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Since the subject of universal healthcare became the rally point for big government ideologues during the Clinton administration, the subject has been alternately pushed onto the media front pages and then allowed to suffer from lack of adequate medical attention required to keep it alive. While the idea resounds in the desires of the American public, the reality of hOw to fund such an pa 9ovEent enuemen programs remains elusive.
The idea sounds great to the cOuntry’s two largest two sectors of growing population which will be the chief beneficiaries. The aging baby boomer generation is approaching retirement and beyond, and a universal healthcare system ll cater to their rising health care costs. This generation is one of the largest in the country, and offering them the opportunity to “opt outr of paying for coming health care expenses is a SIgnificant personal benefit. The other sector of the US population which IS growing at a rapid ate is the poor, including underemployed, and legal and ilegal immigrants. Although this group pays little in taxes and contributes little to the overall real economic progress of the country, politicians continue to cater to class envy by declaring that the ‘rich’ have health care coverage, why shouldn’t those at the lower end of the economic scales have the same benefits. Behind this struggle, health care cOsts are skyrocketing, and two primary reasons tor the increase find their roots in these same two groups.
Life expectancies in the country are getting longer, and the aging boomers will require more health care for longer periods of time. Funding for the existing9 government health care systems is declining due to the same reasons that Social Security is facing implosion. More citizens receiving benefits are fewer citizens are paying into the system. The simple equation of higher demand -plus- lower funding -plus- longer lives -equals- higher costs. Secondly, the poor, uninsured and ilegal immigrants who can receive health care at any hospital are creating increased drag on a system that is already suffering. Every hospital in the country will treat any person entering its emergency wards. If the services are not paid for, the loss is applies to the bottom line, and costs increase throughout the system. A third reason for the push for Universal healthcare is the pragmatic belief that in the long run it will reduce healthcare costs in general. It preventative care is available to everyone from birth, the result will be lesS-costly healthcare needs in people’s later years. Early preventative measures also lessen the magnitude of epidemics; when more people are immunized and have access to treatment, disease cannot spread so easily. (University Wire, 2001)
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Former US Surgeon General C. Everett Koop recently stated: “I think I am right when I write that all Americans have the right to healthcare,” Koop said. “if we agree that there is a right to healthcare, then we are also agreeing that someone must provide these rights,” he said, noting that the right to nealthcare is direrent than some other constitutonal nghts decause it incurs a monetary cost on sOciety. (Anand, 2000) Last year, in a survey of medical- school faculty and administrators published in the New England Journal of Medicine, 57 percent said they favored a single-payer universal healthcare system over either fee-for-service or managed care. Indeed, more and more doctors are now willing to work in coalitions where they learn from and fight for the needs of those whom they have traditionally considered inferiors or adversaries. (Gordon, 2000)
As a result, when President Clinton ascended the podium, and declared that universal healthcare is a rignt which Americans shared, no one quesioned where tne money would come from to Tund such a huge expansion of the federal bureaucracy. This has become the clearest argument for universal healthcare, the right of all people to receive healthcare, in the form of physician visits and pharmaceuticals, regardless of their socioeconomic status. (University Wire, 2001) A person who is poor should not be precluded from the benefit of healthcare simply because he or she cannot afford it. Boomers perceive universal health care as another program to benefit them, and the poor uninsured thought they were looking at a savior.
The core question to answer, however, is not whether heaithcare coverage is a right or not. The costs of health care are skyrocketing, and the needs of the population are increasing. The question is: What IS the most efective means of bringing down costs while at the same time expanding coverage? During the last national election, Oregon placed on its ballot a state wide comprehensive health care program. Oregonians voted ona ballot initiative that called for every resident to receve full medical benefits-ncluding coverage of alternative therapies like acupuncture and massage. After an initial support for the measure, the big question of whether Oregonians were willing to pay a new payroll tax to fund it ultimately affected the polls. The measure went down in defeat because it was no longer the impersonal federal bureaucracy which was going to pay for the system, but the state would have to come up with the money on their own. In 2002, Maine created a state board to draw up proposals for universal care.
Ine Rnode islana oeneral Assembiy released a stuay on the laea, and the nead or one of Calfonias largest health-insurance companies nas called tora plan to Cover all residents. (Sappenfield, 2002)) The American Medical Student Association (AMSA) is the nation’s oldest and largest student run organizaton boasting 40,000 members and local chapters at every medical School in the United States. Recently, the AMSA encouraged students to broaden the scope of their medical education beyond that which is offered in a traditional curriculum, while taking an active role in infiuencing health policy. (US Newswire, 2003) Due to the heavy push in the political arena, medical organizations and states are appearing to climb onboard the idea. This may not be due to their belief that universal healthcare is a good idea for the country.
Rather these organizations do not want to be mowed down by the sweeping changes that are becoming increasingly inevitable. While the activity toward the goal of universal healthcare is increasing, the question still remains to be answered. what is the most effective means to lower costs and expand coverage without intlicting the best health care system in the world with a tatal virus hich robs it of its strength, and will to live? Before the Us pursues this path much further, it would be wise to evaluate the health care systems of other countries which have an existing soCialized, universal coverage system.
Canada, for example, has had a universal healthcare system since 1947. Every Canadian citizen has access to basiC health coverage as a ‘right of their citizenship. Many US citizens who live near the US – Canadian Border often will cross the border to fill medical prescriptons. In these instances, the prescription is less expensive because the Canadian government subsidizes the medical system. In other words, the absolute cost of the medicine is not lower, but the consumer cost is less because of government involvement. While most Canadians are satisfied with their current system, economic pressure is building for reform. As a result, three of Canada’s provincial leaders are signaling a move toward privatization which could significantly alter the Canadian healthcare landscape.
“Our healthcare system is on life Support and it is tading tast, said British Columbia premier Gordon Campbell recently. (Brown, 2002) The premiers of Alberta, ontario, and British Columbia say ballooning costs and long delays for some procedures can only be solved by private initiatives. Up to 40 percent of their individual provinces budgets goes toward healthcare. Canadas nealhcare system is run by n’s 10 provinces and three terniories, Dut is governed by federal guidelines set out in the Canada Health Act. In exchange for following the five principles of the act.
- universal access,
- portability
- public management,
- coverage of all medically necessary services
- no additional user fees,
the Canadian federal government pays a share of the costs. While the federal government originally promised to cover haf of those costs, Ottawa’s share has been declining tor years. currently its contribution hovers around 15 percent. (Browm, 2002)
The idea of universal coverage, which includes the 5 points, delineated in the Canadian health care act sound good. Every citizen has suffered under our existing health care system for reasons which would be solved it these 5 features were legally written into the health care system as rights. Every citizen would benefit if a system could be derived which provides these features. But the system does not survive because citizens have rignts. The system survives, and thrives, because qualitied and talented doctors apply their skills, in public or private practice. The doctors reward for the risk they take, and the effort they put into their career is the profit they recenve from their services, and the pride they can earn by providing the best service possible.
Without a profitable enterprise, the entire system sutfers, both in the quality of service are can provide, and the quality of talent it can attract to provide those services. The trend of medical care to suffer when the federal bureaucracy becomes involves can be seen in the Canadian and other socialized systems. People in need of difficult or intensive medical care do not travel to Canada, Britain, or France. They come to America. Heart surgery patents come to America from across the globe because our health care system has been able to balance the needs of the individual with the needs and desires of health care workers to earn a profitable living in the field of their choice. If a government takes away, or sets fixed tees for services in the medical field, (or any field) the result is a decline in service quality and an increase in costs.
To make a cross – industry comparison, if a business has a package that absolutely, positively has to be there over night, do they call the United States Postal Service, or Fed Ex? Regardless of rights, costs, or obstacles, the private system outperforms the government system on virtualy every point. So, what is the best course to pursue in order to create a health care system which addresses these four points and still produces a profitable, world class health care delivery system? Any changes to our health care system must provide:
- Increased coverage for the uninsured and underinsured.
- Reduction in costs.
- Increased profitability to continue to draw talented people.
- Increased care quality
While these 4 points do not include the emotional knee jerk catch phrase “a persons right to health care,” most Americans would agree that if it is a choice between decreasing care quality or increased costs, Our country would be better served by increasing costs and finding a method to encourage the prices to decrease while keeping quality and choice as key features of the system. One method of decreasing costs would be to insist that government regulation be eliminated from the health card system.
Currently, many federal agencies set limits as to what will be paid for specific procedures. Again, these unmet fees are passes along the system, overal prices rise. Government regulations have strangles the process of research and development. It new medicines and treatments were able to get to the market faster, with lower cost associated to overcoming over burdensome regulations, companies could lower their R&D costs, and increase their rate of return on investments. The most effective means to reduce health care costs, however, would be to allow the customer, the end user to shop around for the best serviIce at the best price.
In a free market economy, one grocery store cannot sell milk for $5 a gallon while another has if available everyday for $2. The principle s0 simple, it has as of yet eluded government bureaucrats. When service providers have to compete for business, they find ways to offer better service at competitive prices. If consumers of health care services were allowed to establish medical savings accounts, they would carry the personal incentive to live healthy lives, and find the best care at the best possible price. Service providers then would also feel the free market based pressures to remain competitive, and provide excellent care.
Works Cited:
- Editorial. 2001. It’s time to talk about universal health care. University Wire. 27 November Anand, Amit 2000.
- Ex-Surgeon General Koop calls for universal care. University Wire, 14 April.
- Gordon, Suzanne. 2000. Humanized Healthcare. The Nation, 21 February, vol 270. pp 16.
- Sappenfield, Mark. 2002. More states flirt with universal heathcare., The Christian Science Monitor, 16 December: 2. MEDICAL STUDENTS RALLY FOR UNIVERSAL HEALTH CARE COVERAGE; REPS MCDERMOTT, KUCINICH, JACKSON, JR. TO ADDRESS STUDENTS ON CAPITAL HILL. 2003. US Newswire, 17 March.
- Brown, Barry. 2002. Canadian provinces move toward privatizing healthcare. , The Christian Science Monitor, 28 February: 7.
