1. 2008;11;13-42Health Care Reform in the United States: Radical Surgery Needed Now More Than Ever
   Health Policy Review
   Laxmaiah Manchikanti, MD.

It is often claimed that American health care provides good medical care, but the system through which that care is financed is falling apart. In 1994, Joseph A. Califano, Jr., former Secretary of Health, Education and Welfare reported that the American health care system was in such turmoil, that it needed radical surgery.

Health care in the United States is different from other countries. Health care costs in America have skyrocketed and in 2006 occupied 16% of the Gross Domestic Product (GDP) with a budget of over $2 trillion. Health care expenditures per capita in the United States are higher than 13 other countries utilized in a sample by the Organisation for Economic Co-operation and Development. Estimated spending according to wealth was utilized to measure each country’s health care spending in comparison to each other. This measure, including various parameters (undoubtedly some have been missed), largely showed that after adjusting to its higher per capita income levels, the United States spends $477 billion - $1,645 per capita more on health care than any other peer country.

Many health care proposals have been forwarded since 1965, when Lyndon Johnson succeeded in enacting Medicare. These come from Republicans, Democrats, Independents, physicians, insurers, non-partisan and partisan groups. However, none has been able to provide a guaranteed proposal to fix the health care ills and also provide reasonable coverage.

This manuscript will review escalating national health care expenditures, factors contributing to health care increases, health care systems in many other countries, and various proposals.