Should the U.S. provide its citizens with universal access to health care?
Interestingly, the United States is the only industrialized and wealthy nation that is yet to provide free and universal healthcare to its citizens. By far, the US is the Earth’s richest nation. Great Britain, France, and Canada have been able to provide its citizens with universal health care. The current health care situation in the US is affected by restricted access to health care and escalating costs. Insurance coverage currently determines the coverage of US healthcare system (Clarke, & French, 2013). Majority of US citizens are covered by insurance provided on a private or employer basis. For instance, an individual pays a certain amount of the insurance premium while the employer pays a major part of the premium. Equally, the employee and employee share the burden of the costs in case a loss occurs.
However, the major challenge with this healthcare arrangement based on insurance is that it is unfair to the elderly, unemployed, or the disabled. For this reason, the government is forced to cater for this insufficiency by providing insurance programs as defined by the 1965 Social Security Amendment Act. The major health care plans created by this Act consist of Medicare and Medicaid (Tanne, 2007). Medicaid concentrates in providing grants to US states in order to fund insurance costs for individuals earning income below a certain level. On the other hand, Medicare program targets the health care needs of the elderly through the provision of supplementary medical insurance.
What does Universal Health Care mean?
Universal Health Care refers to the type of health care made available to all citizens irrespective of their region, gender, income, race, wealth, or health status (Clarke, & French, 2013). The government is capable of providing universal health care using diverse strategies. First, the government can provide refundable tax credits or vouchers to enable citizens to pay for health care provided in the health care sector. The other strategy entails a situation where the government pays public health care providers to provide health care to the citizens. Alternatively, the government can subsidize health care coverage by making it cheaper for citizens to afford health care in the private sector.
Irrespective of the structure and mode of funding universal health care, the common factor is that the government must involve itself in health care programs in order to provide universal access to health care. It does this through its regulative, legislative, or authoritative mandates. In certain situations or program arrangements, the government can also get involved in the management process of health care systems. However, both public and private health care providers must get involved in the provision of universal health care. Since the government is required to be involved in the management of health care systems, a variety of funding strategies are available for the government. Funding strategies include but not limited to taxation and compulsory insurance. As such, the government pays a part of the insurance costs through the universal health care program while the patient can pay the other costs. Single payer health care program involves a type of insurance whereby the government provides the sources of financing health care but does not necessarily have to be involved in the entire health care process.
Historic background of the issue
The American Public Health Association (APHA) has for a long time advocated for the adoption of a Universal Healthcare System for all Americans. This has led to the adoption of several policies aimed at using the single-payer healthcare mechanism to fund universal healthcare. However, such efforts have failed to produce the desired results. This can be attributed to political stalemates among policy makers who have failed to reach a consensus. Many think that the universal care issue began only a few decades ago. This could not be further than the truth because the quest for a universal healthcare program began in 1912 when Teddy Roosevelt ran for presidency under the progressive party. In 1917, a Yale economist, Irving Fisher, argued that health insurance would be an obligation within a few years (Sparer, 2011). Despite being the country with the largest economy and a very impressive gross per capita income, universal healthcare has never become mandatory.
During the progressive error which is the early 20th century, other progressive nations had one form or another of health insurance. In countries like Britain, Germany, and Hungary, there was a form of social benefit that would be paid off to a worker if he lost work hours due to illnesses. Despite its obvious benefits, healthcare was doomed in Germany after the United States declared war against Germany. Many viewed healthcare as a product made in Germany and likely to ruin social security among the liberal Americans.
Universal healthcare faced further challenges in the great depression. In 1932, the committee on the costs of medical care released a report arguing that even though most families were not poor by the day’s standards, illnesses could push most families into financial destruction. All presidents in this era ironically did nothing to improve the issue. Reforms in this area began in 1965 when President Johnson saw a unique position to improve this legislation (Sparer, 2011).
During this period, the socialized medicine (mandatory healthcare) was in full force and politicians kept preaching how it could bring America to economic downfall. Agencies like the American Medical Association were also in the forefront of discouraging the universal medical insurance policies. Presidents like Clinton, Nixon and Kennedy battled with its acceptance. However, the economy started spiraling downwards and universal medical insurance was way more expensive. Due to this issue, despite the majority of parliament ready to pass the Nixon-Kennedy healthcare plan in 1974, the bill did not receive recognition until the 1990’s during Clinton’s era (Vladeck, 2003).
Despite the obvious benefits of this bill, the presidents and activists keep are always held up by the traditional politics of the plan being too expensive. Although President Clinton and his wife fought to have it passed, they were again defeated by congress. However, president Obama was able to successfully implement the ObamaCare into law after a whole century of politics. The ObamaCare is geared towards the delivery of affordable and accessible health to American citizen, helping the government to improve the quality level of health care in the US, regulation of the US health insurance industry, and reduction of healthcare expenditures. It might be the ultimate universal healthcare policy but it brings the Americans close to achieving their quest for a universal healthcare policy.
Why is there a need for Universal Health Care in the US?
The need to deliver universal access to healthcare in the United States is fundamental. Failure to deliver universal care for all American citizens threatens the public’s health status. Making healthcare universal to all citizens should form the main priority for US citizens. In 2010 alone, nearly 50 million Americans lacked were unable to access quality healthcare (Clarke, & French, 2013). Sadly, even countries that do not meet the UN standards for a developed nation such as China have made huge efforts in providing universal care. At the same time, the US spends billions of dollars on health care. Health care costs accounted for over 17.4% of the total GDP in 2012 alone. The Commonwealth Fund argues that countries that provide universal access to health care spent an average of 10.6% of the total GDP to fund health care (Clarke, & French, 2013). Despite the high cost spending on health, the quality of healthcare provision in the US still considered to be below average.
Individuals in the lower income class and middle income classes are incapable of accessing quality healthcare services. Even the wealthy who can afford the high costs of health care can still benefit from the universal access to health care because it will translate to reduced costs. The laws in the United States seem to support the idea of having a universal health care system. For instance, the current laws state that patients involved in an emergency situation should be admitted to Emergency Rooms irrespective of their insurance statuses. This translates into increased costs for health care institutions, money that is eventually passed to insurance companies and consumer’s inform of taxes. In the presence of a universal health care system, the distribution of costs in the form of taxes and insurance premiums would help to distribute health care costs.
The current situation is unfavorable because if an individual loses his job, then there is a higher likelihood that the individual will not be covered by any insurance company because employers play a substantial percentage of insurance premiums. This means that losing a job is equated to losing access to health insurance. However, a universal insurance system ensures that individuals would still access health care irrespective of their job situation.
The last few decades have seen the costs of health care rising at unprecedented costs. Equally, the costs of health care premiums have also risen more as compared to the rates of inflation. The rising costs of health care coupled with increased insurance costs has increased the number of uninsured Americans. Nearly 50 million Americans do not have a form of health care insurance while millions others remain under insured (Clarke, & French, 2013). For those who have insurance covers, the high costs of health care makes it difficult for them to afford adequate financial protection. Fewer employers are able to finance health care for their workers because of the rising health care costs. The percentage of employers that have offered insurance costs has been dropping over the last few years. For those employers that could afford to provide health insurance benefits, deducting higher percentages has enabled them to meet the insurance costs. The government's overall debt has left low and middle income earners with no or low quality access to health care.
A universal access to health care program is likely to improve the welfare of most Americans (Vladeck, 2003). Free access to health care will enable over 50 million Americans who do not have insurance to access quality health care. The number of people aged 25 to 64 would be covered under a health care program. Enhanced access to health care improves the level of economic productivity because more citizens would be working. The government overall debt would also reduce with the reducing costs of health care.
Opponents of the need to have a universal access to health care have cited several issues to support their arguments against the need to have universal access to healthcare. The first reason entails examining the aspect of government control in health care. The current programs such as Social Security and Medicaid/Medicare are managed by the government. These programs are often marred by cases of bankruptcy and bloated bureaucracies. Politicians and unscrupulous healthcare officials mismanage such programs. For this reason, opponents argue that government management in the program is likely to ruin all the system based on its current inability to handle the current health care programs.
The second issue cited by opponents of a universal healthcare system is based on studying the performance of health care programs in countries that have implemented the universal system. A good example is our neighbor Canada. Canadians are reportedly being forced to deal with a myriad of consequences arising from the incompetent healthcare system. It takes months before an average Canadian can be able to access healthcare services from a specialist. The national health care program also fails to cover all health care programs despite the long waits that citizens are forced to wait. This forces citizens to look for private health care policies that satisfy all their healthcare needs. The case is similar in the United Kingdom because patients are forced to wait for more than 3 months in order to undergo surgery.
The third argument entails the aspect of increased taxes among the Americans because the government needs to tax the citizens in order to obtain money to fund its programs.
The last argument against having a universal healthcare access system involves the need to have competition in the health care market. Competition among healthcare providers is necessary because it forces health care providers to develop innovative means of providing healthcare. The growth of biotechnology and pharmaceutical industries explains the need of having a competitive healthcare system that is free from government involvement. Universal access to healthcare would mean that companies would be obliged to share information thereby inhibiting innovation.
Current Position to Universal Health Care
Americans have different values regarding to universal access to health care. Sadly, most Americans who cannot afford quality health care are at high risks of suffering from financial problems thereby incapacitating the ability to pay for quality health care. While most Americans believing in having equal opportunity for all, access to healthcare is not considered a necessity such as education. The second value entails having an inalienable right to life and the pursuit of happiness. This is contrary if viewed from the perspective of the health care system because the current healthcare system denies millions of Americans the right to access treatment and lifesaving medications at reduced costs.
Finally, the US government belies in the need of having economic efficiency in its various operational areas. However, the amount of money spent on health is twice the average amount of money spent by other countries. The American health care system is also affected by increased cases of uninsurance, uneven performance on the quality of health care, and subpar life expectancy. For this reason, it is evident that the average American does not need to have more money to spend on healthcare but rather they need to access affordable healthcare for the money they paid.
The Case Obama Care
The recent adoption of the ObamaCare has brought various effects to American citizens. ObamaCare is the recent national health policy implemented in efforts aimed at reforming the US health care system. Obama Care is also called the Patient Protection and Affordable Care Act or the Health Care reform policy (Lewis, Dowe, & Franklin, 2013). The ObamaCare is geared towards the delivery of affordable and accessible health to American citizens. The Obama Care was also aimed at helping the government to improve the quality level of health care in the US, regulation of the US health insurance industry, and reduction of healthcare expenditures (Lewis, Dowe, & Franklin, 2013).
Before implementing the Obama Care, a significant percentage of Americans did not have access to health care insurance. Cases of denial of treatment, dropping of treatment while in the treatment process and higher insurance charges was a major characteristic in the US health care insurance industry. However, the implementation of ObamaCare is like to help millions of Americans to access affordable health insurance through expanded access to Medicate, Medicaid, and offering cost assistance to individuals unable to cater for healthcare costs (Lewis, Dowe, & Franklin, 2013). The implementation of ObamaCare has also helped in creating new jobs and improving employment levels. The current healthcare facilities are also likely to be improved.
Despite the implementation of the Obama Care, the US is yet to have a universal access to healthcare because the Obama Care is yet to improve reform the US healthcare system. Indeed, it is a complex and comprehensive legislation policy but its level of affordability is yet to be proven.
Political Implications and Policies
The recent battle between Senate Democrats and Republicans regarding the Treasury’s ability to pay bills led to government shutdown. The Senate Democrats and Republicans were unwilling to negotiate a deal that could have led to the prevention of the government shutdown. Eventually, the impasse led to a furlough of approximately 800,000 government workers (Hook, Kristina, and Carol, 2013). President Obama argued that the ideological crusade from House Republicans was geared towards denying millions of Americans access to affordable health insurance. On the other hand, House Republicans accused Senate Democrats of refusing to talk on the ideal strategy that could have led to the reopening of the federal government after it shutdown. House Republicans wanted the government to delay the implementation of the Obama Care (Affordable Care Act) by one year (Hook, Kristina, and Carol, 2013). Republicans viewed making major changes on the health-care law as a strategy for reducing government spending. Such political stalemates have prevented the US government from implementing a health care reform policy that could see the government achieve its long-term goals and objectives of delivering affordable or universal health care policies (Hook, Kristina, and Carol, 2013).
The analysis of the above issues has revealed the need of having a universal access to healthcare in the United States. The current system is untenable because of its design. For many decades, health care reformers have specified the need of having a universal health care system because of the shortcomings of an health care system where the ability to pay determines the quality of health care an individual can access. Despite being the richest and most industrialized nation in the world, the United States is the only industrialized and wealthy nation that is yet to provide free and universal healthcare to its citizens. A universal access to health care program is likely to improve the welfare of most Americans and enable and access to quality health care. With a universal access to quality healthcare, American citizens irrespective of their region, gender, income, race, wealth, or health status would be assured quality access to health care.
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Lewis, A., Dowe, P., & Franklin, S. (2013). African Americans and Obama's Domestic Policy Agenda: A Closer Look at Deracialization, the Federal Stimulus Bill, and the Affordable Care Act. Polity, 45(1), 127-152
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