International Health Systems Research Collaborative

As of 2022, Americans obtain insurance through a complex mix of public and private, for-profit and nonprofit insurers, and approximately 10% of Americans lack health insurance. Roughly 80% of hospitals are not-for-profit, 15% are for-profit, and 5% are operated by the federal or local governments. Physicians are generally paid fee-for-service, though this has been changing since the passage of the Affordable Care Act. The federal government directly funds health insurance for seniors (adults aged 65 and older), people on dialysis and certain individuals with disabilities through the national Medicare program. There are additional government insurance programs for veterans and individuals with low-income (Medicaid and the Children’s Health Insurance Program). States and local government manage and pay for aspects of coverage for the safety net. Private insurance, the dominant form of coverage, is provided primarily by employers. Arguably the defining concerns in U.S. healthcare have been high spending (costs/prices) and lack of universal health insurance. (Read more from the Commonwealth Foundation, the Kaiser Family Foundation, and Health Affairs)