DATE=10-17-2003

TYPE=Special English Feature

NUMBER=7-29061

TITLE=SPECIAL ENGLISH AMERICAN MOSAIC #944-Health Care in US

BYLINE=Nancy Steinbach

TELEPHONE=619-2585

DATELINE=Washington

EDITOR=Arditti

CONTENT=

HOST:

Our VOA listener question this week comes from Guanzhou, China. Mike Li asks about the medical care system in the United States.

Most Americans buy health insurance from private companies through their employers. Workers and employers usually share the cost.

Insurance companies pay some or all the costs when a person visits a doctor or hospital. But they may not pay for some kinds of treatments or services, or there are limits. Also, many plans pay for some kinds of examinations only when a person is sick.

One kind of health insurance is provided by a health maintenance organization, or H-M-O. Groups of doctors work for an H-M-O. Individuals and families pay each month to belong. Their employers usually also pay part of the cost.

Members can see the different doctors within their H-M-O at little or no additional cost. Millions of people belong to H-M-0's. But others want more freedom to choose their own doctors and hospitals. Also, some people say an H-M-O may put too much pressure on doctors to control costs.

About forty-three-million Americans, or fifteen percent, have no health insurance at all.

Many cannot pay for insurance, but have too much money to receive free health care for the poor. Some have no job, or work for a company that does not provide insurance. Still others are sick and cannot get insurance to pay for their treatment.

Two federal programs pay medical costs for some Americans. Medicare pays for many older and disabled people. Medicaid pays for poor people.

Some want a system that pays for all people, like other major industrial nations have. Eight-thousand doctors support a proposal for a national system of health insurance. The proposal appeared in August in the Journal of the American Medical Association. That is the nation's largest doctors group. But the group itself says a single-payer system would limit care and create other problems.

Health costs continue to increase. The government has attempted reforms in the past. But it is a huge job. The Bush administration is proposing to reduce drug costs for older Americans. The idea is to offer a limited drug payment system through Medicare. The Democratic presidential candidates also have health care proposals.