Writing 1301

6th August 2009

Health Care Reform in United States: We Can Not Wait Any Longer

      In America today there is a both grave and dire situation. Millions of American citizens are
currently without healthcare coverage or have merely partial coverage. Millions of people have
been denied health insurance due to pre-existing health conditions and millions of people with
insurance plans have no way to finance a necessary operation because they have been unable to
afford life-or-death treatment due to their grossly inadequate insurance plan that refuses to insure
them. Moreover, federal government spending on national health care, which amounted to two
trillion U.S. dollars, counts towards 16% of the gross domestic product (GDP) in 2005 and the
estimated government expenditure on health care in 2015 is four trillion U.S. dollars, 20% of the
GDP (Achieving 55-56). In other words, the current health care system is an issue that affects
millions of families in the U.S. as well as the economic stability of the nation. Accordingly,
President Obama is commited to working with his administration to pass comprehensive health
care reform his first year in office (Whitehouse).

     In President Obama’s health care reform proposal, the key feature is to create a brand-new
public health care coverage which would provide health insurance to all Americans at an
affordable price with an individual mandate for children. Additionally, the federal government
will work on both reducing the costs and improving the quality of national medical care. Lastly,
the government will spread the idea of health and wellness on a spiritual level, forming a better
society (Leavitt 86-87).  President Obama is not the first president who has proposed health care
reform. According to the information from Kaiser Health Reform Gateway, the history of health
care efforts in the U.S. can, infact,  be traced back to the early 1900s, soon after the Great
Depression when former President Franklin Roosevelt signed the Social Security Act as part of
the health care reform in 1935.  Later on, the government established Medicare and Medicaid as
two of the largest federal programs designed to support people who otherwise could not afford
medical care. In the 1970s, President Richard Nixon passed the Comprehensive Insurance Act,
which effectively began the era of private insurance companies controling the health insurance
market. Twenty years later, in the early 1990’s, President Bill Clinton also proposed health care
reform, which aimed for universal health care for all Americans (Kaiser).

     Unfortunately, all of these attempts have failed to achieve its goal whilst the situation has
worsened, especially during the past decade. Americans cannot afford to wait any longer. More
and more people who actually have insurance plans do not receive the quality care they deserve,
considering the ammount of money they must pay. Moreover, skyrocketing medical bills are
making U.S. business companies less competitive than others in the rest of the world. Therefore,
change in the health care system is certainly needed even if some might argue about the necessity
and possibility of the health care reform.

     People who strongly support the public health plan are the ones that suffer from the current
health care system and feel the urge for change. According to the latest CBC News poll, most
Americans support for substantial changes in the health care system and the idea of providing
more affordable public health care to compete with private insurers. The poll also found that
people are content to pay more in taxes so that universal health insurance will be accessible to
every citizen. The people believe that the government, by cutting high insurance premiums,
imposed on Americans by profit-orientated insurance companies, would actually save them
money in the long run (Connelly and Sack A1). Millions of Americans support this health care
reform because they cannot afford to purchase the necessary health care coverage under  the
current health care system. In fact, the most expensive health care system in the world, according
to the 2000 World Health Report issued by the World Health Organization, is that of the U.S.
Consequently, if insurance premiums keep increasing, more and more people will be unable to
afford health care coverage in the next few years, which in turn may cause serious social
problems.

     More importantly and possibly the most flawed aspect of the whole system is:  people who
already pay hundreds of dollars per month to their insurance companies still cannot get needed
care when they become seriously injured or sick because their insurers often try as hard as they
possibly can to reduce or reject claims in order to cut costs and boost profits. As a result, greater
numbers of people must resort to using money once kept in savings or retirement accounts or
refinancing their homes in order to pay for the medical bill. For example, my boyfriend’s aunt
has severe back problems and urgently needed to have an operation as soon as possible. Even
though she did have a health care plan back then, she was refused this critical operation by her
insurance company. The insurer claimed that this back operation is only an optional choice,
rather than a necessary treatment. However, the truth was that she suffered from her back pain
every single day which caused her to be less productive in her work and personal life. She then
had no choice but to refinance her house, which she had been paying monthly mortgage for over
15 years, and accept to pay higher interest rate to the bank she took loan from.

     Another reason why health care reform is needed is that the disparity between the high costs
paid for current healthcare and the comparatively low quality that is currently being given, is
unacceptable. According to the Commonwealth Fund, a private foundation that works

towards better quality health system and improves the quality and greater efficiency in health
care in America, the United States ranks at the bottom in the industrialized nations in quality of
care. As it shows in the graph above, United States ranks lowest among the six participating
countries in almost all five evaluating criteria while its insurance premium is the most expensive;
almost three times more expensive than New Zealand.

     The fourth argument supporting the health care reform is that many small businesses
companies cannot afford to hire as many employees as they need due to the cost of providing
health care to employees. Therefore these companies are less competitive in the global market
compared to the other companies which have less of a burden in compensation to the employees.
Therefore, most small business companies quit offering health insurance to their employees,
which is one of the main factors why the United States has such a large number of uninsured
people. Besides, those small businesses that do offer health care coverage pay more than what
big firms pay for the same healthcare services (Tozzi 10). Based on the four arguments regarding
the affordability, quality of the care, reliability of insurers and the negative impact on the
nation’s economy, health care reform is seriously needed in the United States.
 

     Nevertheless, when the government implements the health care reform step by step starting
from the Washington D.C, they might find some barriers stand in the way as opponents repute on
the necessity and possibility of the reform. Almost all opponents, especially the Republican
politicians in Congress, hold these two refutations: the government-run health plan will turn
American into a socialist country with no individual liberty and that the federal government,
already trillions of dollars in debt, does not have sufficient money to initiate such a reform that is
estimated to cost 1.6 trillion dollars in the next decade (Karl A15). What opponents who hold
these objections against the health care reform do not realize is that if the government does
nothing while the insurance premium increases every year, more and more people are going to be
uninsured or underinsured. This is the true misery to people. In fact, many aspects of American
government are already socialized such as police and fire department, public school system, mail
services and public library system. In return, these reforms have positive affect in the society
because now people spend less time doing the same amount of work as before and people do not
have to pay for the services.

     As an answer to the individual freedom on health care, President Obama, in the Weekly
Address on 18th July 2009, guaranteed that the government will not interfere with individual
choice on the healthcare plan, nor will the government force people to purchase insurance. In
fact, if people like their current health plan, they can still keep their current health plan. In other
words, people still have freedom and rights on their own health care. In order to reduce federal
costs and provide enough money for this health care reform, the government announces to cut
down the unnecessary expenditure from Medicare and Medicaid by providing the patients the
most appropriate treatment other than the most expensive treatment, eliminate unnecessary
administrative expenditure, which will result in big time savings in the long term. At the same
time, the government is planning to propose more tax on the richest families in America, neither
the middle-class nor the poorest families (Pauly 2272-2273).

       Now that we acknowledged the necessity of the healthcare reform, the question left is how
to effectively implement this reform. The answer is to provide public health care plan and
therefore creating competition among private insurers. The government has already taken
progress as President Obama signed the Children’s Health Insurance Reauthorization Act On
February 4, 2009. This Act will provide quality care to 11 million children and 4 million of those
whom were uninsured before (The White House).Unlike the Unite States, many industrialized
western countries already offer lifetime universal health care to their citizens at no cost or at very
low cost. Those countries have used different strategies to provide affordable health care
coverage for all residents. Some countries use single-payer system such as Canada, United
Kingdom, Japan and Taiwan. In a single-payer system, which means that the government is the
solely payer of health care cost, every resident has access to a medical care and services
regardless of their ability to pay. Others offer a mix of both public and private insurance
providers (also known as pluralistic systems) such as France, Germany, Australia and the
Netherlands. In a pluralistic health care system, the government guarantees full access to medical
care to all residents while providing alternative private insurance plans for people to choose
from. Both single-payer and pluralistic systems are cost-less health care system because of
government involvement in the process of price negotiation (Achieving 66).
     However, right now in American, private insurance companies are able to set the price at their
favor, which is not effective because profit-oriented companies will always try to produce at the
profit-maximizing quantity other than the effective quantity. As a negative result, the premium
increased three times faster than the average wages in the past decade (57). The Obama
Administration prefers the pluralistic system which allows both public and private insurers exist
in the market as he announced to exclude single-payer system at the “Health Care Summit” held
in 2009 (Single 2).Therefore, providing a public health care plan is a great idea not only because
it is more affordable but also because it creates competition among other private insurers, forcing
private insurance companies to produce more comprehensive and relatively cheaper health care
plans. Additionally, the government should increase support for medical programs such as
Medicare and Medicaid because these organizations provide help for poor or disabled people
who qualify for health care coverage.

     The government should also work on reducing the high cost of health care. Personally, I have
always wondered what is the “real cost” of a medical treatment in America. For instance, my
roommate had an additional CT (computed tomography)-scan for tuberculoses test last fall when
she just arrived on campus. The total CT-scan process took less than 5 minutes but the bill was
more than 2,000 U.S. dollars, which would only costs in equivalent less than $50 U.S. dollars in
China given the same equipment. I wonder if some hidden agreement is secretly made between
the hospital and the insurance companies such that people have to pay more than what the
treatment really costs. If so, the government should not let this happen any longer. Investigation
groups should look into the insurance industry and closely look for evidences.

     The controversy generated by the health care reform in United States has been discussed for
over a century. However, millions of Americans still have no health care coverage and the
government spending on medical care increases rapidly year after year. With more than 42.6
million people currently uninsured and with nearly twice the average cost of premiums in
comparison to other developed nations; the United States has by far the most expensive health
care system but yet not the most comprehensive system (Pauly 2271). Meanwhile, the current
health care system which makes small business companies in America pay a large amount of
money every year on employee insurance, works as a hidden business killer. This is time to make
a change and we should seize this opportunity so that, in the future, all Americans will have
equal and easy access to affordable health care with better quality.

                                                Works Cited

“Achieving a High-Performance Health Care System with Universal Access: What the United
States Can Learn from Other Countries.”  Annals of Internal Medicine  148 (2008): 55-75
Academic Source Premier. EBSCOhost. U of Minnesota Lib. 20 July 2009

       < [Link]

Gruber, Jonathan “A Win-Win Approach to Financing Health Care Reform,” New England
Journal of Medicine 361.1 (2009): 4-5 Academic Source Premier. EBSCOhost. U of Minnesota
Lib.14 July 2009

       <[Link]

Judith K, Leavitt.   “The New Administration and Health Care Reform.”   American Journal of
Nursing  109 Jan (2009) 86-87  Academic Source Premier. EBSCOhost. U of Minnesota Lib. 5
Aug. 2009  < [Link]

Kaiser Health Reform Gateway. 18 March 2009 The Henry J. Kaiser Family Foundation. 5
August 2009 <[Link]

Karl, Pove. “The GOP Can Stop ObamaCare.”  Wall Street Journal - Eastern Edition 18 June
253.141 2009: pA15 <[Link]
direct=true&db=aph&AN=43275641&site=ehost-live>.

“Include single payer in healthcare reform.” Massachusetts Nurse Accusation 80.4 Apr. 2009: 2-
2  Academic Source Premier. EBSCOhost. U of Minnesota Lib.5 August 2009
<[Link]

Mark V, Pauly. “Public Health Care and Health Insurance Reform — Varied Preferences, Varied
Options.” New England Journal of Medicine May 2009: 2271-2273                                          
< [Link]

“World Health Organization Assesses the World's Health Systems.” World Health Organization
22 July 2009 <[Link]

President Obama's Weekly Address. Health Reform Government. 18 July 2009.

<[Link]

Sack, Kevin and Marjorie Connelly.  “Poll Finds Wide Support for Idea of Government-Run
Health Plan.”  New York Times 21 June 2009: A1.  Academic Source Premier.  EBSCOhost.  U
of Minnesota Lib.  19 July 2009  < [Link]

The White House: Health Care Reform. July 2009 5 August. 2009

       <[Link]

Tozzi, John. “Health-Care Debate: Issues for Small Business.” BusinessWeek Online 5 May
2009: 10-10 Academic Source Premier. EBSCOhost. U of Minnesota Lib. 4 August 2009
<[Link]
direct=true&db=aph&AN=39460368&site=ehost-live>.