The health system in the United States is characterized by its very high cost, its fragmented nature and the manifold bodies responsible for managing the system. The majority of Americans are covered by employment-based private health insurance. Public insurance only provides cover for people aged over 65 years, and disabled individuals via Medicare, and certain categories of low-income families, together with children through Medicaid/Schip programs. Forty-seven million individuals are without health insurance. Managed care organizations (care networks managed through private insurances) have become the prevailing model, and combine insurance with delivery of health care.