America.gov - Engaging the world

16 June 2008

U.S. Health Care System Major Issue for Presidential Candidates

Podcast examines factors surrounding access to quality health care

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The United States spends more on health care than any other nation in the world, currently estimated at about 16 percent of its gross domestic product. Health care costs are expected to be considerably higher in the future. But despite such high costs, the World Health Organization recently ranked the overall quality of the American health care system 37th out of almost 200 countries worldwide. France was ranked first.

In an election year in which Americans are concerned about the effects of an economic downturn, health care is one of the major political issues the final two candidates for president will be discussing on the campaign trail. Perhaps no other issue divides Republicans and Democrats as much as health care reform.

America is the only wealthy, industrialized nation that does not mandate access to health insurance for all citizens. More than three-quarters of Americans have health insurance, which most people receive through their employers. There are about 47 million Americans without health insurance.

The key element of the health care debate is cost. Health care costs are rising faster than wages and inflation. A slow economy combined with high health care costs means that many Americans cannot afford medical care and are not getting the medical treatment they need. Medical bills have led many Americans to declare bankruptcy.

Although many might say that health care and the economy are separate issues, the fact that most Americans receive health insurance through their employers connects the two. A lost job can mean lost health insurance.  In an increasingly globalized world, those who worry that their jobs could be moved overseas often are concerned as well about how losing their jobs will affect their health care options.

The debate about U.S. health care involves questions of access, efficiency and quality given the high costs. Research has found that Democrats tend to favor a health care system similar to that of Canada, France or the United Kingdom, in which all citizens must have health insurance. Republicans are often interested in providing tax credits or other incentives that will encourage Americans to determine and purchase the health insurance that best meets their needs.

For those who do not have employer-based health insurance, Republican John McCain would offer tax credits to make insurance more affordable. He also seeks to allow Americans to keep their health insurance when switching jobs or moving between states. He believes health care costs can be lowered by encouraging greater competition among providers and he opposes federal universal coverage.

Democrat Barack Obama’s health care plan would require all children to have health insurance. He also would require that employers contribute to their employees’ health insurance costs. Americans who do not have employer-based insurance could choose from a national insurance program with a number of private and government options. To lower costs, Obama says health care providers should be more transparent and publicly report their expenses.

This podcast is produced by the U.S. Department of State's Bureau of International Information Programs. Links to other Internet sites or opinions expressed should not be considered an endorsement of other content and views.

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