The U.S. private health insurance system, the U.S. health care system

For a long time, U.S. insurance companies and medical institutions have formed a "community of interests", resulting in medical services** all the way up. There are also loopholes in the regulation of health insurance programs.

The health insurance system in the United States is divided into public health insurance and private health insurance. The public health insurance system mainly includes health insurance for the elderly and disabled, Medicaid, children's health insurance programs, and other insurances. The most important and widespread, of these, are health insurance for the elderly and disabled, and Medicaid.

Due to loopholes in the supervision of health insurance programs, some doctors still have the power to prescribe after being investigated. In 2011, U.S. Senators Orrin Hatch and Tom Cobain submitted to the Medicare and Medicare Center a list of doctors convicted of health care fraud, and the 34 doctors on the list remained on the list of health care providers after being convicted, meaning they were still able to see doctors and prescribe medications.

For a long time, U.S. insurance companies and medical institutions have formed a "community of interests", resulting in medical services** all the way up. There are also loopholes in the regulation of health insurance programs.

According to the U.S. Department of Health**, the U.S. population over the age of 65 will increase to 49.9 million in 2018 compared to 2003, while the population under 65 will only grow, and the public spending on health care will increase by 87%. The huge funding gap could lead to the bankruptcy of Medicare and even the federal treasury.

Features of the U.S. healthcare industry:

1) Standardized management of diagnosis and treatment procedures. In order to standardize medical services, the American Medical Association has issued a 5-digit "CPT Code" that covers all **, diagnosis, and surgical procedures.

This ** is the basis for judging whether the doctor's diagnosis and treatment is reasonable and the fee charged. At the same time, with reference to the World Health Organization's International Classification of Diseases (ICD), the U.S. Department of Health has developed a reference payment system for medical services called the Related Diagnostic Category (DRG), which pays all hospitals** for similar cases at the same cost.

2) The organizational structure is siloed. Doctors are usually not employed by the hospital, but have an agreement with the hospital through the physician team organization model, the doctor-hospital cooperative organization, etc. The professional diagnosis and treatment departments such as image diagnosis, pathological laboratory testing, and physics within the hospital are also contracted by doctors and charged independently.

One of the reasons for the high cost of medical care is the lack of coordination throughout the medical process.

Legal analysis: The U.S. Health Insurance Act generally refers to the U.S. Health Insurance Act, which is promoted by Trump and repeals and replaces the "Obamacare Reform Act". On May 4, 2017, the U.S. House of Representatives passed this draft, making important progress in repealing and replacing the main elements of "Obamacare".

The bill needs to be approved by the Senate and signed by ** before it can take effect.

Legal basis: Meizheng Tongguo Medical Insurance Law Article 75 Consumers do not need to pay taxes when they purchase new medical insurance. In addition, there will be a tax deduction for the portion of medical expenses.

Allows children to take advantage of their returning parents' insurance plans until the age of 26.