Health care is the medical and related services that keep people healthy, especially during illness. It includes services provided by doctors, nurses, therapists, pharmacists, and hospitals. Some of the services are preventive in nature, such as immunizations or screening for cancer, while others are diagnostic or therapeutic, such as surgery or prescription drugs. A large portion of health care is delivered in hospitals, which are generally larger than other kinds of health care facilities. The federal government plays a significant role in financing health care through the Veterans Health Administration and Indian Health Service, but it has a minimal direct involvement in the operation of health care providers. The majority of health care providers are private businesses.
Health insurance is a legal entitlement to payment or reimbursement for health care expenses under contract, either through a personal contract with a private insurer, a group plan offered in connection with employment, or a public program such as Medicare, Medicaid, or the Children’s Health Insurance Program. It provides a financial incentive to receive regular health care and to seek out preventive services, in order to maintain good health. It also allows individuals to avoid the large financial risk of high medical bills.
Many factors contribute to the availability of health care, including the distribution of physicians, hospital beds, and clinics. In some areas, the distribution of providers does not reflect the population’s needs for services, resulting in backlogs at emergency rooms that serve as providers of last resort. In addition, the cost of health insurance often rises faster than wages and inflation, making it difficult for some to afford coverage.
The 1993 Clinton Health Care Bill proposed a universal healthcare system that would provide every American with a health insurance card guaranteeing a basic benefits package. The bill was never enacted into law, but the idea of universal coverage continues to be debated.
Research on the effects of health insurance varies widely, because researchers cannot control for all possible confounding factors. Nevertheless, evidence suggests that having health insurance results in higher levels of health-related behaviors, reduced need for emergency care, and lower costs for medical procedures and drugs.
Because studies of hospital-based care often include only patients who show up for treatment, and because appropriateness criteria vary widely among hospitals, these studies can be vulnerable to selection bias. Other, more focused studies, such as those examining the effects of specific conditions on outcomes, are less likely to be compromised by selection bias.
Although the United States spends more than any other country in the world on health care, its life expectancy is lower than that of most European countries. A primary reason is the difficulty many Americans have in obtaining health care, which can result from a lack of affordable coverage or a perception that available treatments are unproven. Increasing the quality and availability of health care is a major policy goal. Other goals include reducing the number of avoidable deaths and limiting the impact of medical errors on patient outcomes.