Ideally, the survey was conducted in California, Unites States for the two months: November and December 2013. The total number of respondents was 24 people: 12 males and 12 females were selected. This was from all age brackets; that is 16 - over 65, in the following order: 3 males and 2 females in age bracket 16 - 25, 2 males and 3 females in age bracket 26 - 35, 3 males and 2 females in age bracket 36 - 55, 2 males and 3 females in age bracket 56 – 65, and 2 males and 2 females in ages above 65. The study was carried out using face to face interviews with the respondents through open-ended questionnaires consisting of 10 questions about the Universal Health Insurance. It was unbiased about race or status of living of any interviewee. The interviewees were primarily selected using simple random sampling approach. The response rate was 100%. The following is a discussion on the results and their analysis about their answers to the questions in the questioners.
The first research specific question focused on finding the meaning of Universal or National Health Insurance from the respondent’s perspectives. From the whole sample, only four respondents (about 17 %) did not have any idea about Universal Health Insurance. Two of them were from the 16 - 25 age groups and 2 from the over 65 age bracket. In age bracket 16 - 25, it included a young teenage girl of 16 years and a boy of 17. Otherwise in the over 65 age bracket, 70 and 62 year olds males and females respectively, had no idea about the topic. In addition to that, only 2 people (about 8 %) know about insurance but lacked the right idea/ opinion about Universal Health Insurance. These were a man and a young lady aged 63 and 26 respectively. Otherwise, the rest of the sample (75 %) had almost agreeing opinions with WHO’s definition that Universal Health Insurance is a system that provides health care and financial protection to all the citizen of a country (WHO, 2010).
The study reveals different views regarding the Universal Health Insurance. Some individuals were in favor of the programme while others entirely opposed it. Here, it was clear that four people opposed the programme. One of them disagreed with the insurance programme as a whole, basing his argument on its prohibition in his religion, but agreed to give opinions in the consecutive questions. The other three, based their arguments on I being burdensome. Moreover, they conquered in the idea that there is the likelihood of being healthy throughout lifetime yet paying for a service that has not benefited him/her or may pay a lot and suffer minor sickness. As a matter of fact, a strong opponent from among them suggested a comparison: two people paying equally for the insurance, one of them is cautious about his health and the other indulges into drugs. Fortunately the cautious person never gets sick in his lifetime yet he paid throughout for the insurance which benefits heavily the drug addict. He described it as an opportunistic mechanism of generating money, which may even get lost through corruption. The three agreed in opinion that the scheme could have some benefits, but it does not influence their thinking. Therefore, everybody should care about his/her health and wealth.
Although the respondents had diverse standpoints regarding the programme, the researcher asked all interviewees questions about the recommendations for improvement of the Universal Health Insurance in California. The questions were based on the assumption that all the respondents were in support of the Universal Health Insurance programme. The key motive was just to get a general feeling or views whether they could support the recommended schemes/models of funding the insurance.
Overwhelmingly, a large percentage of the respondents i.e., 75 % (18 people) agreed with the use of business tax deductions, credits, or other financial assistance to help in providing health insurance to employees. They converged on the same opinions that businesses and their employees are close in relationships and personal, therefore, the businesses may easily understand their employees’ needs of health insurance. Further, they had a common opinion that businesses will quickly effect any requirements and changes that may be required in implementing such a model. Of this group, there were 10 males and 8 females mostly from age groups 26 – 55. Secondly, another group of 3 respondents agreed but had some fears. One said that it would be a good idea but businesses aim at making profits, therefore, would give unsustainable financial assistance or credits to their employees for the health insurance. The other two coincided in thoughts that the government generally controls business operations and so this could be government control in disguise. Of the three, two were females and a man. The third group of three, two males from age group 16 – 25 and a females respondent from age group 65 and over, disagreed fully about this, convinced that not everybody is employed or that others are employed as casuals or part-time or short term employments that would not facilitate such a model of funding Universal Health Insurance.
Focusing on a different issue that expanding state government programs for low-income people, such the Children’s Health Insurance Program and Medicaid, in order to give coverage for people with no health insurance, 63 % of the respondents (15) agreed. In age bracket, 16-25, all agreed with this idea likewise to those above 65 years. Six others were distributed in the middle groups. They all had common views that the government should look into the health of low income earners and that expanding such programs of Medicaid and Children’s Health Insurance will help a great deal. Most of these respondents pointed out that they have low incomes since some of them are building up their careers, therefore, had no permanent well paying jobs such as the lower age group. The older age group said they had already retired with no salary for health services. Six respondents (about 25 %) in the middle age brackets agreed and disagreed with this model; they were swaying on both sides. They shared common ideas that the government should be responsible for the health of the population especially for manageable diseases. Therefore expanding Medicaid and Children Health Insurance programs for the low income people, who have no health insurance, would be so effective in achieving Universal Health Insurance. They had same ideas that most average and high income people could manage to insure their health. However, from the same group came worries about procedures the government would use in achieving this. They were cautious about increment in taxation to fund such a process. Thirdly, three people appreciated universal health cover even for the low income earners but solidly disagreed with this method, citing high taxation and lack of trust/ unreliability in government services. Instead, they anticipated for better models of funding universal insurance.
While answering the question that required businesses to offer private health insurance for their employees, most of the responses were so closely linked to the first question, making the results, here, almost similar. The majority, 17 respondents (about 70 %) mostly from 26 – 55 age groups, showed enthusiasm and solid trust in privatizing health insurance. They pointed out that health insurance is a sensitive matter, therefore, requiring a very trustable and reliable channel of operation as in private health insurance. Four respondents in this group had divided views. They all accepted that it would be a way of ensuring universal health cover, but two of them pointed out that it would be a new entrant project into businesses that strive to make profits. Further, it will reduce employees’ incomes to finance the project. The other two people identified the unemployed people as a hindrance into this model. They instead had questions on how this group could be insured. Thirdly, 13 % (3 respondents) rejected this method. Just like in the first question two males from age group 16 -25 and females from age group over 65, strongly disagreed. They unanimously complained that not everybody in the population is employed or that other people are casually employed, part-time contracts that cannot enable this system efficiently. They pointed out that it could be the feeble point in ensuring universal health cover.
As cited in Clied (2008), offering uninsured Americans income tax credits, tax deductions, or other financial aid can help purchase private health insurance grow. When asked their opinion on the above matter, 22 interviewees (about 92 %) agreed with Clied, though, three of them were skeptical about it. The 19 who agreed unconditionally were psyched by the reduction of the tax burden and instead being given financial support in order to pay for themselves insurance. They as well agreed that it gives them the freedom of choosing which private health insurer they could work with, and the freedom of choosing the health insurance they want. They were simply enthusiastic about the freedom to manage their own health insurance. This group commonly agreed that such a method is likely to ensure Universal Health Insurance. They included four in the 16-25 age range, three from 26-35 age range, four from the 36-55 age range, five from age bracket 56-65 and three from the over 65 bracket. Three welcomed the model, but with doubts. This was composed of one from each of the 16-25, 36-55 and over 65 age brackets. A respondent among the three strongly doubted the reality of such an idea of the government reducing income taxes on uninsured Americans and instead provide financial assistance. The respondent pointed out that the size of the uninsured American could be very big. Also, the respondent added that this could be discriminatory as in other people who have insurance would also wish to have same offers of tax reductions, tax credits and financial assistance since. The other two doubted if the uninsured would use the opportunity for the prescribed purpose. They added that this uninsured population, likely from the low income earning group, might use the opportunity in settling other financial needs. They suggested that the government should further make follow-ups with the private insurers to ascertain this. The two strong opponents, both from age bracket 26 – 35, had a common opinion that it might be costly to the government and not every uninsured would put the opportunity into its appropriate intention. They also faulted it as a discriminatory method.
Regarding the expansion of Medicare to cover people under age 65 who do not have health insurance, a larger majority about 63 % (15 respondents) viewed this as a suitable way of ensuring health insurance reaches everybody. This included both males and females from all age brackets and even 2 from the above 65. While some easily agreed about expanding Medicare to cover people under age 65 who do not have the health insurance, a number pointed out that Medicare was trustable with heath insurance above other companies/schemes. They therefore agreed with this idea that expanding it will enhance National Health Cover. The remaining 37 %, 9 respondents disagreed with this method. They pointed out it would not be universal as in the people above 65 years are left out of the insurance scheme. This was the common and basic point of their argument, especially from the 2 above 65 who together disagreed with this model. However, several people in this group had more opinions of rejecting this model. For instance, two of them claimed that Medicare is not the sole health insurer company in the industry to offer the service. They further added that its services are not rewarding the cost.
Unconditionally, 50% of the interviewees agreed with a national health plan that is financed by the taxpayers in which all Americans would get their insurance from single government plan/ general revenue financing. They all had the same opinion that the government should have the responsibility of health of its people therefore readily agreed that the government should cover all the Americans collectively. However, 9 people showed a mixed reaction for this plan/model. They all agreed with it that the government has the responsibility of ensuring the population had better health services, therefore, a single national government plan was appropriate. However, they cited some faults with this scheme. For example, six of the respondents from this group pointed out that while other people, who are not working, therefore, not taxed may benefit from taxes of those who are working. They described this as an unfair method. The other three identified with the government’s plans being untrustworthy though the idea can be achievable. The third group, 13 % disagreed with this opinion simply because they could not trust the government’s activities.
The plan to expand the Medicare and Medicaid services to cover persons who are illegally in the state attracted a relative average support from the interviewees. This suggestion received support from 13 respondents (about 54 %). Two of them were from the 16 – 25 age bracket, three from the 26 – 35 age bracket, three from 36 – 55 age bracket, two from 56-65 age bracket and three from the above 65 age group. Six of these respondents pointed out that being illegally in the country did not subject, the idea is to achieve universal health cover for everybody in the country, therefore, accommodating them in Medicare and Medicaid would be highly effective. On top of this, the remaining seven agreed ideally that Medicare and Medicaid were trustable with the service and therefore suitable for such a group. They suggested that expanding these schemes will enable universal health insurance. Seven of the remaining group (about 29 %): 3 from age range 16-25, 2 from age range 26-35, and 2 from age range 36-45, welcomed the idea that it would enable universal health insurance but gave worries about it. They claimed that intruders are illegal the law cannot allow them access these services unless they are registered. Further, they said the intruders could benefit from something they had not worked for. The remaining four respondents (17 %) were strongly against the idea arguing that it does not make sense insuring outsiders before the nationals are wholesomely insured. Three of them were from age range 55-65, and one from the over 65 age group.
As per the findings, harmonizing the contributions into a single national scheme that would insure all Americans who contributed/ social insurance system is vital. This strategy of achieving universal health cover got many proposers, 85 %, 20 respondents. Five of them were from the 16 – 25 age bracket, 5 from 26 – 35 age range, three from age bracket 35 – 55, three from age bracket 56 – 65 and the four from the over 65 bracket. They all were in a common opinion that most American wish to have a universal health cover but there are many insurers with varying items to offer which makes it impossible. They also acknowledged that having a collective pool will reduce the cost per person since pouring a lot of money into the scheme will be contributed. The remaining 4 respondents: two from age bracket 36 – 55 and two from age bracket 56– 65 disagreed with this scheme citing possibilities of corruption. They also gave agreeing opinions that harmonizing the amount to be contributed will stress those earning less while in favor for the high income earners.
Glied, S. A. (2008). Health care financing, efficiency and equity. Working paper 13881. Cambridge, Massachusetts: National Bureau of Economic Research.
World Health Organization. (2010). The world health report: health systems financing the path to universal coverage. Geneva: World Health Organization.