Health care in the United States is provided by many separate legal entities. The U.S. spends more on health care, both as a proportion of gross domestic product (GDP) and on a per-capita basis, than any other nation in the world. Current estimates put U.S. health care spending at approximately 16% of GDP. The health share of GDP is expected to continue its historical upward trend, reaching 19.5 percent of GDP by 2017. In 2007, the U.S. spent a projected $2.26 trillion on health care, or $7,439 per person.
According to the Institute of Medicine of the National Academy of Sciences, the U.S. is the only wealthy, industrialized nation that does not have a universal health care system. In the United States, around 84% of citizens have some form of health insurance; either through their employer (60%), purchased individually (9%), or provided by government programs (27%; there is some overlap in these figures). Certain publicly-funded health care programs help to provide for the elderly, disabled, children, veterans, and the poor, and federal law mandates public access to emergency services regardless of ability to pay. U.S. government programs accounted for over 45% of health care expenditures, making the U.S. government the largest insurer in the nation. Per capita spending on health care by the U.S. government placed it among the top ten highest spenders among United Nations member countries in 2004.
Americans without health insurance coverage at some time during 2006 totaled about 16% of the population, or 47 million people. Health insurance costs are rising faster than wages or inflation, and "medical causes" were cited by about half of bankruptcy filers in the United States in 2001.
The debate about U.S. health care concerns questions of access, efficiency, and quality purchased by the high sums spent. The World Health Organization (WHO) in 2000 ranked the U.S. health care system first in both responsiveness and expenditure, but 37th in overall performance and 72nd by overall level of health (among 191 member nations included in the study). The WHO study has been criticized both for its methodology and for a lack of correlation with user satisfaction ratings. The CIA World Factbook ranked the United States 41st in the world for lowest infant mortality rate and 45th for highest total life expectancy. A recent study found that between 1997 and 2003, preventable deaths declined more slowly in the United States than in 18 other industrialized nations. On the other hand, the National Health Interview Survey, released annually by the Centers for Disease Control's National Center for Health Statistics reported that approximately 66% of survey respondents said they were in "excellent" or "very good" health in 2006.
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