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US health care system : ウィキペディア英語版
Health care in the United States


Health care in the United States is provided by many distinct organizations. Health care facilities are largely owned and operated by private sector businesses. 58% of US community hospitals are non-profit, 21% are government owned, and 21% are for-profit.〔()〕 According to the World Health Organization (WHO), the United States spent more on health care per capita ($8,608), and more on health care as percentage of its GDP (17.2%), than any other nation in 2011.
60–65% of healthcare provision and spending comes from programs such as Medicare, Medicaid, the Children's Health Insurance Program, and the Veterans Health Administration. Most of the population under 67 is insured by their or a family member's employer, some buy health insurance on their own, and the remainder are uninsured. Health insurance for public sector employees is primarily provided by the government.
The United States life expectancy of 78.4 years at birth, up from 75.2 years in 1990, ranks it 50th among 221 nations, and 27th out of the 34 industrialized OECD countries, down from 20th in 1990.〔 Of 17 high-income countries studied by the National Institutes of Health in 2013, the United States had the highest or near-highest prevalence of obesity, car accidents, infant mortality, heart and lung disease, sexually transmitted infections, adolescent pregnancies, injuries, and homicides. On average, a U.S. male can be expected to live almost four fewer years than those in the top-ranked country, though notably Americans aged 75 live longer than those who reach that age in other developed nations.〔("U.S. Health in International Perspective: Shorter Lives, Poorer Health" ) (2013) National Institutes of Health Committee on Population, Board on Population Health and Public Health Practice〕
A comprehensive 2007 study by European doctors found the five-year cancer survival rate was significantly higher in the U.S. than in all 21 European nations studied, 66.3% for men versus the European mean of 47.3% and 62.9% versus 52.8% for women. Americans undergo cancer screenings at significantly higher rates than people in other developed countries, and access MRI and CT scans at the highest rate of any OECD nation. People in the U.S. diagnosed with high cholesterol or hypertension access pharmaceutical treatments at higher rates than those diagnosed in other developed nations, and are more likely to successfully control the conditions.〔Atlas 2011, pp. 205–207〕 Diabetics are more likely to receive treatment and meet treatment targets in the U.S. than in Canada, England, or Scotland.〔Atlas 2011, pp. 150–156〕 A study showed that the U.S., Japan, and France recorded the highest survival rates among 31 nations for four types of cancer.〔(【引用サイトリンク】url=http://www.webmd.com/cancer/news/20080716/cancer-survival-rates-vary-by-country )
America is a global leader in medical innovation. The US solely developed or contributed significantly to 9 of the top 10 most important medical innovations since 1975 as ranked by a 2001 poll of physicians, while the EU and Switzerland together contributed to five. Since 1966, Americans have received more Nobel Prizes in Medicine than the rest of the world combined. From 1989 to 2002, four times more money was invested in private biotechnology companies in America than in Europe. The United States also has the most advanced hospitals in the world.〔(【引用サイトリンク】url=http://www.topmastersinhealthcare.com/30-most-technologically-advanced-hospitals-in-the-world/ )
Gallup recorded that the uninsured rate among U.S. adults was 11.9% for the first quarter of 2015, continuing the decline of the uninsured rate outset by the Affordable Care Act.〔(【引用サイトリンク】url=http://www.gallup.com/poll/182348/uninsured-rate-dips-first-quarter.aspx )〕 A 2004 Institute of Medicine (IOM) report said: "The United States is among the few industrialized nations in the world that ''does not guarantee access'' to health care for its population." A 2004 OECD report said: "With the exception of Mexico, Turkey, and the United States, all OECD countries had achieved universal or near-universal (at least 98.4% insured) coverage of their populations by 1990." Recent evidence demonstrates that lack of health insurance causes some 45,000 to 48,000 unnecessary deaths every year in the United States.〔〔 In 2007, 62.1% of filers for bankruptcies claimed high medical expenses. A 2013 study found that about 25% of all senior citizens declare bankruptcy due to medical expenses, and 43% are forced to mortgage or sell their primary residence.
On March 23, 2010, the Patient Protection and Affordable Care Act (PPACA) became law, providing for major changes in health insurance. The medical system will be forced to change normal procedures.〔 They will be required to prepare for upcoming programs to meet federal regulations. The constitutionality of the law, as well as its impact on insurance coverage, insurance quality, insurance premiums, medical quality, and the economy are subjects of ongoing debate.〔






==History==
(詳細はウィキペディア(Wikipedia)

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