What You Need to Know About The Healthcare System

The healthcare industry touches all Americans, yet terms like health insurance and Obamacare leave many scratching their heads. Healthcare is a complex area, and there are some things that you really need to know.

Healthcare is Big Business


Many Americans may think about healthcare as an altruistic industry, but it’s actually a massive money maker. In 2013, Americans spent around $2.8 trillion on healthcare. It’s expected that by 2019, that figure will jump to a staggering $4.5 trillion. The link between healthcare and money is so strong that healthcare economics is one of the foundations of an Executive Master of Health Administration degree.

Perhaps most troubling for Americans is that the money isn’t just going to hardworking doctors and nurses. The nation’s five largest for-profit health insurance companies make in excess of $3.3 billion in profits every year. Critics of America’s healthcare system insist that healthcare costs are rising to increase profit margins, not to improve patient care.

Patient Protection and Affordable Care Act Revamped National Healthcare

The Patient Protection and Affordable Care Act, commonly known as Obamacare, hasn’t solved America’s healthcare problems, but it has helped protect more people. It has allowed Americans to purchase federally regulated and heavily subsidized health insurance during an annual open enrollment period; it has also expanded Medicaid, improved Medicare, and introduced a number of new benefits and securities for local citizens.

After Obamacare's introduction, Americans couldn’t be denied coverage or treatment on the basis of past illnesses. Women could no longer be charged more than men, and individuals couldn’t have treatment halted if they made a mistake on their application forms. Americans also gained a greater ability to appeal health insurance decisions.

As a result of the reforms, a Gallup poll conducted in April 2014 found that just 13.4 percent of Americans were without health insurance. This was the lowest figure since the introduction of the Gallup poll in 2008 and, according to the Department of Health and Human Services, could be the lowest number of uninsured people since before 1998.

More Changes Are Coming

Obamacare is still in its nascent stages. Starting in 2016, employers with 50 or more employees must provide health coverage to all full-time workers. Employers must pay at least 60 percent of the minimum essential healthcare insurance. While they may ask their workers to make a contribution to the cover, this contribution cannot be more than 9.5 percent of their household income.

Currently large employers — those with 100 employees or more — must provide coverage to at least 70 percent of their workforce, while mid-sized employers — those with 50 - 99 employees — are not required to provide any insurance coverage. The expansion of workplace health insurance will help extend healthcare coverage to people who aren’t already covered by subsidized private insurance and the expansion of Medicaid. Employers that fail to comply will receive a no-cover penalty of $2,000 per year multiplied by the number of full-time employees minus 80 employees.

Healthcare might be a complex issue, but it’s vital that all Americans understand these basic points about this changing industry.