Job Seeker Information

Hi and welcome to what will probably be many articles about careers in the healthcare industry.  This article is designed to give you an overview of the basics of the somewhat embattled US healthcare system.  This is not an exhaustive review of the entire industry, but it should give someone who is considering healthcare jobs a leg up.

In the US, a diverse selection of individuals and legal entities pay for health care- patients are offered both inpatient and outpatient services by charitable, commercial, or governmental entities.  The healthcare system is funded by a mix of public and private funding, with the government picking up about 45% of the total annual cost.

Medicine is practiced in a variety of facilities throughout the United States.  Obviously, there are for-profit hospitals, operated by private corporations, and there are also nonprofit hospitals, which are usually operated by the government or nonprofit or religions organizations.  Hospitals provide a small amount of outpatient care in emergency rooms and specialty clinics but are run primarily to provide inpatient care.

The law uses a “fee for service” business model when it comes to healthcare similar to other service industries, meaning that the patient must pay out-of-pocket, in full, for all medical treatment rendered.  If a patient has insurance, they will pay a set monthly premium that will help pay most of the cost of medical treatment, however, a deductible (a minimum part of the total cost) is usually paid up front.  Alternatively, the patient may have to pay a “co-payment”- a small part of the cost of every procedure.,

Most health care coverage provided through a person’s work is provided through managed care organizations which pay much lower prices for medical services than an individual would if they paid out of pocket.  The thing that makes managed care different from traditional insurance is that the health plan organization has contracts with specific health care providers, as the managed care organization is able to bring their numbers to bear to negotiate price reductions.

There are many individuals that are not covered by private insurance, but are covered by government programs such as Medicaid (which provides care to the poor), Medicare (which provides care for the elderly and disabled), or the Veterans Administration (which provides care to veterans, their families and survivors).  In 2006, Medicaid provided coverage for 38 million Americans while Medicare did the same for about 40 million.  Another 11 million people are eligible for coverage but are not enrolled in any kind of government program.

The number of physicians accepting Medicaid has decreased over the past decade due to high administrative costs and low levels of reimbursement.  Another program, the State Children’s Health Insurance Program was created in 1997 to provide coverage for children in families that earn too much to qualify for Medicaid yet can’t afford to buy health insurance- however, this program is already losing funding in may states.    

As you move forward in your career, only you can decide if the health care industry is right for you.  Be vigilant, don’t get discouraged- and you will find the healthcare jobs you’re looking for in no time at all!

Today I’m going to discuss the healthcare system in the US to give you a better idea bout what you might be in for when looking for healthcare jobs.  First let’s look at some basic facts about the type of care and locations where the healthcare industry operates.  Who is “the healthcare industry”, anyway?  In the United States, healthcare is provided by an array of public and private entities, funded by both public and private sources.  The breakdown is that the US government foots about 24% of the bill, with private insurance paying about 36% and out-of-pocket expenses being about 15% of the total cost.  That adds up to lots and lots of healthcare jobs for qualified individuals!

Types of Healthcare Services

• Ambulatory care- aka “outpatient” care, where no hospital stay is required
• Home Health Care = Nursing services, ordered by physicians and provided in the patients’ residence
• General Practice- general practitioners of “family medicine”
• Specialty Practice- specialty physicians- oncologists, pediatricians, cardiologists, etc.
• Non-Physician  - physician assistants and nurse practitioners

Where are Healthcare Services typically administered?

·        Private Hospitals (usually operated by private corporations, for a profit)

·        Nonprofit Hospitals (usually operated by religious organizations or independent nonprofit organizations, or governments)

·        Specialty Clinics such as prenatal clinics, surgical centers, or family planning clinics

·        Hospice care (for patients with less than 6 months to live, typically subsidized by charities and/or government and provided in the patients’ home)

What other things does the medical industry do?

·        Research, development, production and marketing of pharmaceutical drugs

·        Manufacture of Medical equipment/ devices

·        Medical research

This may come as a shock to you- it certainly did to me- but the US spends over $7,000 a year per person, for a total of 2.25 TRILLION dollars (facts are from 2007).  That means that we spend more, as a function of either GDP or on a per-capita basis, than any other developed nation in the world, and as I stated before, it means a lot of work for people looking for healthcare jobs.  Healthcare counts for 16% of our yearly GDP!

The US is the only wealthy industrialized nation in the world without a universal healthcare system.  About 16% of the total population is uninsured, with the rest being insured either through the government, their employer, or privately purchased insurance.  There are also programs, funded by taxpayers, to provide healthcare coverage for the elderly, the disabled, children, veterans, and the poor.  In fact, the government is the largest insurer in the country, spending 45% of the total cost of healthcare every year.  Federal law mandates that medical services providers must provide emergency care to anyone that requests it, regardless of their ability to pay.  There’s a real problem with healthcare costs rising faster than wages or inflation- in the year 2001, over half of all people who declared bankruptcy did so because of “medical causes”.

The healthcare industry in the US is not thought of very highly throughout the rest of the world.  The World Health Organization conducted a study in 2000 that ranked the US healthcare system as the best in the world in terms of responsiveness and expenditure, but 37^th overall in performance and 72^nd overall in overall level of health.  However, that particular study has been widely discredited as not correlating very well with patient surveys about their own feelings on their medical care.

Bear these basic facts in mind when you decide if the healthcare industry is right for you, and come back for part 2 of my series on healthcare jobs!