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Universal Health Coverage - Essay Example

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The paper "Universal Health Coverage" describes that despite the United States being the richest nation in the world, it still does not have universal health coverage. This is attributed to various factors: high-cost medical care since most medical facilities are operated as private businesses…
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Universal Health Coverage
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Universal Health Coverage s A developed nation implies that the health caresystem functions efficiently. Since universal health coverage involves extension of health care, its implementation is via statutes, legislation, and taxation. Most developed nations have initiated global medical care coverage, the United States still does not have universal health coverage due to the high minimum standards. The majority of the population cannot access adequate health care, and this has been termed as a crisis. There are divided opinions on whether the universal health care should be implemented. The high cost of the multi-payer system is at the core of the unsustainable medical care costs in America. Medical care does not obey the laws of demand and supply. This makes the seller set the price as far as they can. In the U.S, the price has been set too high making it impossible to provide universal health care. The federalism form of government also makes it difficult to initiate changes to government policies. Furthermore, America does not have a uniform medical care system, making it difficult for the implementation of universal health coverage. The nation has substitute programs that have extended insurance coverage to the legal American citizens in place of universal healthcare coverage. There are already costly related programs, such as Social Security Disability Insurance. If the universal health coverage is implemented, it will put the American firms at a global competitive loss. Next, the insurance policies that have been bought abroad stops being effective in America, especially for those people travelling from the home countries to the U.S. Universal health care coverage would reduce the competition the competition between the American biotechnological and pharmaceutical sector that has resulted in numerous medical breakthroughs. These issues have made it difficult for the United States to have universal health coverage. Introduction Health care is a very crucial component in any economic system. Borger et al. (2006) observe that universal health coverage entails some certain form of government action that is aimed at expanding medical care as far as possible in addition to setting minimum standards. Numerous distinct organizations in the U.S provide medical care. Most of the medical care facilities are operated and owned by the private sector enterprises. Statistics have indicated that about 56% of the American community hospitals are non-profit, with the remaining 22% are either state-owned or operate as non-profit organizations (Niles, 2014). The U.S spends more on the well-being of its population as percentage of the gross domestic product (GDP) in contrast to any other developed nation. In 2013, the nation $2.8 trillion on health care alone. This is 750 billion more than the per capita costs of health care in other developed nations. The majority of the spending in health care goes to programs, like the Veterans Health Administration, Medicaid, Medicare, and the Children’s Health Insurance Program. An estimated 50.8 million Americans do not have access to adequate medical care. A study conducted by the Harvard Medical School established that about 45,000 deaths occur every year in the U.S due to lack of access to medical care. Even though it is very expensive to acquire medical care, there is still debate on whether to implement the universal health coverage or not. To that effect, drawing on a variety of sources the paper will discuss why in spite of most developed nations having universal health coverage, the United states, despite being the richest nation does not have it. Discussion In 2012, a report by the Institute of Medicine reported that the U.S is among the few developed nations across the world that do not guarantee access to medical care to its citizens. There is an ongoing political debate on the quality, efficiency, and access, as well as the sustainability of the American health care. If the government-authorized system of universal health to be ratified in America remains a hotly debated subject. Most people across the nations are divided along party affiliations with regard to their opinions on the American health care system and what needs to be done to improve it and even provide universal medical coverage. The proponents of the debate claim that many uninsured American citizens create a direct along with hidden costs that is shared by all. Therefore, by expanding coverage it would result in the reduction of costs. Contrarily, the opponents of universal coverage argue that the scatteredand localized insurance firms are too small to do that. Besides, the provision of the universal coverage would mean higher taxes. On one hand, the Democrats posit that the single-payer medical care system is the most efficient. On the other hand, the Republicans put forward the view that there is need to provide tax breaks both to the people and businesses who buy health insurance (Ketelaar et al., 2011). This differing views have made the U.S not have the universal health coverage. Most of the hospitals are operated as private entities (Institute of Medicine, 2012). The cost of accessing medical care extremely high. In 2014, an estimated $3.1 trillion was spent on medical care as compared to $2.8 trillion in 2013 (Martin et al., 2014). Currently, the American medical care costs are more than 17 % of the GDP and continue to rise (Burnham, 2014). In the past decade, the insurance costs have also been on the rise. Kelley et al., (2012) asserts that due to the high cost of medical care, most people cannot purchase insurance coverage. About 62% of all the American bankruptcies are a result of unpaid medical bills (Burham, 2014). Ketelaar et al. (2011) share the view that there has been a change in the way medical facilities are operating. Most of them have turned out to be profit generating organizations making health care, nearly inaccessible to the majority of the American people. The hospitals are setting their fees for their services and products according to a hugely inflated pricing scheme bearing no relationship to cost as compared to other developed nations. In the same way, most of the American hospitals have highly paid physicians. Therefore, Burnham (2014) evidences that some health professionals, especially those in the private hospitals argue that universal coverage would lower their wages. Besides that, America does not have a universal health care system due to high drug prices as compared to other developed nations. Martin et al. (2014) share the evidence that under the current health care system, the drugs are so inflated to the extent that if the pharmaceutical prices were to be controlled at the same level like in other developed nations. It would result in more that $90 billion in savings every year as well as 25% in Medicare. In the U.S, the higher drug prices are attributable to the American consumers who are subsidizing costs that the drug firms cannot recover; while most industrialized nations use the power of bulk-purchasing to negotiate aggressively for the drug prices. There is stiff competition between the biotechnological and pharmaceutical companies in the U.S. being the fastest growing sectors in America, the universal health care would reduce their growth and development because the government would also insist of sharing the profits accrued by these firms. As this would negatively impact on the revenues of these industries, and later drive them out of business. The competition between these two entities has tremendously assisted the medical community and their elimination via universal health coverage would lead to various challenges in the healthcare system, especially in the production of drugs and other medical biotechnologies. There has been tremendous growth to the level that the nation’s gross domestic product has exceeded those nations with universal medical care systems (Blumenthal & Collins, 2014). About 59% of the American health care system has already been financed by the government through taxes. Therefore, the addition of another program that will also be financed by the government by means of subsidies and taxes would result in a financial strain to the government. Blumenthal and Collins (2014) share the evidence that people visiting the United States cannot buy a health insurance that is available for American citizens as well as permanent residents. Unlike other developed nations where the visitors who have insurance policies purchased domestically still remain effective while in that country, the domestic insurance policies bought abroad cease being effective once in America. These variations in applicability of domestic insurance policies are effective when a person crosses from their home nation during international travels. Proceeding further, immigrants make a significant number of the global population in various countries. Whereas in other industrialized nations both legal and illegal immigrants can be provided with health insurance, in America; it is only the legal immigrants that can be accessed to health insurance. This has been attributed to the recent health care changes (Blumenthal & Collins, 2014). The private insurers charge considerably higher administrative costs as compared to non-privatized counterparts, such as Medicaid. This is attributable to the logistical challenges associated with numerous insurance plans along with carriers. As a consequence, the private insurance systems inevitably increase the cost of health coverage (Wilper, 2009). Based on the idea that the American government is not directly involved in the management of the healthcare system and it requires the mixed utilization of private-public health care systems to deliver universal coverage, this makes it hard for the U.S to provide the global medical cover. This is because there is minimal interaction among private, public, and government-owned health care facilities. This translates to a high cost of medical care which make the citizens unable to buy the health insurance (Baicker & Finkelstein, 2011). Considering that in a universal health care system there is the provision of healthcare coverage to any willing person, the program is funded by government taxes. In the U.S, most of the government funds have been channeled to Medicare and Medicaid (Niles, 2014). However, these programs do not count as universal health care due to the fact that they target a certain group of citizens. America does not have universal health care coverage is that in spite of a considerable number of people being uninsured citizens, most of the population already has coverage. It is projected that all these people will keep the same coverage (Young, 2014). Figure 1: Americans With health insurance (Young, 2014) [Adopted from the U.S Census Bureau data]. The other reason why the U.S does not have a universal health care system is that there are substitute programs that have expanded insurance coverage to the legal American citizens. The Health Care and Education Reconciliation Act of 2010 formerly Patient Protection and Affordable Care Act has attempted to extend insurance coverage to the legal American citizens. The federal government would subsidize the legal residents of America of households with an income of up to 400 percent of the nation’s poverty level. This has resulted in a drop of those who are uninsured from 17% in 2013 to 13% in 2014 (Blumenthal & Collins, 2014). In a move to rectify the medically induced bankruptcy, the law does not allow insurers to cap the liability of an individual’s health care needs. Kelley et al. (2011) add that the maximum “out-of-pocket” pay has been reduced from 9.8 percent to 2 percent. The costs of these conditions are offset by various fees and taxes, together with cost-saving measures, for instance, the Medicare taxes for the high-income people, feed on medical gadgets and pharmaceutical firms, and taxes on indoor tanning. Young (2014) shares the view that according to the U.S Census Bureau, both the Children’s Health insurance and Medicare cover an estimated 60 million people from low income households. The Medicaid is projected to grow by millions under the Obama care. The other reason why the U.S does not have a universal health care system, yet it is the richest nation in the world is that the employer-based insurance system in the U.S that drains businesses; while the health insurance premiums increase digging further into the profit margins of the employers. This undermines the ability of the enterprise to invest in expansion (Niles, 2014). The removal of employer-based coverage has been to some extent offset by increased enrollment in Medicaid that has been to offer a safety-net for the lowest income Americans. Based on the view that health insurance costs are developed on prices of American products, the businesses in the developed nations are responsible for shouldering most of the workers health insurance costs. This puts the American firms a loss on global competitiveness (Niles, 2014). This explains why the nation does not have a universal health care system yet. Next, programs such as the Social Security Disability Insurance as well as the criminal justice system would have higher costs as compared as they have now if there would be universal medical care coverage (Niles, 2014). Lastly, Santerre and Neun (2011) argue that the health care systems in most developed nations started to change in the 19th century with equity as the major objective. The U.S largely resisted the movement to universal health insurance because of a general distrust of the government, a highly heterogeneous population, and a move to commitment to individual freedom in contrast to equality reasons. Other health economists have argued that the federalism form of government makes is very hard to ratify across-the-board changes in government policies. Conclusion In summary, despite the Unites State being the richest nations in the world, it still does not have the universal health coverage. This is attributed to various factors: high cost medical care since most medical facilities are operated as private businesses; the ineffetiveness of domestic insurance policies bought outside the U.S; the people are also divided along party lines with regard to the implementation of the universal health coverage. The implementation of the universal health care is through legislation, regulation and taxation, which has been impeded by the varied opinions; the U.S also does not have a uniform health system, stiff competiton between the American biotechnological and pharmaceutical sector has resulted in numerous medical breakthroughs and universal health coverage would hinder the growth of these industries, presence of substitute programs that have extended insurance coverage to the legal American citizens, high costs of related programs, and the federalism form of government also makes it difficult to make total changes to government policies. Universal health care systems have their pros and cons. In this regard, the topic of universal health care coverage remains a highly debatable topic. References Baicker, K., & Finkelstein, N. (2011). "The Effects of Medicaid Coverage, Learning from the Oregon Experiment," Engl J Med, 365(8):683-685. Blumenthal, D, & Collins, R. (2014). “Health care coverage under the Affordable Care Act: A progress report,” New England Journal of Medicine, 371 (3): 275–81. Borger, C., Smith, S., & Truffer, C. et al. (2006). "Health spending projections through 2015: changes on the horizon". Health Aff, 25 (2): 61–73. Burnham, J. (2014). Health Care in America: A history, New York: Routledge. Institute of Medicine. (2012). How far have we come in reducing health disparities?: Progress since 2000: Workshop summary. Washington, DC: The National Academies Press. Kelley, S., McGarry, K., Fahle, S., Marshall, M., Du, Q., & Skinner, S. (2012). "Out-of-Pocket Spending in the Last Five Years of Life". Journal of General Internal Medicine 28 (2): 304-309. Ketelaar, A., Faber, J., Flottorp, S., Rygh, H., Deane, H., & Eccles, P. (2011). "Public release of performance data in changing the behaviour of healthcare consumers, professionals or organisations," Cochrane Database Syst Rev 11 (11): CD004538. Martin, B., et al. (2014). "National health spending in 2012: Rate of health spending growth remained low for the fourth consecutive year." Health Affairs 33(1): 67-77. Niles, N. (2014). Basics of the U.S. Health Care System . New York: Sage. Santerre, R., & Neun, ‎. (2011). Health Economics. New York: Cengage Learning. Wilper, P., Woolhandler, S., Lasser, E., McCormick, D., Bor, H., & Himmelstein, U. (2009). “Health insurance and mortality in US adults,” American Journal of Public Health 99 (12): 2289-2295. Young, J. (2014, February 2). Heres why the richest nation in the world still cant get health care right. Retrieved April 4, 2015 from http://www.huffingtonpost.com/2014/02/13/american-health-care_n_4718923.html . Read More
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