The US health system has both considerable strengths and notable weaknesses. With a large and well-trained health workforce, access to a wide range of high-quality medical specialists as well as secondary and tertiary institutions, patient outcomes are among the best in the world. But the US also suffers from incomplete coverage of its population, and health expenditure levels per person far exceed all other countries. Poor measures on many objective and subjective indicators of quality and outcomes plague the US health care system. In addition, an unequal distribution of resources across the country and among different population groups results in poor access to care for many citizens. Efforts to provide comprehensive, national health insurance in the United States go back to the Great Depression, and nearly every president since Harry S. Truman has proposed some form of national health insurance.
Review of the Literature
The Affordable Care Act of 2010.
In March 2010, under the Obama administration, the United States enacted major health-care reform. The Affordable Care Act (ACA) of 2010 expands coverage to the majority of uninsured Americans, through: (a) subsidies aimed at lower-income individuals and families to purchase coverage, (b) a mandate that most Americans obtain insurance or face a penalty,
(c) a requirement that firms with over 50 employees offer coverage or pay a penalty, (d) a major expansion of Medicaid, and (d) regulating health insurers by requiring that they provide and maintain coverage to all applicants and not charge more for those with a history of illness, as well as requiring community rating, guaranteed issue, non-discrimination for pre-existing conditions, and conforming to a spec...
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... on $50,000 of income. A similar situation would occur if one spouse earned a wage limit over the threshold and the other spouse did not. Since a company's payroll system only keeps track of information about its own employees, the spouse with lower earnings would not have the tax withheld but would still be subject to it at tax time.
Title X. Reauthorization of the Indian Health Care Improvement Act. The Act reauthorizes the Indian Health Care Improvement Act (ICHIA) which provides health care services to American Indians and Alaskan Natives. It focuses on modernization of the Indian health care system and improvement of health care for 1.9 million American Indians and Alaska Natives. Prior to passage of the ICHIA in 1976, there was a 24-year gap between life expectancy for Native Americans and the general population. Today, that gap has narrowed to 2 ½ years.
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