Medical Service in the usa

In the final decades of the 20 the century, Americans increasingly view good health as something to which they have the right. Self-employed private physicians who charge a fee for each patient visit are the foundation of medical practice in the United States. Most physicians have a contractual relationship with one or more hospitals in the community.

They send their patients to this hospital, which usually charges patients according to the number of days they stay and the facilities – operating room, tests, medicines – that they use. Some hospitals belong to a city, a state or, in the case of veterans’ hospitals, a federal government agency. Others are operated by religious orders or other non-profit groups. Still others operate for profit.

Some medical doctors are on salary. Salaried physicians may work as hospital staff members, or residents, who often are still in training. They may teach in medical schools, be hired by corporations to care for their workers or work for the federal government‘s Public Health Service.

Physicians are among the best paid professionals in the United States. In the 1980-ies, it was not uncommon for medical doctors to earn incomes of more than 100,000 dollars a year. Specialists, particularly surgeons might earn several times that amount. Physicians list many reasons why they deserve to be so well rewarded for their work. One reason is the long and expensive preparation required to become a physician in the US. Most would-be-physicians first attend college for four years, which can cost more than 12,000 dollars annually at one of the best private institutions. Prospective physicians then attend medical school for four years. Tuition alone can exceed 41,000 a year. By the time they have obtained their medical degrees, many young physicians are deeply in debt. They still face three to five years of residency in a hospital, the first year as an intern, an apprentice physician. The hours are long and the pay is relatively low.

Setting up a medical practice is expensive, too. Sometimes several physicians will decide to establish a group practice, so they can share the expense of maintaining an office and buying equipment. These physicians also take care of each other‘s patients in emergencies.

Physicians work long hours and must accept a great deal of responsibility. Many medical procedures, even quite routine ones, involve risk. It is understandable that physicians want to be well rewarded for making decisions which can mean the difference between life and death.

Health Services in the usa Situation for intercultural communication: a Russian doctor comes to the usa for a tour and speaks to an American guide about the problems of health services in the usa

Tourist: I know that there is quite a difference between our two systems of medical services. How is medical service organized in your country?

Guide: You see, in the USA there are three levels of organization of medical services.

T: What are these levels?

G: They are private doctors, medical institutions and the United States Public Health Service.

T: Who are the private doctors paid by?

G: The Private or family doctors receive the pay directly from their patients.

T: I’ve heard that you have the so-called «group practice». What does it mean?

G: The thing is that not all doctors have a private office of their own, some work in teams with several other doctors, that is the essence of the notion «group practice».

T: What medical aid do private doctors render?

G: Well, they give their patients regular examinations, medical advice and vaccination.

T: Can they hospitalize a patient if they find it necessary?

G: Certainly, they can. They may send a patient either to a private or to a state hospital.

T: Is there any kind of free medical aid in the USA?

G: Yes, there are two programs for rendering free medical aid to the population of our country: Medicare and Medicaid.

T: I wonder who comes under the Medicare program?

G: Medicare provides free medical care for all the Americans over 65.

T: And what does Medicaid mean?

G: Medicaid provides free medical aid for all those whose income is very low.

T: What questions come under the control of Public Health Service?

G: These are broader questions of medicine such as vaccination of school children, investigation of epidemics, scientific research dealing with the treatment of cancer and heart diseases.

T: What do you think about the main problems facing American medicine?

G: I believe they are practically the same as in your country: treatment of cancer and cardiovascular diseases, but the major problem of today is finding a vaccine against AIDS, the most disastrous disease of the 21 st century.