I was excited about the Patient Protection and Affordable Care Act (Obamacare) from the get-go. The U.S. desperately needed this reform. Compared to other First World countries, the U.S. is far behind in providing adequate social safety nets for its citizens, especially in regards to health care. For instance, 137,000 people died over seven years because they were uninsured.[i] That number is unacceptable and could’ve easily been decreased with greater accessibility.
A major problem that plagues the United States’ health care system is how inopportune accessibility is. Health insurance is often too expensive to buy or too difficult to get. Private insurance companies are for profit, not for a person’s health. This is true. Just look at insurance companies denying people coverage based on pre-existing conditions. Government-issued health insurance is needed to make the system and its ideology change from profit-driven to people-driven.
The U.S. is a great country to live in if you’re young and healthy, but many people do not fall under both groups; a great number of people need more help—last year around 50 million people lacked health insurance.[ii] Health care premiums more than doubled over the past decade for families, leaving it too expensive to buy coverage. Additionally, for the most part, no one buys health insurance until they absolutely need to go to the doctor, which increases the cost, too.
To fight against rising costs, the reformers included a mandate; everyone must get some form of insurance, which is crucial to the success of the health care reform bill—it’s also the most controversial facet. The reform allowing for universal coverage only works if everyone pays into it (you spread the cost, you spread the risk). One reason why insurance is so expensive is because many people only purchase insurance when they are truly sick and need it, thus insurance companies increase cost to cover their expensive customers. Imagine how expensive auto insurance would be if only drunk and negligent drivers are buying it. Certainly, it would be costly! If everyone, sick and healthy, buys insurance, the costs will go down because not everyone will be using it.
In addition, since mostly sick people are seeking and purchasing insurance, a trend of denying people for preexisting conditions or dropping people from their existing plan has erupted—which, as a matter of fact, has happened to me many times. The health care reform would also eliminate that happening.
Another good reason to increase accessibility is because uninsured people can also reflect poorly on society by causing an observable blemish to exist. A person can be young and successful one day, become seriously ill the next, then have a burdening hospital bill which leaves him or her penny-less, literally overnight. One huge benefit of public financing is that this would never happen—well, at least not because of hospital bills, anyway. A person would never have to sell their house, work multiple jobs or have to sacrifice their children’s education by using their savings to pay for hospital bills.
There are many cases where people fall deep into poverty because of a hospital bill. Hospital bills can, and often are, outrageously high. For instance, in my last blog I talked about my recent flare-up with Crohn’s disease. My four-day stay in the hospital with the two emergency room visits was around $30,000. That’s just shy of the average yearly income for many states in the U.S. Just imagining the burden and the stress of having to pay these large bills would probably land the person back into the hospital, ergo increasing his or her bills further. A person with high medical bills and no assistance can and do eventually fall into poverty. So, in addition to having bad health, he or she can no longer afford his or her home, provide for their family, etc. The U.S. already has a very high homeless population for a plethora of reasons. We shouldn’t allow medical bills to be another contributing factor.
In a country that has universal health care like Great Britain, for example, you can get a liver transplant, a procedure that costs tens of thousands of dollars, but the patient doesn’t pay a thing. A patient may live their whole life without hearing the words “it costs” or “here’s your bill.” This is done by an increased tax rate. Generally, Americans upon hearing “tax increase” go into a panicked frenzy and scream for blood. But, in regards to health care, the upside of a tax increase is fruitful and will help millions. People will be insured and won’t have to worry about the cost of a procedure, routine check-up, or whatever. And there are alternatives, heterodox things to tax besides people, if you’d like. Soda tax, anyone? Taxing soda would put a lot of money into the government’s pockets with the only side effect being, decreased obesity and diabetes. By 2030, the obesity rate in the U.S. is predicted to increase to 42 percent.[iii] We should be increasing or having special “bad food” taxes on everything from candy bars to fast food corporations. There would be lots of money to be made and healthier people resulting.
Many countries consider these unfortunate outcomes—poverty, homelessness, hunger, etc.—and develop safety nets to ensure that people are supported, no matter what happened in their life. For instance, the Netherlands finds investing in human capital to be considerably beneficial to their country—and, it’s a wonderful thing!
When I travel, I frequently come across people from all over the world, mostly Europeans, though, who are quick to criticize the U.S. over many things—our foreign policy, FOX News, death penalty, obesity, our famed stupidity, to name a few. But mostly, they criticize the U.S. as being a country that doesn’t care about or take care of its people; a backwards nation. Most recently a Dutchman told me, “… in the Netherlands we have great safety nets because we believe people should live good lives. For example, we don’t want sick people not getting better, we don’t want homeless people not getting homes and we don’t want jobless people not being able to afford food and education. What good are these people to society? To the country?” What he was saying is, if a person is down for whatever reason, health, no job, etc. they are not contributing to society, to the country—this includes not paying taxes. The Netherlands invests in its people’s well-being as they believe that people are worth investing in because the country prospers as a result of it. A great idea! Many Americans are overweight, sick, poorly educated, penny- and job-less. Perhaps it’s about time we invest in them and get back on track.
Tuition rates for college over the past 10 years have been having double-digit increases, while not coincidentally, government funding has been going down. There is something fundamentally wrong with that. A lot of that is George W. Bush’s fault for going to war, while simultaneously decreasing taxes. In every other major war in American history, the president expected everyone to contribute—even the rich, as taxes were always increased to pay for it. Unfortunately, contemporary conservative ideology is, we won’t hesitate to go to war, but we won’t pay for it. In fact, we didn’t pay for it, the Chinese did.
The U.S. government is not always an effective, cost saving, well-greased machine, but in regards to health care, indubitably money would be spent more carefully and effectively, resulting in increased efficiency and lower costs. Private insurance companies are highly inefficient. For instance, in a Fareed Zakaria report, “The least efficient payers in the world are the American private insurance companies. They have administrative costs of 20 to 30 percent. That’s a 30 percent tax on every dollar you spend on health care. Britain is totally socialized medicine [and its] administrative costs [are] 5 percent. Canada is private doctors and public payers – 6 percent administrative costs. So it turns out, for some reason in health care, governments are doing this more efficiently than our private sector.”[iv]
Having greater efficiency would do a lot to reduce costs and improve our overall health care system—faster, better and cheaper. No matter in what field, we should always strive to be better and make things better. If a car gets 50 MPG, why not push for 51? We landed on the moon, now let’s get to Mars. The health care reformers have this attitude and we should embrace it.
Having universal access to health care would increase life expectancy, the prevention of disease and disability, quality of life, detection and treatment of health conditions and preventable deaths.
According to David Brown of the The Washington Post, “The United States is showing decreasing or stagnating life expectancy even as the nation’s overall longevity trend has continued upwards… In one-quarter of the country, girls born today may live shorter lives than their mothers, and the country as a whole is falling behind other industrialized nations in the march toward longer life.”[v] Factors such as obesity and smoking contribute to that, but also, a difficulty in accessing health care. Additionally, by not having to fork over loads of money to health care, people could afford to buy better, healthier foods or get a gym membership.
Generally, people do not eat fast food because it is delicious—it’s not—but because it’s cheap. Having better eating habits would increase our overall health and increase our life expectancy, but good eating habits are also expensive. I know this to be the case as I almost exclusively eat local and organic foods. Also, studies show that eating well increases our brain functions, leading students to do better in school, thus improving our declining educational system.
As aforementioned, one major problem with our health system is accessibility. Nicholas Kristof of The New York Times mentions in one of his articles about the need for greater health care accessibility, “Great health care is often less about breakthrough technologies than it is about access. And for all the disagreements about President Obama’s health care proposal, let’s focus on this: it unquestionably would increase access, while its defeat would diminish access.”[vi] Mr. Kristof then goes on to say, “Our children are two-and-a-half times as likely to die before the age of 5 as children in Sweden.” And, “The average person in Honduras or Vietnam is expected to live longer than the average African-American in New Orleans.”[vii] His examples show the sad reality of what low access to heath care brings. What’s even more discouraging, if the Obama’s health care reform gets overturned, which it likely could since five of the nine supreme court justices are conservative, the above trend is only going to get worse.
Even though Obama’s health care reform can help millions, there are many critics. Many of these critics say, the reform dispossesses a person of his or her choices; yet another freedom stripped away. Their reasoning for this is because the health care mandate provision pushes people into buying insurance by penalizing them if they don’t. “Obama can’t tell me what to do! It’s unconstitutional!” they trumpet. Yes, everyone has to have health care coverage—no option there, but in actuality, it gives people greater choice. It only superficially decreases rights. By having both a public, government backed insurance option—which is the more affordable alternative—and a private insurance option, people would have greater selection of policies to choose from that fits their need and budget. There would be an accessible option for everyone, poor or rich, leading to universal coverage. No longer will people have to suffer because they cannot afford insurance premiums.
Critics also say, Obama is a socialist for his wanted health care overhaul, but according to the Heritage Foundation, Switzerland has greater economic freedom than the U.S., but they still have universal health care—which is powered by an individual mandate.[viii] Interestingly enough, that’s proof that we can be a capitalistic country and still have universal health care. And, because I am a China academic, I’ll say that State Run Capitalism, or whatever you want to call the People’s Republic of China’s (PRC) political system these days, can work. Although the PRC’s health care model is not one we would want to follow, they certainly do other things quite well. Obama is not a socialist, though.
Many times, listening to Conservative and Tea Party people I get the impression they are saying, “I (and my family) am young, strong and healthy and neither need nor want health care from my government and I certainly do not want to pay for someone else’s health care. If I decide I want this I will pay for it myself or get it through my job.” There are only two things wrong with this statement. First, why should your job have to pay for your health care? Just because we as a nation of job seekers started giving health care insurance as a work benefit does not mean it is still a good idea today when we are in competition with the world to manufacture goods cheaply. Secondly, most people do not realize that we, as a nation, are already paying for everyone’s health care, it just isn’t obvious. The following is a list of sources, which pay very substantial amounts into our health care money pool:
1) The Federal government essentially covers all its employees through a variety of means of insurance. This includes not only our elected officials, but appointed officials like judges and regular employees like clerks and Forest Rangers too.
2) Every state covers its elected officials and regular employees with some kind of health care coverage.
3) Most cities, counties and municipalities provide health care coverage for elected officials and their employees.
4) Medicare covers everyone over 65 years of age.
6) Many companies and corporations provide health care coverage for their executives and employees.
7) Many people, including self-employed pay for their own insurance coverage.
8) Many people pay medical expenses out-of-pocket or on an installment basis. Even with insurance there are usually expenses and co-pays, which wind up being paid this way.
9) The Veterans Administration (VA) operates a complete medical/ hospital system for veterans in and out of the Armed Forces. VA programs may also provide coverage to family members of veterans.
10) The Medical Assistance (MA) program usually operates as a county program funded by property taxes, but it also receives monies from State and Federal sources. The MA program covers uninsured or under insured people who meet certain income requirements.
11) By law doctors, hospitals and clinics must provide a certain amount of services free as determined by law and their boards of directors.
12) There are also special situations where people are a ward of the State, committed to an institution or in prison, where the State is committed to taking care of individual medical needs.
There is some expert thought that there is plenty of money to provide for every person in the country except that it is so inefficiently spent on administration and duplication of services. Also, there’s and ideological difference, with half the people saying, people should take care of themselves or we shouldn’t have government involvement. However, people are not always in a position to take care of themselves. If they could, there wouldn’t be as many deaths or homeless. If you are under the impression that people want to be homeless or die because they can’t afford a procedure, you’re wrong. We need government involvement because it’s the only valid way to provide access to health care to everyone. It’s evident that private insurance companies are not solely the answer. We must get creative, and take from countries that do health care well, like Sweden, and look into ways to improve upon it. Other First World countries make it work, and we should, too.
For many reasons, I support President Obama and his health care reform. Is it perfect? No. Nothing is. But, it’s undoubtedly a step in the right direction.
[i] Zakaria, Fareed. “Zakaria: Private Health Insurance Is Not Efficient.” “Global Public Square. 16 Mar. 2012. Web. <http://globalpublicsquare.blogs.cnn.com/2012/03/16/zakaria-private-health-insurance-is-not-efficient/>.
[ii] Million, NEW YORK (CNNMoney) — The Number of People Who Lacked Health Insurance Last Year Climbed to 49.9. “Number of People without Health Insurance in U.S. Climbs.” CNNMoney. Cable News Network, 13 Sept. 2011. Web. <http://money.cnn.com/2011/09/13/news/economy/census_bureau_health_insurance/index.htm>.
[iii] Brown, David. “Study Predicts 42 Percent of Americans Will Be Obese in 2030.” Washington Post. The Washington Post, 08 May 2012. Web. <http://www.washingtonpost.com/national/health-science/study-predicts-42-percent-of-americans-will-be-obese-in-2030/2012/05/07/gIQAeaDL9T_story.html>.
[iv] Zakaria, Fareed. “Zakaria: Private Health Insurance Is Not Efficient.” “Global Public Square. 16 Mar. 2012. Web. <http://globalpublicsquare.blogs.cnn.com/2012/03/16/zakaria-private-health-insurance-is-not-efficient/>.
[v] Brown, David. “Life Expectancy in the U.S. Varies Widely by Region, in Some Places Is Decreasing.” Washington Post. The Washington Post, 15 June 2011. Web. <http://www.washingtonpost.com/national/life-expectancy-in-the-us-varies-widely-by-region-and-in-some-places-is-decreasing/2011/06/13/AGdHuZVH_story.html>.
[vi] Kristof, Nicholas D. “Access, Access, Access.” The New York Times. 17 Mar. 2010. Web. <http://www.nytimes.com/2010/03/18/opinion/18kristof.html>.
[vii] Kristof, Nicholas D. “Access, Access, Access.” The New York Times. 17 Mar. 2010. Web. <http://www.nytimes.com/2010/03/18/opinion/18kristof.html>.