Should U.S. Provide Free Healthcare Coverage For All?
Should U.S. Provide Free Healthcare Coverage For All?
The healthcare system is an important factor in the success of any country. It is an engine for innovation, as it disseminates life-enhancing treatments for the citizens to have better health. The healthcare system can provide enormous benefits to its citizens. With continuous consumption of healthcare services by individuals comes a growing demand for healthcare services that provide happiness and satisfaction to people. For this, patient satisfaction has been labeled as “a complimentary measure of healthcare quality” (Browne et al., 2010, p.921). In fact, this rate of satisfaction by patients appears to be the key in determining incentive compensation, since this rate of satisfaction reflect the healthcare quality and outcome of the respective healthcare system. To increase the rate of satisfaction of citizens, is it right to say that there should be free provision of healthcare to all citizens?
Based on the report of Davis et al. (2014), they stated that the main difference why the United States was ranked last among the list of nations, was with regards to “the absence of universal health insurance coverage” (Davis et al., 2014, p.7). This was also the statement of Khazan (2014), while adding that the full implementation of the Obamacare happened after the data of the report was collected in 2007, so it was expected that U.S ranked low in the data. When it came to the rankings, however, it appeared that the United States had more difficulty in coordinating care, receiving timely information, and in dealing with administrative disturbance. While other nations were able to adopt an up-to-date health information system, the United States was still catching up in coming up with modern financial incentives that would reinvent their health information technology systems.
Meanwhile, the United States ranked low when it came to the Healthy Lives Scale that considered the following: (1) infant mortality; (2) healthy life expectancy at age 60; and (3) mortality from preventable conditions (Khazan, 2014). It appears that the United States spent about 17.7 percent of GDP on healthcare alone, which is a lot more than other countries like Australia, which only spent 8.9 percent of their GDP (Khazan, 2014). It appears that the problems have something to do with “managing administrative hassles for both doctors and patients, avoiding emergency room use, and reducing duplicative medical testing” (Khazan, 2014). These are all under the efficient care category. Also, it was stated,
Other nations ensure the accessibility of care through universal health systems and through better ties between patients and physician practices that serve as their medical homes. (Davis et al., 2014, p.8)
With this, citizens were able to experience the benefits behind the accessibility of healthcare, which meant they were able to find relief in simple things, such as receiving relevant information from hospitals and specialists, and receiving seamless, coordinated care as well. One would question whether it is right for U.S. to provide free healthcare insurance to all its citizens, or if it would be better to be selective in the provision of free healthcare to citizens.
The Root Causes of the Spiraling Costs of Healthcare
Healthcare in the United States was designed on a one-to-one basis between caregivers that have distinct qualifications, as well as, the suppliers that develop innovative drugs and devices for patients with dissimilar needs. Its costs far exceeded those being marketed as standardized products because of their specialties. They were also difficult to control because the laws regarding supply and demand did not operate here. More so, providers built perverse incentives, which began when hospitals and physicians were given full autonomy and pricing power, which allotted them monopolistic regional domination. It also limited the consumers’ choice of their healthcare plans, and eliminated the availability of competition. One example is having a single health insurer that dominated the entire U.S. market, which undermined competition in hundreds of markets across the country (Faguet, 2013, p.26). There was only two insurers across the States of Alabama, Arkansas, Iowa, Maine, Montana, and Wyoming, and they provided more than 80 percent of health insurance across the said States (Faguet, 2013, p.27). In Alaska and Vermont, more so, the domination rose to more than 90 percent of the insured population (Faguet, 2013, p.27).
With this multi-factor interplay, it made the U.S. healthcare the world’s most expensive, next to 10 other countries usually in the western part of the globe. However, in spite of being one of the world’s expensive healthcare system, it failed to provide a better health outcome to its citizens than other OECD (i.e., Organization for Economic Cooperation and Development) countries. As Faguet (2013) reasoned out, healthcare in the United States is “the only industry where products and suppliers rather than consumers generate demand” (p.23). This stemmed out from the first half of the 20th century by “skewed legislation” (Faguet, 2013, p.23), when incentives were designed to benefit the groups of providers, which led to greater competition and thus, promoted price escalation. Prices went up rapidly with the scientific progress, which gave rise to a new breed of pricy specialists in the market.
Another issue is the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 that enabled the drug companies to only receive preferential treatment, forbidding Medicare from negotiating the drug prices with the drug companies. It is for this, that individuals pay the Department of Veterans Affairs about 58% less for drugs as compared to those paying Medicare (Faguet, 2013, p.27). Also, although Medicare has some built-in incentives for its providers, they removed the consumer incentives, such as what took place during World War II when the U.S. workforce was fighting abroad. The U.S. Administration imposed wage controls “to prevent inflationary pressure on salaries but allowed employers to offset salary stagnation through health benefits” (Faguet, 2013, p.27). Thus, it led the employers to sacrifice their health insurances as an alternate compensation, which began the trend of employer-provided health insurance in the 1950s. It began an employer-provided health insurance that was said to be “the worst mixture of market and government policy” (Faguet, 2013, p.27), since it removes consumer restraint to consumption of health services.
Should U.S. Provide Free Health to All Citizens?
The U.S. Administration should provide free healthcare to all its citizens, no matter what their age, gender, health, culture, religion, or socioeconomic status. As of 2009, the number of uninsured Americans reached to 50.7 million, which is “almost one in six U.S. residents” (Wolf, 2010). This is the lowest rate since 1987 when the government began keeping its data (Wolf, 2010). The numbers came from citizens who lost their jobs in the recession, those being dropped by their companies, and those who wanted to cut costs among others. Another reason was the rising cost of medical care, wherein based on a Kaiser Family Foundation report, workers now are already paying 47 percent more than they did back in 2005 for family health coverage, while individuals pay 20 percent more (Wolf, 2010).
With these rising prices, many agree that the U.S. Administration should cover more citizens in the uninsured population, especially those in low-income families that were “three times as likely to be uninsured as those with incomes above $75,000” (Wolf, 2010). Usually, workers who were 18 to 64 years old were uninsured, since the programs under Medicare, Medicaid, and Children’s Health Insurance Program cover either the young or the aged (Wolf, 2010). They were about to expand the health insurances to more individuals and families, which insists that the U.S. Administration should provide free health to everyone.
On the other hand, it may be difficult for the U.S. Administration to provide free health to everyone, especially those in the middle-age range. According to the opponents, this report exposes some fallacy in the way they shield the soaring medical costs by extending insurance programs and services to more citizens. The soaring medical costs is said to rise still, which may be the reason why 56 percent disapprove of the new law (Wolf, 2010). A study that Cohen et al. (2012) conducted was reported by National Research Council (2013) that “one-third of American households reported problems paying medical bills” (p.106). Still, most citizens fail to receive optimal quality of care due to the inefficiencies between the fragmented health systems across the government.
Conclusion
Citizens should not be required to have health insurances, while States should not be required to have additional costs for services not covered by the federal government. There is much more the government can do to sustain free health coverage for all. Woolhandler said,
We should adopt a zero-tolerance policy toward lack of health coverage. Today’s Census Bureau report underscores the urgency of going beyond the federal health law and swiftly implementing a single-payer, improved-Medicare-for-all program. (Woolhandler et al., 2012)
References:
Browne, K., Roseman, D., Shaller, D., & Edgman-Levitan, S. (2010). Analysis & commentary: measuring patient experience as a strategy for improving primary care. Health Affairs Millwood, 29(5), 921-925.
Davis, K., Stremikis, K., Squires, D., & Schoen, C. (2014, June). Mirror, mirror on the wall: How the performance of the U.S. health care system compares internationally. Retrieved January 16, 2017 from http://www.commonwealthfund.org/~/media/files/publications/fund-report/2014/jun/1755_davis_mirror_mirror_2014.pdf.
Faguet, G.B. (2013). The Affordable Care Act: a missed opportunity, a better way forward. New York, NY: Algora Publishing. Print.
Khazan, O. (2014, June 16). U.S. Healthcare: most expensive and worst performing. The Atlantic Magazine. Retrieved January 16, 2017 from http://www.theatlantic.com/health/archive/2014/06/us-healthcare-most-expensive-and-worst-performing/372828/.
National Research Council. (2013). “Chapter 4: Public health and medical care systems.” U.S. health in international perspectives: Shorter lives, poorer health. Washington, DC: National Academic Press. Retrieved January 16, 2017 from https://www.nap.edu/read/13497/chapter/1.
Wolf, R. (2010, September 17). Number of uninsured Americans rises to 50.7 million. USA Today. Retrieved January 16 from http://usatoday30.usatoday.com/news/nation/2010-09-17-uninsured17_ST_N.htm.
Woolhandler, S., Himmelstein, D., Adams, G., & Almberg, M. (2012, September 12). Despite slight drop in uninsured, last year’s figure points to 48,000 preventable deaths: health expert. Physicians for a National Health Program. Retrieved January 16 from http://www.pnhp.org/news/2012/september/despite-slight-drop-in-uninsured-last-year%E2%80%99s-figure-points-to-48000-preventable-.
