"The health-care system in the United States has evolved over the past 60 years through incremental public policy initiatives. These public policy changes have mainly been on the federal level.
The federal government is the largest single provider of healthcare services in the United States. In 2010, there were approximately 4.4 million federal government employees, including temporary employees. The Federal Employees Health Benefits (FEHB) Program is administered through the Office of Personnel Management and manages the health insurance and retirement benefits for federal employees, retirees and their survivors. These employees have the widest selection of health plans in the country. An open enrolment period is conducted in the autumn of each year and employees can select plans ranging from fee-for-service, health maintenance organisations, consumer-driven health plans that offer catastrophic risk protection with higher deductibles, preferred provider organisations, health savings accounts and high-deductible health plans..."