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The United States has a population size of about 281,421,906 - more than twice the number of people who live in Japan. Its infant mortality rate is 6.82 per 1,000 live births, and life expectancy at birth is 74.24 years for men and 79.9 years for women. Per capita GDP is $33,900, of which 12.9%, or $4373 per person per year, is spent on health care.
Today, the U.S. is overwhelmingly dominated by the private health care market (20% HMO's, 50% other managed care, 30% other), and the role of government is generally kept to a minimum. Its pluralistic health care system also includes Medicare (government insurance for the elderly), Medicaid (government insurance for the poor and disabled), voluntary health agencies, and enterprises with health functions. The U.S. health system is financed primarily through private insurance agencies. As such, over 60% of all U.S. health expenditures come from private sources (i.e., personal income).
Primary care physicians act as gatekeepers, and are generally reimbursed by a fee-for-service system. The patient frequently pays for primary care service out of pocket. Specialists are not restricted to hospitals and are paid via fee-for-service.