancer and diseases of the heart and blood vessels, including hypertension, stroke and atherosclerosis. Also much medical research is done on illnesses of aging, disabilities caused by arthritis, mental illness, drug addiction and genetic problems. We must seek new knowledge about the causes and cure of these diseases.

Health service in the USA

Сare doctors are often the point of entry for most patients needing care, but in the fragmented health care system of the U.S., many patients and their providers experience problems with care coordination. For example, a Harris Interactive survey of California physicians found that:

• Four of every ten physicians report that their patients have had problems with coordination of their care in the last 12 months.
• More than 60% of doctors report that their patients "sometimes" or "often" experience long wait times for diagnostic tests.
• Some 20% of doctors report having their patients repeat tests because of an inability to locate the results during a scheduled visit.

According to an article in The New York Times, the relationship between doctors and patients is deteriorating. A study from Johns Hopkins University found that roughly one in four patients believe their doctors have exposed them to unnecessary risks, and anecdotal evidence such as self-help books and web postings suggest increasing patient frustration. Possible factors behind the deteriorating doctor/patient relationship include the current system for training physicians and differences in how doctors and patients view the practice of medicine. Doctors may focus on diagnosis and treatment, while patients may be more interested in wellness and being listened to by their doctors.

Many primary care physicians no longer see their patients while they are in the hospital; instead, hospitalists are used. The use of hospitalists is sometimes mandated by health insurance companies as a cost-saving measure which is resented by some primary care physicians

ANSWER THE QUESTIONS:

1. What are the three levels of health care system in the USA?
2. What are the duties of a private doctor?
3. What is the role of hospitals in the USA?
4. What major medical departments do American hospitals have?
5. What health insurance programs exist in the USA?
6. What are the chief scientific problems facing American medicine?

Test

1. In the USA, they have government-financed and ______________ hospitals.

1) Private

2) Free

3) Public

4) Community

2. The relationship between doctors and patients_________________.

• is becoming worse
• is improving
• is good
• is poor

3. Using self-help books and web postings lead to increasing ___________ among patients.

1) happiness

2) satisfaction

3) stress

4) recovery rates

4. In the USA, a family doctor gives his patients regular examinations and ……………...

1) tutorials

2) inoculations

3) drugs

4) insurance policies

1. The insurance policy is more expensive for ____________ .

1) men

2) women

3) children

4) over-65 population

Medicare is a federal program providing free medical care for ______________

1) the elderly

2) low – income people

3) those who have more than 3 children

4) dependent children