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How does US healthcare work?

By Sima Kotecha
Newsbeat US reporter

image copyrightAP
image captionPresident Barack Obama makes a statement to the nation in the East Room of the White House

In the States, there is no NHS. If someone gets ill, it's likely they will have to pay for their treatment.

The US government does fund two kinds of health plans though: Medicare and Medicaid. They are especially designed for the elderly, disabled, poor, and young.

However, many Americans have their healthcare paid for by their employer. It's often included as a fringe benefit in job packages.

But some aren't as lucky. According to the US Census Bureau, in 2007 almost 46 million people in America didn't have health insurance.

It's thought the figure's rising as the country copes with a recession and many continue to lose their jobs.

A recent study published in the American Journal of Medicine says the biggest reason for bankruptcy is medical debt.

Paying in instalments

It's claimed 62% of bankruptcies are caused by high health costs.

Not having health insurance doesn't mean people are turned away if they get sick though.

Hospitals and doctors must treat those needing help but often at the end of the procedure patients are asked for their details so an invoice can be mailed to them.

The cost can be paid in instalments depending on their financial circumstances.

Research shows individuals who have no insurance neglect their health because they don't have regular screenings and check-ups.

And those who do have insurance, aren't always covered because of the plan they've got.

Some schemes are cheaper and therefore include basic treatments. Anything extra, is an additional cost.

'NHS style'

However the situation in the States now looks set to change.

President Obama has narrowly won a key vote that means he can go ahead with plans to introduce a different healthcare system.

The idea has been very controversial and Republican party representatives all voted against it. There are worries it will mean higher taxes.

However, the reforms have been the president's main aim since coming to power and now an extra 32 million Americans - most of them poor - will be covered by health insurance.

It also outlaws the practice of companies denying health cover to people with pre-existing medical conditions.

The changes will cost the US government an estimated $940bn (£627bn) over 10 years.

"We proved that we are still a people capable of doing big things," Mr Obama said in remarks after the vote.

"This legislation will not fix everything that ails our healthcare system, but it moves us decisively in the right direction," he said.

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