- Area: Social Sciences
- Program: Political Science
- Type of Writing: Essay (Analytical, Interpretive)
- Course Level: 1000
- Year: 2019
- Paper ID: SS.P.S.E.184.108.40.2066
Analysis of a Current American Issue – Access to Affordable Healthcare
Lack of affordable healthcare is an issue facing millions of Americans today. For millions of Americans the reality of their situation comes down to choosing to pay their rent or paying for high insurance premiums. According to the Current Population Survey Annual Social and Economic Supplements (CPS ASEC), in 2017, 8.8% of people, or 28.5 million people in the United States did not have health insurance at any point during the year. (US Census Bureau 2019). This is not surprising considering that the price of healthcare for the average American accounts for almost a third of their wages. According to the National Conference of State Legislators “In 2018 the average annual premium for employer-based family coverage rose 5 percent to $19,616; for single coverage, premiums rose 3 percent to $6,896.” (Cauchi & Garcia) When the average American household in 2017 took home $61,372 annually according to the U.S. Census Bureau. (US Census Bureau 2018) And that is just the insurance premium. Many of these insurance plans are high-deductible plans, meaning that patients must meet a certain out-of-pocket limit for their health insurance to contribute. Christina LaMontagne, Vice President of Nerdwallet Health, a company that analyzes and compares health care prices, said “A lot of Americans are struggling with medical bills … If you have an out-of-pocket maximum of $5,000 or $10,000, that’s really tough.” (Mangan 2013) The average deductible an American can expect to pay according to the International Foundation of Employee Benefit Plans is $1,491 with single coverage and $2,788 with family coverage. (International Foundation of Employee Benefit Plans) This out of pocket deductible is the average amount of money a family must come up with in addition to their annual insurance premium costs to be eligible for partial coverage from their insurance company for additional health care costs. This lack of affordable healthcare means that many families are having to go without care, and sometimes without insurance as a whole, to make ends meet.
One of the proposed solutions to this lack of affordable health care is a socialized healthcare system implemented by the U.S. government. Socialized healthcare or universal healthcare defined by the World Health Organization, “means that all people and communities can use the promotive, preventive, curative, rehabilitative and palliative health services they need, of sufficient quality to be effective, while also ensuring that the use of these services does not expose the user to financial hardship.” (World Health Organization 2019) Universalized healthcare is a system that many developed countries have embraced worldwide including Germany, The United Kingdom, Canada, Japan, Singapore, and Australia to name a few.
One of the arguments that some Americans have against universalized healthcare is that the quality of healthcare would undoubtedly suffer. It is supposed that if competition were eliminated, premiums were reduced, and if we were to transition to a socialized system, the quality of our care would naturally decrease. However, evidence that compares our healthcare system to other systems around the world suggests that this may not be the case. Even though the United States spends more per capita than any other country on health care, they are ranked poorly among other developed nations. According to the journal “Health care in the United States—basic human right or entitlement?” published in the Annals of Oncology by G. H. Jones and H. Kantarjian, “The United States is the richest nation in the world, and we spend more on health care than any other nation (18% of our gross domestic product; two to three times more than other advanced nations). Yet, we rank poorly in objective measures of health care outcomes. Among 16 high-income nations, the United States ranks low in avoidable mortality.” In fact, “Americans also rank 27th (of 34) in life expectancy.” (Jones 2015)
This disparity between quality of healthcare and the high price that Americans pay may be since less than a third of the amount of money that is paid into the healthcare system is actually used towards patient care. Later found in the article by G H. Jones and H. Kantargian, “In the United States, less than one-third of the dollars are vested in patient care. The rest is diverted toward profits for the healthcare industry: high costs of hospital care; expensive procedures, drugs and devices; physicians’ fees; ancillary services; excessive administrative bureaucracy and regulations; and high salaries and bonuses to health care associates.” (Jones 2015)
Another argument against universalized healthcare is that access to healthcare for everyone would mean overcrowded emergency rooms and longer wait times to see doctors. And this phenomenon has been documented in the case of Medicaid. According to a Government Accountability Office report, “9.4 percent of Medicaid beneficiaries indicated that they delayed medical care because they could not get an appointment soon enough, or once they arrived for the appointment, the wait was too long. In contrast, 4.2 percent of individuals with private insurance reported delaying care because, once they arrived for the appointment, the wait was too long.” (Office, U.S. Government Accountability 2012) While an increased wait time for patient care may be a result of a socialized health care system, this sends an undeniable signal to the healthcare industry that there is a lack of resources. This deficiency is not something that should continue to be ignored and could be supplied with additional trained professionals. This lack is something as a country we could work to address by creating incentives such as subsidies for students that choose to pursue their education in health care.
Some argue that socialized healthcare should not be implemented in the United States because healthcare is not a basic human right, nor is it guaranteed to us anywhere in the constitution. It has been contested by many Americans that they do not wish to “foot the bill” for the poor choices other people make in regard to their health. In “Health care in the United States—basic human right or entitlement?”, it is explained that this idea may be traced to ideas rooted in Darwinism, “The reluctance of the United States to embrace universal health care may be traced to some earlier ideological movements. The writings of William Graham Sumner had a profound effect on America in the last three decades of the 19th century” … “It was based on the notion that the population was increasing geometrically but resources were increasing arithmetically. ‘Civilization has a simple choice,’ Sumner said, ‘liberty, inequality, survival of the fittest,’ or ‘not-liberty, equality, survival of the unfittest.” (Jones 2015)
While some citizens of the United States may be guided by these early ideologies, much of the world has already declared health care as a basic human right. Found in the article, “Constitutional rights to health, public health and medical care: The status of health protections in 191 countries.” it is documented that the United Nations recognized the “right to health” in its foundational document, the 1948 Universal Declaration of Human Rights. (Heymann, Cassola, Raub, & Mishra 2013) According to G H. Jones and H. Kantargian, “The United States, Mexico, South Korea, and Turkey are the only member nations of the Organization for Economic Cooperation and Development that do not recognize universal health care as a basic human right.” (Jones 2015) And while healthcare is not explicitly stated as a basic human right in the United States constitution, it is clearly stated in the Declaration of Independence, “We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty and the pursuit of Happiness.” (US History) And it could be argued, that if one is subjected to a life of limited access to basic healthcare their right to life and the pursuit of happiness is being infringed upon.
While universalized healthcare may not be a basic human right that is agreed upon by everyone, in my opinion it is a step in the right direction to preserve human dignity. If an individual or family must choose between paying for their basic needs such as putting food on the table or paying to see a doctor, this a problem. Because we are one of the wealthiest, most developed nations on the planet, it is my opinion that we should have a system that guarantees all citizens access to the necessary medical interventions that exist today. If this may require additional resources devoted to the healthcare industry, so be it. It is my opinion that the health and wellbeing of us all should be prioritized over profits. As said by Mahatma Gandhi, “It is health that is real wealth and not pieces of gold and silver.”
“Average Health Care Deductible Nearly $1,500 for Individual Coverage Through an Employer Plan.” IFEBP, International Foundation of Employee Benefit Plans, www.ifebp.org/aboutus/pressroom/releases/Pages/Average-Health-Care-Deductible-Nearly-$1,500-for-Individual-Coverage-Through-an-Employer-Plan.aspx.
Cauchi, Dick, and Alise Garcia. Health Insurance: Premiums and Increases, www.ncsl.org/research/health/health-insurance-premiums.aspx.
Heymann, Jody, et al. “Constitutional Rights to Health, Public Health and Medical Care: The Status of Health Protections in 191 Countries.” Global Public Health, vol. 8, no. 6, 2013, pp. 639–653., doi:10.1080/17441692.2013.810765.
Jones. “Health Care in the United States-Basic Human Right or Entitlement?” OUP Academic, Oxford University Press, 13 Aug. 2015, academic.oup.com/annonc/article/26/10/2193/144592.
Mangan, Dan. “Biggest Cause of Personal Bankruptcies? Medical Bills.” CNBC, CNBC, 24 July 2013, www.cnbc.com/id/100840148.
Office, U.S. Government Accountability. “Medicaid: States Made Multiple Program Changes, and Beneficiaries Generally Reported Access Comparable to Private Insurance.” U.S. Government Accountability Office (U.S. GAO), 15 Nov. 2012, www.gao.gov/products/GAO-13-55.
“The Declaration of Independence: Full Text.” Ushistory.org, Independence Hall Association, www.ushistory.org/declaration/document/.
US Census Bureau. “Income, Poverty and Health Insurance Coverage in the U.S.: 2017.” The United States Census Bureau, 12 Sept. 2018, www.census.gov/newsroom/press-releases/2018/income-poverty.html.
US Census Bureau. “Health Insurance Coverage in the United States: 2017.” Health Insurance Coverage in the United States: 2017, 16 Apr. 2019, www.census.gov/library/publications/2018/demo/p60-264.html.
“What Is Universal Coverage?” World Health Organization, World Health Organization, 18 Apr. 2019, www.who.int/health_financing/universal_coverage_definition/en/.