The U.S. health care system is made up of several organizations; public and private agencies, charitable and professional organizations, federal, state, and county programs included. Veterans Healthcare and Medicare are examples of government run programs. A big issue in the healthcare system is affordable insurance. There have been a lot of changes in the U.S healthcare system over the years with changes in the organizational structure and delivery of health care. Mergers and acquisitions have consolidated medical service providers into fewer, but larger, corporate models. Managed care has become a popular form of healthcare delivery service (Maurer & Smith, 2013).

Currently, health care is neither available nor accessible to everyone. Millions lack health insurance and are unable to pay for basic services. The U.S healthcare system compared with health care systems in other developed countries, the delivery network in the United States seems disorganized and confusing.

According to the Centers for Medicare and Medicaid services 2015, U.S. health care spending increased 5.8 percent to reach $3.2 trillion, or $9,990 per person in 2015. With coverage expansion that began in 2014 as a result of in the Affordable Care Act continued to have an impact on the growth of health care spending in 2015 with the overall share of the U.S. economy devoting to health care spending was 17.8 percent in 2015, up from 17.4 percent in 2014.

Growth in U.S. health care costs results in part from such unique features as the predominant FFS payment system, extensive third-party insurance coverage, a fragmented multipayer system, and a vigorous biomedical research establishment combined with rapid diffusion of new technologies. The fragmented U.S. structure gives providers incentives to provide additional services and to bill for higher levels of service to increase revenues. The fact that health insurance in the United States is primarily employer-based, cost containment must be a high priority for employers if cost-control goals are to be attained. Another alleged source of excessive health spending is the high cost of medical malpractice premiums and defensive medicine (De Lew, Greenberg & Kinchen (1992).

The issues that why prompted the need for healthcare reform include making Medicare more efficient hence ensuring tax dollars go into providing caring for seniors, Reform will bring skyrocketing healthcare costs under control hence saving for families and businesses and lastly reform will bring about choice of high quality care that is affordable.