Universal Healthcare in the United States
Nearly 45,000 annual deaths are due to lack of health insurance, according to a study published by the American Journal of Public Health, more than doubling an estimate from the Institute of Medicine in 2002 (Cecere). Forty-five thousand people per year are the same as 120 people per day, or 5 people per hour dying because they do not have health insurance. More people die every year from not having health insurance than people dying of kidney disease (Wilper, Woolhandler, and Lasser). The United States has the power to bring this number down drastically if it were to provide basic healthcare insurance to all its citizens. The United States was built on beliefs of self-reliance and sustainability, and when the constitution states, “promote the general Welfare,” it is further fortifying these beliefs. The bible says in Mark 12:31 “love your neighbor as yourself.” Children are taught to love, not fight, to help, not hurt, to fix, not break. Healthcare is a human right, and denying that right is unconstitutional, unethical, and inhumane.
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Universal healthcare is defined by the World Health Organization as a system in which every citizen can receive health services, without incurring financial hardship. The United States should provide basic healthcare to every citizen, regardless of income or health status. Basic healthcare includes physical healthcare, as well as mental healthcare. If a person were to experience a traumatic event, such as a car crash, they should be provided first with immediate medical care, which is already standard, but the person should also be provided counseling or therapy if a psychiatrist deems necessary. Poor mental health is leading to other significant problems in America such as school shootings, a high suicide rate, and the opioid epidemic. Poor mental health can stem from a traumatic event or a series of traumatic events, and if a person does not receive care for their mental health, it could potentially put others in danger.
The United States must provide healthcare to all its citizens because it is what the American people want. Universal healthcare in the United States would have a positive effect globally, economically, politically, and socially. In the last elections the number one issue for voters was access to affordable healthcare. All races and genders, except for black women- who said healthcare was the 2nd most important issue behind racial injustice- cite healthcare as their foremost priority (H. S. Edwards). In a recent survey, 70 percent of Americans, including a slim majority of Republican voters, support some version of the universal healthcare proposal Medicare for all. Medicare for all has been turning into the “Preserve-and-Fix” method. The “Preserve-and-Fix” method is the idea to take the Affordable Care Act, which was put in place by former president Barack Obama, preserve the parts that are working, and fix the parts that are not. American citizen and business owner Kevin Johnson put this into words in an interview with TIME magazine when he said, “I’m saying, let’s keep the parts that work and fix the parts that don’t.” The current Trump administration is heading toward giving states the right to do whatever they want with the ACA. This is a step in the right direction, but if any real change is going to be made, it is going to have to come from the federal government.
Republican candidates, including 2020 presidential hopefuls, have begun to take back their promises to repeal the ACA. Dave Joyce, a representative from Ohio, voted to abolish the ACA 31 times, but most recently he voted to keep it. Dave Joyce is not an anomaly; Republican representatives and senators alike have begun to vote to keep, or “Preserve-and-Fix” the ACA, despite their previous promises. The ACA is not perfect, as Larry Levitt, senior vice president at the Kaiser Family Foundation puts it, “it’s fair to say it has failed middle-income Americans.” The ACA was an effort to help the people who needed it, but it did some damage to others in the process. Since 2008, the average family’s health insurance premium has increased 55 percent, and deductibles have tripled (S. H. Edwards). When the ACA was passed in 2010, it was partially an attempt to slow these rising figures, as well as protect those with pre-existing conditions and provide necessary healthcare to people who could not get it. The ACA did a few of these things including helping 20 million people get health insurance through Medicaid expansions and federal subsidies, but it did very little to help slow the rising cost of health insurance for middle-income Americans.
One of the main arguments against universal healthcare in the United States is insurance companies would lose revenue, and the government would have too much control over our healthcare, straying from capitalism and creating a socialist state. Insurance companies would not lose revenue because they could be given the right to provide more luxurious levels of healthcare than what the government provides, like elective or cosmetic operations and prescriptions. The government’s universal healthcare program could provide a “base layer” of healthcare, while insurance companies could create optional, cost-effective plans that would cover things such as elective surgeries and office visits. This would promote insurance sales and create new revenue for insurance companies, driving sales and promoting capitalism. Another option for the government would be to run their healthcare program through insurance companies, which would help the insurance companies gain revenue, as well as staying away from having too much government control and creating a socialist state. In France, the government has a universal healthcare system, but 90 percent of French citizens own health insurance above what is provided by the government to the other 10 percent in medical emergencies (Gawande).
Universal healthcare critics have also been claiming it will create a drastic increase in taxes and will only worsen the situation for middle-income Americans. If the government elected to run their program through insurance agencies, the funding necessary for the program would be much lower than if they were to do it by themselves through taxation. The current Trump administration has a focus on lowering taxes, and if they were to adopt a universal healthcare plan, they would more than likely choose the less taxing plan. With this critique comes the argument that it will increase the government debt because they will need to provide funding. In 2013, the Congressional Budget Office calculated that a plan like the “Preserve-and-Fix” plan would reduce the federal deficit by $158 billion over the next decade. Universal healthcare would have positive effects economically in our nation, and in our relations with other countries.
Over $2 trillion is spent every year on healthcare and medicine in the United States; $600 billion of that is administrative costs (Gawande). A new proposal for healthcare could realign these expenditures and balance them as much as possible. The Canadian government is more efficient with healthcare spending; they spend 10 percent of their GDP on healthcare and provide full health coverage for all citizens. The United States spends about 14 percent of its GDP on healthcare, but 45 million Americans have no health insurance, and many more have limited coverage (Jackson Jr.). In 2007, 57 million Americans had difficulty paying their medical bills, up 14 million from 2003. Employers are dropping healthcare because they do not have enough money to provide healthcare policies to their employees. This has even been affecting hospitals; half of American hospitals operated at a loss in 2007 (Jackson Jr.). Nobody has solved the rising cost of health insurance, but some countries have slowed it more effectively than the United States. Optimizing healthcare spending would go a long way to fixing our current healthcare issue and slow rising costs.
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Every developed country compared to the United States has some form of a universal healthcare system. Universal healthcare began in Germany in 1883 and has spread out from there (Formosa). The universal healthcare systems the United States would most likely model a system after are Canada and France. Canada converted to a universal healthcare system in 1984 under the Canada Health Act, and France converted in 1945, at the conclusion of World War II. Similar to the “Preserve-and-Fix” solution, which proposes solutions from within, the “Preserve-and-Copy” solution proposes to keep what works from the ACA, and simply “copy” other countries practices, such as Canada and France. As stated before, even though France has a universal healthcare system in place, 90 percent of its citizens own healthcare insurance on top of what the government provides to them. Successful universal healthcare systems in countries like France, Switzerland, the Netherlands, and Canada, incorporate capitalistic mechanisms to maintain itself like competition, market prices, and consumer choice to prevent too much government control and provide funding for the program. The United States would need to keep this at the forefront of their proposal to adopt a universal healthcare system if they want it to be successful. “Therefore, if there is a lesson which U.S. policymakers can take from National Health Care systems around the world, it is not to follow the road to government-run national health care, but to increase consumer incentives and control.” (Tanner) As Michael D. Tanner states here, government-run healthcare is not the solution to our recurring issue, but government-backed healthcare is necessary to solving the issue. The United States would want to stay away from a system like Britain’s nationally-run service and would want to model more after a system like France in which all physicians practice under nationwide public health insurance. The government would not own the health insurance, then, but a public, government-funded insurance service would cover physicians.
The mental illness issue in America is on the rise, creating issues such as the high suicide rate and school shootings. Nearly one in five American adults lives with a mental illness, with a reported 44.7 million in 2016 (NIMH). The National Institute of Mental Health divides mental illnesses into two categories: mental illness and serious mental illness. Mental illness is defined as a mental, behavioral, or emotional disorder. Serious mental illness is defined as a mental, behavioral, or emotional disorder resulting in serious functional impairment, which substantially interferes with or limits one or more major life activities. To have a real effect on helping mental health, a universal healthcare system would have to cover serious mental illness. This number of mental illness is not going to go down anytime soon either, as it is most prevalent among young adults aged 18-25. The best chance America will have with aiding people with mental illness will be to provide them the chance to get help with their problem, because if it is unaffordable for someone to get help, there is a very slim chance they will get help. Reducing mental illness will also increase productivity in every area of our nation, simply because it is one less thing about which these people have to worry. An increase in productivity will make our country more efficient, and that will reflect positively on President Trump and would raise his approval rating, who is currently scoring poorly on the healthcare aspect of his presidency.
Universal healthcare critics have begun an argument that has been gaining traction recently which is that implementation in the United States would be extremely difficult, or even impossible. In a plan proposed by dozens of top Democrats, including several 2020 presidential hopefuls, the solution for implementation in American would be to provide the care given to people 65 and over, to everyone (Salyer). Another option could be, as stated before, to copy a successful foreign system such as Canada or France. These systems have been put into the world and serviced developed countries very similar to the United States so it is proven they would work. This is further proven by the fact that France’s health insurance costs $2,600 less per capita than the current cost of the United States, disproving the counterclaim that universal healthcare would be more expensive.
The United States is making a mistake by not adopting a universal healthcare plan. The government has multiple options for implementing a universal healthcare plan including “Preserve-and-Fix,” “Preserve-and-Copy,” and Medicare for all. They could also run their program through insurance companies, or to create a “base layer” and allow insurance companies to provide plans above that. Implementation in the U.S. would be difficult, but not impossible. The government should also implement universal healthcare because it would benefit the United States globally, economically, politically, and societally. More specifically, universal healthcare has been proven to work in other countries, it would help to slow rising costs of health insurance, the mental illness issue would decline, and it is what American citizens want.
- Cecere, David. “The Harvard Gazette.” 17 September 2009. Harvard News. 11 December 2018. <https://news.harvard.edu/gazette/story/2009/09/new-study-finds-45000-deaths-annually-linked-to-lack-of-health-coverage/>.
- Edwards, Sweetland Haley. “The Health Care Voters.” TIME 12 November 2018: 41.
- “Formosa.” 17 March 2018. Formosa Post. 12 November 2018. <https://www.formosapost.com/pros-and-cons-of-universal-health-care/>.
- Gawande, Atul. “The United States Can Achieve Universal Health Care Without Dismantling the Existing Health Care System.” Universal Health Care. Detroit: Greenhaven Press, 2010. 190.
- Jackson Jr., Jesse L. “The United States Should Guarantee the Right to Health Care Through a Constitutional Amendment.” Grover, Jan. Healthcare. Detroit: Greenhaven Press, 2007. 28.
- “NIMH.” November 2017. National Institute of Mental Health. 12 December 2018. https://www.nimh.nih.gov/health/statistics/mental-illness.shtml
- Salyer, Kirsten. “TIME.” 1 July 2016. TIME Web Site. 5 November 2018.
- Tanner, Michael D. “CATO.” 23 February 2009. CATO Institute. 12 November 2018. <https://www.cato.org/publications/commentary/universal-health-care-not-best-option>.
- Wilper, Andrew P., et al. “U.S. National Library of Medicine.” December 2009. U.S. National Library of Medicine. 11 December 2018.
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