Universally Healthy Americans
Policy Challenge 1
2020-0706 SWGS 6702
By: Rickard Jean-Noel
July 14, 2020
Over the course of American history, there has been a huge debate to what Americans are entitled to. The US Constitution is based on the ideals that all are created equal, however we often times see that this is a contradiction based on the treatment of the people in America. We are told that we are entitled to life, liberty, and the pursuit of happiness, but somewhere along the way healthcare was left out of this. America has a health care problem that causes thousands of Americans to go into bankruptcy every year because of medical expenses. According to the film “Sick Around the World” The WHO (World Health Organization) states that the US is rated 37th in the world in regard to quality and fairness regarding healthcare (Sick Around the World 2008). This often times leaves us with more questions than answers, in regard to solving this issue.
According to HealthCare.gov, on March 2010 a” very comprehensive health care reform law was enacted, that is better know as ACA, PPACA, or Obamacare”( https://www.healthcare.gov/glossary/affordable-care-act/). According to HealthCare.gov, there were there primary goals of the ACA which including the following:
- Make affordable health insurance available to more people, specifically those that live under the 100% and 400% poverty level
- Expand Medicaid program to cover all adults with income below the 138% of the federal poverty level.
- You can not be turned down insurance due to pre-existing health conditions.
- Support innovative medical care delivery methods designed to lower the cost of health care generally. (https://www.healthcare.gov/glossary/affordable-care-act/)
According to https://www.ncsl.org/research/health/the-affordable-care-act-brief-summary.aspx, there were key provisions that were added to the ACA and that took effect January 1, 2014. These included but not limited to:
- Required employers to cover their workers or pay a penalty. There were exceptions for small business employers.
- Provide tax credits to certain small business that cover certain costs of their employees’ health insurance.
- Required individuals to have insurance, exceptions to those that have financial hardship and/or religious beliefs.
Young adults were now covered under their parent’s healthcare. (The Affordable Care Act: A Brief Summary, Martha King 2011, https://www.ncsl.org/research/health/the-affordable-care-act-brief-summary.aspx).
Many people, especially Republicans feel that we should rid ourselves of the dreaded “ObamaCare”. Only of the main reasons is that fact that former President Barack Obama was associated with creating the legislation, which many are not too happy about. Others argue that the cost of health insurance is extremely high under the ACA. According to “8 Reasons to Still Hate Obamacare”, “In 2018 costs have risen by another 19 percent for high-cost plans and 32 percent for the cheapest plans, according to a study by the Urban Institute. Overall inflation for all other goods and services are running at 2 percent”. The article goes on to mention that entitlement spending has increased, Healthcare cost is still increasing, Americans are now paying more money for less health coverage, there are less insurance providers to choose from, there are still several million people uninsured, and there are way better alternatives. (“8 Reasons to Still Hate Obamacare”, Stephen Moore, 2018, https://www.heritage.org/health-care-reform/commentary/8-reasons-still-hate-obamacare).
Given the results of the research, it would be safe to state that some adjustments could be made to the ACA. The ACA can not be repealed without replacement. This is because it would leave about 19 million Americans without health insurance, according to https://www.rand.org/health-care/key-topics/health-policy/in-depth.html. Along with the lost of coverage for almost 20 million Americans, states would also lose “up to $135 billion in federal funding for Medicaid and subsidies paid into the healthcare marketplace” (Repealing the Affordable Care Act & The Effects It can Have, Jeff Rum, 2019, https://www.gaucherdisease.org/blog/repealing-the-affordable-care-act-the-effects-it-can-have/).
In the film “Sick Around the World”, the narrator going around the world and compares the US healthcare system to that of other countries. The first Country that he compares it to is Great Britain’s Healthcare. They have government run national health service, where they never have to pay medical bills. The people pay for health insurance through taxes and the hospitals are state owned and the doctors are government employees. As a result of this, they pay much higher taxes to cover health care. There are also gatekeepers, who are the general practitioners, who have to forward you to the specialist. The doctors get bonuses for keeping their patients healthy, but there isan exceptionally long waitlist to see specialist and for certain medical treatments(Sick Around the World 2008).
The next country in the film is Japan. In Japan, everyone is covered, and they spend less than half per capital then that of the US. Japan also has the longest life expectancy and lowest infant mortality rate. Everyone gets insurance either through their employer or through a community-based insurer. The government pays for the poor that cannotafford to pay. 80% of the hospitals are privately owned and all doctors’ offices are privately owned. They can see any specialist at any time. The Japanese Health Ministry comes up with the price of everything in regard to medical care and medication. There is a set price for every medical procedure for everyone that can be found in a billing book. If you lose your job, you do not lose your insurance, you just switch to a community insurer. They cannot deny anyone healthcare and there is no waitlist. The downside is that Majority of the hospitals are in debt because cost is too low(Sick Around the World 2008).
Germany follows the Bismarck Model. Under the Bismarck Model, all basics are covered including medical, dental, and mental treatment. Private doctors and private hospitals. Germans pay premium based on income. Even though their healthcare is more expensive then Japan and UK, but cheaper than the US. Because of the price of healthcare, Doctors are underpaid(Sick Around the World 2008).
Taiwan has national health insurance that includes everyone. They have one government insurance that does not let anyone opt out, including the rich. There is no gatekeeper to see a specialist and no wait time. Clinics are open on weekends. They have a smart card that tracks everyone’s doctors’ visits, and best of all, no one goes bankrupt for medical bills. A total of 6.2% of the GDP is spent on healthcare, compared to the US use of 16%. They spend less then Japanon healthcare, however the government has to borrow funds from banks to cover the price of healthcare(Sick Around the World 2008).
In Switzerland, Insurance companies cannot pick who they provided care to, such as pushing away the old and picking the young. The insurance companies are not allowed to make a profit from basic healthcare. People who refuse healthcare was automatically assigned to a carrier and have to pay the bills. The Swiss believes that it is a basic human right for everyone to have health coverage. Therefore, they have universal healthcare for all of their citizens. Many health insurers are nonprofits organizations. The benefit packages are fixed, and so are the prices and services received. The insurance companies’ payout faster to compete(Sick Around the World 2008).
After reviewing the information provided, we can conclude that while the ACA (ObamaCare) was in fact revolutionary for the United Stated, it still fell short when compared to the healthcare provided by other Countries. When we compare the healthcare systems of Japan, The UK, Germany, Taiwan, and Switzerland, we can say that Switzerland has one of the best health coverages and they provide universal health care to all of itscitations. In order for the insurance to be reliable to the people, it must be an insurance coverage that covers all people regardless of their preexisting medical conditions. The premiums of those that are unable to afford it must be covered by the government, and funding would ultimately come from taxpayers. There must also be a set price for medical care and medical procedures that are affordable. If the following can be adjusted to the ACA (ObamaCare) then perhaps it would be better suitable for everyone. The main concern for everyone is coverage and affordability, therefore if the price of the insurance and the price of medical procedures and medication were fixed, it would be better for everyone. However, there must be a balance because we would not want hospitals to go bankrupt or for doctors to go broke. The best course of action would be for medical professionals, government officials, and members of a committee of citizens to come together in a bipartisan action to complete a new and improved ACA, that is actually affordable for everyone.
A recent alternative that was introduced by Senator Bernie Sanders in 2011, was the American Health Security Act.This plan would be“a Medicare-for-all proposal that would replace the ACA as well as Medicare, Medicaid, and SCHIP with uniform, single-tiered coverage managed by the federal government” (https://www.rand.org/health-care/key-topics/health-policy/in-depth.html). The plan would not allow private health insurance and there would be little or no cost sharing for enrollees. Like the majority of Senator Bernie Sanders proposals and ideas, it was deemed to be too socialist and was dismiss and ignored. I believe however that this might be the best option in regards to universal healthcare for Americans.
- Sick Around the World, Produced and Directed by Jon Palfreman, PBS, 2008
- “8 Reasons to Still Hate Obamacare”, Stephen Moore, 2018, https://www.heritage.org/health-care-reform/commentary/8-reasons-still-hate-obamacare
- Repealing the Affordable Care Act & The Effects It can Have, Jeff Rum, 2019, https://www.gaucherdisease.org/blog/repealing-the-affordable-care-act-the-effects-it-can-have/