The United States does not have universal health care or a system of socialized medicine, although programs such as Medicare and Medicaid provide basic health insurance to elderly, disabled, and poorer residents. For most Americans, health insurance is provided as an employee benefit, while unemployed, part-time, and self-employed workers must pay for their own insurance. As of 2001, 41.2 million people in the United States (14.6% of the US population) had no health insurance coverage. By 2004, this had risen to 45 million (15.6%). The U.S. Census Bureau attributed the drop primarily to the loss of employer-provided plans due to the economic downturn and a continuation of rising costs.

   A recent Harvard University study found that medical bills are a leading cause of bankruptcy in the United States. The study found that many declaring bankruptcy were part of the middle class and were employed before they became ill, but had lost their health insurance by the time they declared bankruptcy. In the U.S., people leaving a job can continue with their former employer's health insurance plan under the COBRA at a rate that is usually double the rate the employee paid while employed. When an employer-insured person loses a job due to illness and does not have sufficient resources to continue to pay for COBRA health insurance, they also lose their coverage.

   Efforts to provide universal health care in the 1960s and early 1990s floundered against widespread opposition by politicians who objected to government control of medicine and business groups which opposed further regulation of the healthcare and insurance industries. Despite a general consensus, codified in the federal Emergency Medical Treatment and Active Labor Act, that emergency care must be provided even to the indigent, it is not universally accepted in the United States that the availability of broader health care should be considered a right and paid for by public funds.