The US Health Service system does not provide universal coverage and can be defined as a mixed system, where publicly financed government Medicare and Medicaid health coverage coexists with privately financed market coverage. Out-of-pocket payments and market provision of coverage predominate as a means of financing and providing healthcare.As of 2019, around 50% of citizens received private insurance coverage through their employer , 6% received private insurance through health insurance marketplaces , 20% of citizens relied on Medicaid, 14% on Medicare, and 1% on other public forms of insurance , leaving 9% of Americans uninsured.