Health care prices are skyrocketing, and the nation is desperately looking for a solution. Liberals urge the nationalization of the industry and progression towards universal health care, while conservatives look to the private sector for a solution. With the economy in turmoil and credit down the drains, it is getting harder and harder for the average American to afford health care. The government should take a larger role in providing the public with affordable health care.
Opponents of a nationalized health care system say that there is no health crisis, but they fail to see the reality around them. The current health care system is broken. About 44.7 million Americans are uninsured, while 16 million who are insured cannot afford to pay for medical bills. Meanwhile, we spend $5,467 per capita on health care insurance, the highest in the world, yet we are ranked 29th in the world in life expectancy and 37th in child mortality rates for children under five years old. A 2002 study by the Institute of Medicine found that there are 18,000 deaths per year due to the lack of health insurance. Currently, we have a system based on Medicare and Medicaid, outdated programs created in the 1960s. Reforms under Bush, notably the Medicare Modernization Act, have failed to contain costs. As Barack Obama points out, we have fallen into a vicious cycle: "As the uninsured cause premiums to rise, more employers drop coverage. As more employers drop coverage, more people become uninsured, and premiums rise even further." Failing to provide coverage for the uninsured costs us $15 billion more in taxes and $922 in premiums for families.
So what can be done? There is no certain solution, but a single-payer health care system seems to be the best. Critics say that this is a move towards socialism, yet the US is the only developed nation without some kind of universal health care system. We may mock our northern neighbors, but Canada is paying a lot less for better health care. American hospitals spend twice as much as Canadian hospitals on billing, paying over $1,000 per capita on paperwork while Canada only pays $300 per capita. Overhead costs in Canada are below 3% as opposed to 13.6% in the US.
The Physicians for a National Health Program have proposed a national health insurance (NHI) plan that has the US Government as the sole payer for health expenses. It would cover every American for medically-necessary services (meaning not things like cosmetic surgery) and eliminate the need for any private insurance companies. Each hospital would receive a monthly lump sum that is negotiated annually to cover overhead. Hospitals and other institutions such as health centers and HMOs will receive either a global budget or capitation premiums (annual fees based on the amount of people who receive service) for outpatient care. Meanwhile, physicians will be paid on a fee-for-service system. Because payments comes directly from the government, bureaucracy and red tape would be greatly eliminated, so doctors would no longer be forced to stop caring for a patient because the administration found out he or she had no health insurance. The NHI plan would also make sure capital is allocated to the best programs in the areas of greatest needs, based on deciions by regional health planning boards. This would improve on the current inefficiency of capital spending, in which only hospitals that are prosperous can expand, while less fortunate ones in areas with the most need cannot. As for prescription drugs and medical supplies, the government would pay for all drugs and supplies on a national list established by an expert panel. Since the government would be the only purchaser, it has considerable leverage over pharmaceutical companies on drug prices, thus containing costs. Of course, the NHI would be supported by tax dollars, preferably an income or progressive tax. The government already pays for two-thirds of health spending in the U.S., including public employee's private health insurance and subsidies to private insurance. According to the NHI plan, this would rise to about 85% of health costs, but because there would no longer be any need for private insurance companies, money that would have gone towards private insurance overhead and profits would be used to finance national health care.
Critics charge that patients would get limited, lower quality care under such a plan. But NHI would provide each person with a card that could be used at any practitioner or institution free of co-payments or deductibles. Not only would patients have freedom of choice, but they would not be forced to choose between multiple, confusing plans that give private insurance companies an unfair advantage over uninformed patients. Also, because revenues would become stable and administration streamlined, hospitals and other health institutions could focus on providing quality health care rather than being pressured financially. The only expansion would be based on regional and local needs. Fee-for-service practitioners would be motivated to provide quality care, since they are paid based on how hard they work (indicated by an electronic system involving patients' NHI cards).
Other options are inferior. If a private insurance system were to try to cover all Americans, it would create a few problems. First, it would not be able to coexist with a public system for those who cannot afford private insurance, since private insurers and the wealthy would lobby for underfunding of the public system. Second, even if there were no public system, private insurance would create different levels of care (high quality for the rich, low quality for the poor). Third, it would be hard to contain costs if there are multiple payers. There are some other plans that have been proposed as well. McCain has offered a plan involving tax credits of $2,500 per individual and $5,000 per family. Yet according to the Kaiser Family Foundation, the average cost of health care for a family of four is $12,000. Again, only the affluent would benefit. Another plan is to offer Medicare enrollees vouchers to purchase private insurance. But, as in the past, the privately-run HMOs the plan wants to push Medicare enrollees into would recruit mostly healthy seniors who would have cost Medicare little. Thus the HMOs would profit off of low-risk options, while the less affluent seniors would be forced into lower quality plans. Finally, some Democrats want to expand Medicaid eligibility. This would only be digging a deeper hole, however, since Medicaid already offers poor coverage and large expansions in the past have proven to fail (Medicaid enrollment grew from 20.2 million to 31.7 million between 1987 and 1993, but the number of uninsured rose by 8.7 million). Plus, with the economic downturn on our hands, states would scarcely be able to keep up funding of Medicaid.
Therefore, it is clear that a nationalized health care system is the best option. Health care is a right, and cannot be treated like a commodity. We all deserve equal and fair coverage. American exceptionalists say that we are the greatest country in the world, yet a significant portion of our nation continues to remain uninsured. A universal health care system may not solve our problems overnight, but it would be best for us all in the long run.
Type of Politics Practiced:
Currently, Social Welfare, including Health Care, is practiced with Client Politics. Social Welfare and Health Care benefits are given to a small group while a large part of society pays the cost. The type of politics that we advocate for Health Care is Majoritarian, in which both the costs and benefits are distrubited to everybody. We would hope to accomplish this through a government-sponsored universal Health Care insurance plan.
Important interest groups and elites influencing the debate over Universals Healthcare:
1. President Obama
While President Obama does not support government funded universal healthcare (he believes this come with too many high taxes), he does want to provide healthcare insurance to every American . If an American has health insurance that they are happy with, they keep that health insurance. Obama hopes to lower the cost of health insurance for these ensured Americans by covering a company’s catastrophic health costs, and by making companies that don’t offer health insurance “contribute a percentage of their payroll towards the costs of their employees health care”. For the 47 million Americans without healthcare Obama plans to establish a National Health Insurance Exchange, which would give the public many different private healthcare plans to choose from. These plans would be affordable and have benefits similar to those received by members of Congress.
2. The American Medical Association is a big proponent of quality health care for every American. They largely support reform within the current healthcare system, and their major goal is to find a way to get the uninsured quality health care. The AMA supports making better use of current government healthcare funds by using them primarily for people with lower incomes (who are often uninsured), and reforming the Medicare system . The AMA also strongly supports SCHIP (State Child Health Insurance Program) and state health insurance for children as a number one priority. The AMA also supports the removal of tax breaks for employees receiving healthcare through their employers and would “finally get assistance under the AMA proposal”. The AMA's desired reforms fall under three main pillars of change: Subsidies for those who most need financial assistance when it comes to healthcare, choice of plan for individuals and families, and greater individual responsibility and protections for high-risk individuals. Subsidies should come in the form of vouchers or tax credits, and should be larger for families and individuals with lower incomes. This money will be shifted from the billions of dollars each year in tax breaks used to assist people in higher tax brackets. In order to ensure greater choice the AMA proposes that the government pay the premiums of people who switch jobs and/or healthcare plans, which will help individuals feel less constrained to their current plan. They could then have their choice of using the old plan, the new job’s plan, or an independent plan. The AMA also wants to streamline the existing healthcare regulations and make sure these regulations allow, “market experimentation” (finding the most attractive plan for consumers). It also wants to reward companies for taking in people with many types of patients.
3. Max Baucus
Max Baucus is the Democratic senator from Montana and a fervent supporter of universal healthcare. Recently, he released to the senate his blueprint for healthcare in America. Baucus (along with senator Edward Kennedy from Massachusetts) is the largest driving force for universal healthcare in congress. He hopes to have his final legislation drafted by Inauguration day . Baucus’s desire to get the legislation out quickly comes from his desire to avoid what happened with president Clinton and healthcare (Clinton acted too slowly and healthcare become a back burner issue). There are 5 principles of Baucus’s reform plan (entitled “Call to Action, Health Reform 2009”). He first wants to create universal coverage. He then wants everyone in America to share the burden so that it does not fall solely on the individual or the company. He plans to do this by pooling individual and company purchasing power. He then wants to slow the growing cost of health care, and prevent many diseases that are a drain on government health care money (like cardiovascular diseases and diabetes). He then wants every citizen to share responsibility with his or her fellow Americans for covering the uninsured.
4. Divided We Fail
Divided We Fail is a group of 53 million consumer advocates, business executives, and union members that believes “all Americans should have access to affordable, quality health care”. They recently announced a million dollar advertising campaign to pressure Barack Obama to keep healthcare reform a top priority. Divided We Fail believes that Americans should have access to cheap prescription drugs, and these costs “should not burden future generations”. They also believe that prevention is an important aspect of reducing healthcare costs, and that Americans should have more choices when it comes to health car providers.
5. Libertarians
The libertarian part is the third largest in the nation and is very critical of universal health care. Libertarians favor small government, low taxes, more individual control and less government control; their healthcare proposal encompasses all these things. There are three components to the Libertarian health care proposal. First, they want to establish Medical Savings Accounts where money could be deposited (tax free) and drawn upon when needed. Libertarians would also work to make all health expenses tax deductible. Second, they want to deregulate the healthcare industry, which they say increase cost and decrease choice. Third, they want to replace the FDA with “more agile, free-market alternatives”.
Sources:
Obama, Barack. "Universal Health Care Is Necessary to Increase Access to Quality Medicine." Opposing Viewpoints: Medicine. Ed. Louise Gerdes. Detroit: Greenhaven Press, 2007. Opposing Viewpoints Resource Center. Gale. 5 November 2008 <http://find.galegroup.com/ovrc/infomark.do? &contentSet=GSRC &type=retrieve &tabID=T010 &prodId=OVRC &docId=EJ3010302239 &source=gale &srcprod=OVRC &userGroupName=berw2747 &version=1.0>.
1. Both Democrats and Republicans acknowledge the need for drastic reform in the health care system
2. Over 47 Million Americans go without health care
3. Health care costs are increasing faster than inflation rates
4. US spends more money on health care than any industrialized nation
5. The government does play a major role within health care such as by having programs like Medicare and MedicAid
6. National surveys show that the main reason why people are unisured is because of the high price of health coverage
7. Average cost of health care for a family is $12,000 per year, roughly 5% more than 2007
8. Medical bills easily affect the entire economic stability of a family, those without health coverage have a harder time paying off debts and bills when they recieve medical treatment
9. Our current health care system is free market based, the individual decides whether they can or cannot afford health care
10. Those without insurance are 25% more likely to die in any given year than those with health insurance
Why Health Care Should Be Nationalized
Opponents of a nationalized health care system say that there is no health crisis, but they fail to see the reality around them. The current health care system is broken. About 44.7 million Americans are uninsured, while 16 million who are insured cannot afford to pay for medical bills. Meanwhile, we spend $5,467 per capita on health care insurance, the highest in the world, yet we are ranked 29th in the world in life expectancy and 37th in child mortality rates for children under five years old. A 2002 study by the Institute of Medicine found that there are 18,000 deaths per year due to the lack of health insurance. Currently, we have a system based on Medicare and Medicaid, outdated programs created in the 1960s. Reforms under Bush, notably the Medicare Modernization Act, have failed to contain costs. As Barack Obama points out, we have fallen into a vicious cycle: "As the uninsured cause premiums to rise, more employers drop coverage. As more employers drop coverage, more people become uninsured, and premiums rise even further." Failing to provide coverage for the uninsured costs us $15 billion more in taxes and $922 in premiums for families.
So what can be done? There is no certain solution, but a single-payer health care system seems to be the best. Critics say that this is a move towards socialism, yet the US is the only developed nation without some kind of universal health care system. We may mock our northern neighbors, but Canada is paying a lot less for better health care. American hospitals spend twice as much as Canadian hospitals on billing, paying over $1,000 per capita on paperwork while Canada only pays $300 per capita. Overhead costs in Canada are below 3% as opposed to 13.6% in the US.
The Physicians for a National Health Program have proposed a national health insurance (NHI) plan that has the US Government as the sole payer for health expenses. It would cover every American for medically-necessary services (meaning not things like cosmetic surgery) and eliminate the need for any private insurance companies. Each hospital would receive a monthly lump sum that is negotiated annually to cover overhead. Hospitals and other institutions such as health centers and HMOs will receive either a global budget or capitation premiums (annual fees based on the amount of people who receive service) for outpatient care. Meanwhile, physicians will be paid on a fee-for-service system. Because payments comes directly from the government, bureaucracy and red tape would be greatly eliminated, so doctors would no longer be forced to stop caring for a patient because the administration found out he or she had no health insurance. The NHI plan would also make sure capital is allocated to the best programs in the areas of greatest needs, based on deciions by regional health planning boards. This would improve on the current inefficiency of capital spending, in which only hospitals that are prosperous can expand, while less fortunate ones in areas with the most need cannot. As for prescription drugs and medical supplies, the government would pay for all drugs and supplies on a national list established by an expert panel. Since the government would be the only purchaser, it has considerable leverage over pharmaceutical companies on drug prices, thus containing costs. Of course, the NHI would be supported by tax dollars, preferably an income or progressive tax. The government already pays for two-thirds of health spending in the U.S., including public employee's private health insurance and subsidies to private insurance. According to the NHI plan, this would rise to about 85% of health costs, but because there would no longer be any need for private insurance companies, money that would have gone towards private insurance overhead and profits would be used to finance national health care.
Critics charge that patients would get limited, lower quality care under such a plan. But NHI would provide each person with a card that could be used at any practitioner or institution free of co-payments or deductibles. Not only would patients have freedom of choice, but they would not be forced to choose between multiple, confusing plans that give private insurance companies an unfair advantage over uninformed patients. Also, because revenues would become stable and administration streamlined, hospitals and other health institutions could focus on providing quality health care rather than being pressured financially. The only expansion would be based on regional and local needs. Fee-for-service practitioners would be motivated to provide quality care, since they are paid based on how hard they work (indicated by an electronic system involving patients' NHI cards).
Other options are inferior. If a private insurance system were to try to cover all Americans, it would create a few problems. First, it would not be able to coexist with a public system for those who cannot afford private insurance, since private insurers and the wealthy would lobby for underfunding of the public system. Second, even if there were no public system, private insurance would create different levels of care (high quality for the rich, low quality for the poor). Third, it would be hard to contain costs if there are multiple payers. There are some other plans that have been proposed as well. McCain has offered a plan involving tax credits of $2,500 per individual and $5,000 per family. Yet according to the Kaiser Family Foundation, the average cost of health care for a family of four is $12,000. Again, only the affluent would benefit. Another plan is to offer Medicare enrollees vouchers to purchase private insurance. But, as in the past, the privately-run HMOs the plan wants to push Medicare enrollees into would recruit mostly healthy seniors who would have cost Medicare little. Thus the HMOs would profit off of low-risk options, while the less affluent seniors would be forced into lower quality plans. Finally, some Democrats want to expand Medicaid eligibility. This would only be digging a deeper hole, however, since Medicaid already offers poor coverage and large expansions in the past have proven to fail (Medicaid enrollment grew from 20.2 million to 31.7 million between 1987 and 1993, but the number of uninsured rose by 8.7 million). Plus, with the economic downturn on our hands, states would scarcely be able to keep up funding of Medicaid.
Therefore, it is clear that a nationalized health care system is the best option. Health care is a right, and cannot be treated like a commodity. We all deserve equal and fair coverage. American exceptionalists say that we are the greatest country in the world, yet a significant portion of our nation continues to remain uninsured. A universal health care system may not solve our problems overnight, but it would be best for us all in the long run.
Type of Politics Practiced:
Currently, Social Welfare, including Health Care, is practiced with Client Politics. Social Welfare and Health Care benefits are given to a small group while a large part of society pays the cost. The type of politics that we advocate for Health Care is Majoritarian, in which both the costs and benefits are distrubited to everybody. We would hope to accomplish this through a government-sponsored universal Health Care insurance plan.
Important interest groups and elites influencing the debate over Universals Healthcare:
1. President Obama
While President Obama does not support government funded universal healthcare (he believes this come with too many high taxes), he does want to provide healthcare insurance to every American . If an American has health insurance that they are happy with, they keep that health insurance. Obama hopes to lower the cost of health insurance for these ensured Americans by covering a company’s catastrophic health costs, and by making companies that don’t offer health insurance “contribute a percentage of their payroll towards the costs of their employees health care”. For the 47 million Americans without healthcare Obama plans to establish a National Health Insurance Exchange, which would give the public many different private healthcare plans to choose from. These plans would be affordable and have benefits similar to those received by members of Congress.
2. The American Medical Association is a big proponent of quality health care for every American. They largely support reform within the current healthcare system, and their major goal is to find a way to get the uninsured quality health care. The AMA supports making better use of current government healthcare funds by using them primarily for people with lower incomes (who are often uninsured), and reforming the Medicare system . The AMA also strongly supports SCHIP (State Child Health Insurance Program) and state health insurance for children as a number one priority. The AMA also supports the removal of tax breaks for employees receiving healthcare through their employers and would “finally get assistance under the AMA proposal”. The AMA's desired reforms fall under three main pillars of change: Subsidies for those who most need financial assistance when it comes to healthcare, choice of plan for individuals and families, and greater individual responsibility and protections for high-risk individuals. Subsidies should come in the form of vouchers or tax credits, and should be larger for families and individuals with lower incomes. This money will be shifted from the billions of dollars each year in tax breaks used to assist people in higher tax brackets. In order to ensure greater choice the AMA proposes that the government pay the premiums of people who switch jobs and/or healthcare plans, which will help individuals feel less constrained to their current plan. They could then have their choice of using the old plan, the new job’s plan, or an independent plan. The AMA also wants to streamline the existing healthcare regulations and make sure these regulations allow, “market experimentation” (finding the most attractive plan for consumers). It also wants to reward companies for taking in people with many types of patients.
3. Max Baucus
Max Baucus is the Democratic senator from Montana and a fervent supporter of universal healthcare. Recently, he released to the senate his blueprint for healthcare in America. Baucus (along with senator Edward Kennedy from Massachusetts) is the largest driving force for universal healthcare in congress. He hopes to have his final legislation drafted by Inauguration day . Baucus’s desire to get the legislation out quickly comes from his desire to avoid what happened with president Clinton and healthcare (Clinton acted too slowly and healthcare become a back burner issue). There are 5 principles of Baucus’s reform plan (entitled “Call to Action, Health Reform 2009”). He first wants to create universal coverage. He then wants everyone in America to share the burden so that it does not fall solely on the individual or the company. He plans to do this by pooling individual and company purchasing power. He then wants to slow the growing cost of health care, and prevent many diseases that are a drain on government health care money (like cardiovascular diseases and diabetes). He then wants every citizen to share responsibility with his or her fellow Americans for covering the uninsured.
4. Divided We Fail
Divided We Fail is a group of 53 million consumer advocates, business executives, and union members that believes “all Americans should have access to affordable, quality health care”. They recently announced a million dollar advertising campaign to pressure Barack Obama to keep healthcare reform a top priority. Divided We Fail believes that Americans should have access to cheap prescription drugs, and these costs “should not burden future generations”. They also believe that prevention is an important aspect of reducing healthcare costs, and that Americans should have more choices when it comes to health car providers.
5. Libertarians
The libertarian part is the third largest in the nation and is very critical of universal health care. Libertarians favor small government, low taxes, more individual control and less government control; their healthcare proposal encompasses all these things. There are three components to the Libertarian health care proposal. First, they want to establish Medical Savings Accounts where money could be deposited (tax free) and drawn upon when needed. Libertarians would also work to make all health expenses tax deductible. Second, they want to deregulate the healthcare industry, which they say increase cost and decrease choice. Third, they want to replace the FDA with “more agile, free-market alternatives”.
Sources:
Obama, Barack. "Universal Health Care Is Necessary to Increase Access to Quality Medicine." Opposing Viewpoints: Medicine. Ed. Louise Gerdes. Detroit: Greenhaven Press, 2007. Opposing Viewpoints Resource Center. Gale. 5 November 2008 <http://find.galegroup.com/ovrc/infomark.do? &contentSet=GSRC &type=retrieve &tabID=T010 &prodId=OVRC &docId=EJ3010302239 &source=gale &srcprod=OVRC &userGroupName=berw2747 &version=1.0>.
"Proposal of the Physicians' Working Group for Single-Payer National Health Insurance." 30 August 2003. Physicians for a National Health Program. 5 November 2008 <http://www.pnhp.org/publications/proposal_of_the_physicians_working_group_for_singlepayer_national_health_insurance.php>.
"Tax credits at heart of McCain's health care proposal." 29 April 2008. CNN. 5 November 208 <http://www.cnn.com/2008/POLITICS/04/29/mccain.healthcare/
"Universal Health Care." Issues & Controversies On File 23 Sept. 2005. Issues & Controversies. Facts On File News Services. 5 November 2008 <http://www.2facts.com>.
Article:Health Care Costs Increase Strain- New York Times
Interest group sources:
http://www.lp.org/issues/healthcare
http://www.washingtonpost.com/wp-dyn/content/article/2008/11/11/AR2008111102511.html
http://baucus.senate.gov/issues/healthcare.cfm
http://www.voicefortheuninsured.org/amaproposal.html
http://www.barackobama.com/issues/healthcare/
http://www.nchc.org/facts/coverage.shtml
http://www.ama-assn.org/ama/pub/category/18785.html
1. Both Democrats and Republicans acknowledge the need for drastic reform in the health care system
2. Over 47 Million Americans go without health care
3. Health care costs are increasing faster than inflation rates
4. US spends more money on health care than any industrialized nation
5. The government does play a major role within health care such as by having programs like Medicare and MedicAid
6. National surveys show that the main reason why people are unisured is because of the high price of health coverage
7. Average cost of health care for a family is $12,000 per year, roughly 5% more than 2007
8. Medical bills easily affect the entire economic stability of a family, those without health coverage have a harder time paying off debts and bills when they recieve medical treatment
9. Our current health care system is free market based, the individual decides whether they can or cannot afford health care
10. Those without insurance are 25% more likely to die in any given year than those with health insurance