FOKUS AMERIKA Büro Washington Dr. Almut Wieland-Karimi 1023 15 th Street NW,# 801 Washington, DC 20005 USA Tel.:+1 202 408 5444 Fax:+1 202 408 5537 fesdc@fesdc.org www.fesdc.org Nr. 3/ 2008 Covering America: The US Health Care System and the 2008 Election Karen Davenport 1  The United States spends 16 percent of its gross domestic product on health care serv­ices, yet 47 million Americans lack health insurance coverage. Individuals without health insurance go without needed care, while the care they do manage to receive results in higher insurance costs for other Americans.  The current American health care system is experiencing rapid cost growth, which inhib­its business development, reduces the nation’s economic competitiveness, and places families at financial risk.  Presidential candidates have offered health care reform proposals that seek to control costs and expand coverage. The two major approaches feature either public program expansions combined with subsidies for private insurance, or a move from employment­based coverage to individually-purchased coverage, combined with fixed-dollar tax cred­its to partially cover premiums. Over the last 18 months, voter anxiety over health care issues and reform has grown, making health care a pre-eminent domestic issue in American voters’ minds as the United States heads into the 2008 presiden­tial election. And for good reason – health care represents a large and growing part of the US economy, while health care costs threaten families’ financial security and America’s global competitiveness. Many of the presidential candidates have offered their own prescriptions for how the US health care system can expand cover­age and control escalating costs – but un­derstanding their approaches requires a basic understanding of the fragmented Ame­rican health care system. Overview of the US Health Care System In 2006, the United States spent$2.1 trillion on health care services, which represents 16 percent of the country’s gross domestic product(GDP). This spending covered hospital care, physician visits, rehabilitation therapies, long-term care services, prescrip­tion drugs and more – everything that Ame-