Although most Americans have some form of private health insurance, some people cannot afford insurance. They can get medical coverage through two social programs established in 1965.

The United States has evolved a mixed system of private and public responsibility for health care. The vast majority of Americans pay some portion of their medical bills through insurance obtained at work. About five out of six American workers, along wit

Self-employed private physicians who charge a fee for each visit by a patient have been the norm for American medical practice. Most physicians have a contractual relationship with one or more hospitals in their community.

Certain aspects of the American welfare system -- especially AFDC payments -- came under criticism in the 1980s and 1990s, and the system itself became an issue in national elections.