Outline
I
Introduction and Background
A
Thesis: Everyone in America
should have access to healthcare and the
universal healthcare system is the
best way to accomplish this goal.
B
Background
1 Definition of
universal healthcare
2 Types of universal
healthcare plans and the countries with them
3 History of health
insurance in the US
a Definition
of health insurance
II
What’s
wrong with the healthcare system in the US?
A
Problem with access to healthcare
B
Problem with cost of healthcare
C
Problem with lack of increase in health levels
III
Universal healthcare is the answer
A Why insurance is important
B Why single payer will work best
C
Advantages to universal healthcare
D
Arguments against universal
healthcare
IV
Conclusion
Solving the Healthcare System in the United States
Laura Landis
Biology Senior Seminar
Fall 2006
I. Introduction
Marilyn Tanner needed surgery. She had been diagnosed with stage two breast cancer over a year ago, but she and her husband did not have health insurance. So the Tanner family was trying to save money so that Marilyn could have her surgery. There was another problem though. Marilyn’s husband was a pastor at the local church and she was staying home with their young son, so it was taking them a long time to save up the money needed for the expensive surgery. This situation is not unique by any means. It is happening to families just like Marilyn’s all across America.
Every year, more and more families and individuals are without insurance. As of 2005, there are 46.6 million people (that’s 15.9% of the total population) without health insurance according to the Census Bureau (
DeNavas, Proctor, & Lee, 2006). It is clear, given this information, that the current healthcare system in the United States is not working. It is only those who are able to pay who are getting the healthcare that they need and those who can not pay are stuck. It is time for a new system- an organization with universal healthcare.
Everyone should have the right to healthcare and the universal healthcare plan is the best way to accomplish this goal.
Background
Universal healthcare is simply when all citizens of a country have their healthcare paid for, regardless of their health or financial status. There are a variety of systems that can be used to provide insurance to all citizens, the most common being the single-payer. Countries such as Canada, Denmark and Sweden have a single-payer system. In this type, the entire healthcare practice is government-run (
Physicians, 2006). This means that tax dollars are used to provide the funding for healthcare of the population. Usually a small percentage is taken out of employees’ checks and employers pay a slightly higher percentage. This money all goes to one governmental agency that is then responsible for managing the money for healthcare in the whole country.
Another option to provide universal healthcare is the multi-payer system. Although the specifics of this example vary greatly between countries, there are some basics that are the same. The most important fact is that everyone living in the country is eligible for healthcare. Employees and employers add equal amounts of money into funds called Sickness Insurance Funds (SIFs) (
Physicians, 2006). This then covers a majority of the citizens. The rest of the population, less than 10%, is covered by private insurance. This 10% is civil servants and the wealthy that are above a certain income level and have chosen to pay for their own health insurance (
Physicians, 2006). It is important to note that these private insurance companies are tightly regulated by the government, not like those here in the United States which are largely unregulated. The premier examples of the multi-payer system are those as seen in Germany and France.
The healthcare system in the United States is quite different from any of the above mentioned examples. As early as the beginning of the 20th century, some began to feel that national healthcare was needed in the United States. In 1911, Supreme Court justice to be, Louis D. Brandeis, gave a speech recommending a policy of national healthcare (
Balkin, 2003). In 1965, President Lyndon Johnson signed into law the Titles of the Social Security Act that provided for Medicare and Medicaid. Medicare was intended to be a health insurance program for all Americans over the age of 65, while Medicaid was to be a fund matching program so that states could provide more health insurance to their low-income and disabled citizens (
Balkin, 2003). The rest of the population should have been covered under private insurance companies.
II. Things Wrong With the Healthcare System in the United States
According to the Census Bureau, health insurance is provided by either private companies or the government (
DeNavas, Proctor, & Lee, 2006). Private insurance can come from an employer, union, or be purchased by an individual (
DeNavas, Proctor, & Lee, 2006). Governmental insurance includes many programs, from Medicare to military coverage to plans provided by the state (
DeNavas, Proctor, & Lee, 2006). Yet, as stated above, almost 16% of the citizens in this country are living without health insurance of any kind. This is not even taking into account the thousands of undocumented people living here. When the Census Bureau was counting insured people, they counted those who had insurance for any time during the past year (
DeNavas, Proctor, & Lee, 2006). It is then quite probable that even more people did not have health insurance for the entire year, just part of it (
DeNavas, Proctor, & Lee, 2006).
It is clear from this information that the healthcare system in the United States today is not working. There are three main reasons why the system is flawed: access to healthcare is limited, the cost of healthcare is high, and that despite technology, the people of the United States has a fairly low health level.
Any parent who has had to wait several days to get a sick child in to see a doctor can tell stories about the problems with access to healthcare. One of the reasons why it has become harder to get in to visit a doctor is because of specialization (
Fuchs, 1974). More and more doctors have begun to choose a subspecialty of their field (
Edge & Groves, 2005). This then means that there are fewer general practitioners, which for the average person means a longer wait in the doctor’s office (
Edge & Groves, 2005).
Another problem is the location of the majority of doctors. Doctors typically enjoy living closer to metropolitan areas because of the access to modern medical technology (
Fuchs, 1974). This then means that people living in rural areas have a low doctor-to-patient ratio (
Edge & Groves, 2005). Not only does this mean that the typical patient will have a more difficult time getting in to see a doctor, it means that many conditions, which in the early stages are easily treatable, are allowed to progress to a point at which the chance of recovery drops significantly (
Edge & Groves, 2005). Patients who have a heart attack and are 30 minutes from the closest hospital do not receive emergency care in a timely manner, which makes the chance of complete recovery much lower.
One of the main reasons people do not buy health insurance is because they cannot afford it. These are people who are just barely scraping by and do not have enough money to pay premiums. What if a person in this situation needs emergency medical care? There is no way they will be able to pay all the costs of a hospital visit. The price of healthcare in America today is staggering; it accounts for 15.3% of the GDP, about 1.7 trillion dollars a year (
Edge & Groves, 2005). This is up from being 8% in 1973 (
Fuchs, 1974). Because of this increase in cost, many of the uninsured people in this country will refuse to visit the doctor until they become too weak to refuse to do so anymore. By this time, the cost of the cure will be a lot more than what it would have originally been to prevent the sickness at the beginning (
Edge & Groves, 2005).
As healthcare costs have continued to climb, so has the cost of insurance. Health maintenance organizations, or HMOs, have greatly increased their premiums (
Edge & Groves, 2005). This means that employers can no longer afford to provide health insurance to their employees (
Burger, 2003). Even when employers can afford to give basic insurance, the employees still have to input a lot of money for deductibles (
Burger, 2003). Besides making money this way, HMOs are spending large amounts of money on mergers and acquisitions of other similar companies (
Burger, 2003). Over a nine year period starting in 1993, over 78 billion dollars was spent on mergers amongst HMOs (
Burger, 2003). HMOs are not the only ones involved in pointless buying and selling. Hospitals and drug companies have also been partaking in these activities. This accounts for almost 600 billion dollars spent in the same nine year time period (
Burger, 2003).
Developing new drugs has become a multi-million dollar industry in the United States. The government gives out numerous grants for such research and pharmaceutical companies claim to spend a majority of their budgets on this research as well (
Balkin, 2003). Once these new drugs are developed though, drug companies spend billions of dollars on advertising, both to consumers and doctors (
Balkin, 2003). In fact, some companies actually spend more money on advertising than they do on research (
Balkin, 2003). This then raised the price of the drug exponentially.
Prescription drug costs have become a major reason for the sky high costs in healthcare today. A majority of the healthcare plans now in place in the United States do not include any provisions for the drugs doctors deem necessary. That is why prescription drug plans have been so popular during recent elections; the government has realized that this is a huge flaw in the health system and therefore is trying to correct it.
Another reason the cost is rising is due to advancing technology. Over time, healthcare has become a fairly advanced science. Treatments have gone from blood-letting to CAT scans. Along with this new, more sanitary technology has come an increased cost though. Part of this is due to procedural costs, but also there is an increased cost because more technicians are needed to perform these procedures (
Edge & Groves, 2005). It takes time and money to train these people, leading to higher overall costs.
If the technology used in healthcare is becoming better and more refined to treat many different aliments, why does the health level in the United States not increase? According to the 1997 US census, the United States of America has the highest infant mortality rate in any of the developed countries. The U.S .rate is at 7.2 babies per 1,000 and the closest country is at 6.1(
Balkin, 2003). According to the World Health Organization, the average life expectancy age in the United States is 70 (
Balkin, 2003). Only one other developed nation, Denmark, has lower than this age expectancy (
Balkin, 2003). These comparisons say that the United States healthcare system is clearly not what it could be. But then when looking at the average cost between developed nations, something else appears. People in the United States pay way more annually in healthcare than do the people in any other similar country. The average developed nation spends about $1,800 a year per a person, while the United States pays over $4,000 (
Balkin, 2003). The country closest in spending, Switzerland, pays only $2,800 (
Balkin, 2003).
III. Universal Healthcare is the Solution
One of the reasons it is so important for people to have some type of healthcare plan is because many diseases have become very easy to cure. More often than not, the people without health insurance are those who are working for minimum wage, trying to provide for their families. It is children from these families that do not get the basic healthcare that they need. This usually ends up meaning that they do not get immunized as infants against preventable childhood diseases (
Edge & Groves, 2005). Immunizing children is not a huge cost, but without health insurance, families living at, or just above, the poverty line cannot afford to protect their children with these simple vaccinations (
Edge & Groves, 2005).
Another reason it is important to have some type of health insurance is the cost of medical procedures. According to Al Weldy, who is on the board of Goshen Community Hospital, people with insurance do not pay the same amount for the same procedure as though without insurance. This is because insurance companies bargain with the hospital to arrange lower prices for their customers (Alan Weldy, personal communication, October 16, 2006). Not only do the uninsured have to pay the full cost of the procedure themselves, but they actually have to pay a higher amount than those with insurance.
Evidently, there are many reasons that the healthcare system in the United States is in need of a serious overhaul. The best possible course of action for America is to create a system of universal healthcare. As mentioned earlier, there are two main types of universal systems, that of single-payer and that of multi-payer. Although both systems have been shown to work in various countries, the simplest and most effective system is generally considered to be that of the single-payer (
Balkin, 2003).
There are many advantages to creating a universal healthcare system. One of the most noticeable would be a huge decrease in the amount of administrators, and therefore paper work (
Messerli, 2006). Currently, each insurance company has their own set of paperwork that must be filled out for every patient. This means that the average hospital has to fill out huge amounts of paper work that varies with every patient. If all health insurance was taken care of by one organization, there would be a more uniform way of taking care of paper work. This would then greatly cut costs because hospitals would not have to hire administrators who just fill out paper work all day long. It has been found through looking at budgets that the administrative costs for the Medicare program are only about two percent of the total cost of the program (
Balkin, 2003). This is quite an impressive statistic as this lowering in cost would translate to savings for both the government and the individual.
Another advantage would be the creation of a national patient database. Because a patient would feel comfortable visiting, and would be able to afford, any hospital, this database would come about naturally. This would then allow doctors immediate access to critical, accurate patient information (
Messerli, 2006). As of now, patients themselves are required to give their own medical history whenever they visit a doctor. The problem is many do not remember every detail of the medical background. Even if they do remember most of it, they may forget a critical medical detail that they did not think was important as a non-medical person (
Messerli, 2006).
One of the things modern doctors fear is being sued by the insurance companies. This fear makes doctors afraid to treat patients with aggressive care that may save lives (
Messerli, 2006). If there were no more insurance companies, doctors would feel free to treat patients with the full extent of their knowledge and skill. They would be allowed to do what is best for the patient without having to worry about whether the person has the money to pay for the expensive procedure or not.
Although there are many people who believe that a universal healthcare system would be for the best for all American people, there are still some who have doubts. If healthcare were to be free to the patient, many people worry that some would abuse the system by going to the doctor all the time for non-critical complaints. But this is not going to be the case. Instead, the average American will be more inclined to practice preventive measures. One of the reasons mentioned above for why universal healthcare is needed is that many children of lower income families do not get the basic immunizations they need (
Edge & Groves, 2005). By providing the shots free, children will become less likely to pick up and transmit diseases such as chicken pox (
Messerli, 2006). This will then decrease the need for these children to visit the doctor later in life. It is not only children illnesses that will be prevented. Women will be provided with mammograms every year so that breast cancer can be caught at an early stage reducing the number of surgeries being performed (
Messerli, 2006). This preventative practice again will save much money. There are many other similar tests that will be provided as a part of the health plan and therefore much money, as well as many lives, will be saved.
Another common objection to the universal healthcare system is that many jobs will be lost in the insurance business. What most people do not realize is that even if the United States were to have a universal healthcare plan, not every single procedure would be covered. Therefore those that wanted would be able to buy supplemental insurance for other things, such as cosmetic surgeries (
Balkin, 2003). Those opposing the universal system also claim that governmental agencies never work well (
Messerli, 2006). In order to fix this problem, some of the people from the insurance companies should then work for the governmental plan because they already know the ins and outs of providing a working healthcare system. They also know how to make the doctors and other healthcare staff charge only what is necessary for a procedure, which would again decrease costs to the average American (Alan Weldy, personal communication, October 16, 2006).
IV. Conclusion
It has been shown that the current healthcare system in the United States is not working. Many people are without health insurance. Even those with health insurance still have trouble accessing medical care due to specialization and location of doctors. The cost of healthcare is continuing to increase without an increase in the health level of Americans. The best solution is to have a universal healthcare system which would provide basic medical care to everyone in the United States. Not only will patients receive better care, it will also cost less.
Marilyn, and many others like her, is still waiting for her surgery. As time goes on, she will need more and more medical care and will still not have the money for it. It is apparent that the current system of healthcare is not providing care for all citizens. Instead, the United States needs a universal healthcare system where everyone is provided with the medical care they need.
Work Cited
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Health Care: Opposing Viewpoints. San Diego: Thomson Gale.
Burger, D. (2003) Now is the time... 'the nurses' proposal for universal healthcare & a
single standard of care'.
California Nurse, 99(8), 10.
DeNavas-Walt, Carmen, Bernadette D. Proctor, and Cheryl Hill Lee. (2006).
Income,
Poverty, and Health Insurance Coverage in the United States: 2005. Retrieved November 5, 2006
from
http://www.census.gov/prod/2006pubs/p60-231.pdf.
Edge, Raymond S. and John Randall Groves. (2005).
Ethics of Healthcare: A Guide
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Fuchs, Victor R. (1974).
Who Shall Live? Health, Economics, and Social Choice.
New York: Basic Books, Inc.
Messerli, Joe. (2006).
Should the Government Provide Free Universal Health Care
for All Americans? Retrieved October 1, 2006 from
http://www.balancedpolitics.org/universal_health_care.htm.
Physicians for a National Health Program. (2006).
What is Single Payer and
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http://www.pnhp.org/.