The Accidental System Essay, Research Paper
Healthcare is an expensive and limited resource in the United States of America.
Healthcare currently accounts for one-seventh of the economy, approximately 1.3 trillion
dollars a year. ?The government spends about half, 75 million dollars, on programs like
Medicare and Medicaid to support the poor and elderly populations. While insurance
companies, out-of-pocket expenses, and charities account for the other half of health
costs? (Markus Nov. 27). Still, there are 43 million people without health insurance, 10
million of which are children. Children and adults in non-western countries enjoy a
national health program where everyone is covered by the government. However the
quality of healthcare received in the U.S. is higher when compared to those of European
countries. The United States is the only industrialized nation not to offer a nationalized
health care program to its citizens. Healthcare is a fundamental right of all people and
should be treated as a national responsibility rather than a marketable good.
The problem with the current health system is that access to coverage and services
has been compromised for large numbers of people, especially the poor and needy and
those with chronic health problems. Individuals and families have seen cutbacks in both
government and employer-sponsored health insurance coverage. Many workers are afraid
to change jobs for fear they will lose their health insurance. Many people are uninsured
because the premiums are too high and insurers prefer to enroll only the healthy. And
many small employers are priced out of the health care insurance market entirely. An
increased life expectancy, consumer demand for top quality health care; rising costs of
health providers and hospitals for medical equipment, nursing home care, prescription
drugs; increased costs of malpractice insurance; and extraordinary improvements in
medical technology have increased the overall cost of healthcare today. But the healthcare
system employed in the United States is structured such that it avoids the ?trilemma? of a
nationalized healthcare delivery system. The trilemma exists in the maintenance of costs,
access, and quality of care. The balance of the three opposing entities is difficult to sustain
with the implementation of a national healthcare delivery system similar to those practiced
in European countries like the Netherlands, Sweden and Germany. Unlike other
industrialized nations that created their health insurance systems through specific
legislation, the U.S. employer-based, ?accidental? system is now the source of coverage
for more than 152 million Americans.
There are two main market perspectives prevalent in health care in America today.
They are free market competition and government regulation. Each approach offers
different costs and benefits, and there is much disagreement as to exactly what those costs
and benefits are. Most people believe that all people are deserving of health care as an
ethical human right and requiring government regulation because the current healthcare
market is not efficient enough to cover all people. The market system does not wo
because there is a lack of information among consumer groups and a lack of equal
accessibility. Government regulation increases equity of access and injects the “values of
political accountability, public access to information, and public participation” (Patel 95).
The insurance industry that currently dominates the healthcare market is driven by market
forces and the pursuit of profit, which in turn has produced an interest in limiting the
accessibility of healthcare. Markets have centralized the goal of insurance companies
around profit-making which has caused insurance companies to under-write those with
pre-existing conditions or high risk people from coverage. The profit-making objective of
the healthcare economic market has lead to terribly high costs, and limited access to the
best available care in the world. The market system can flourish if their is an abundance of
healthcare suppliers, no monopolization of industry, a public informed of their care
options, and interchangeable goods within the healthcare market.
There are 43 million uninsured people an increase from 39 million last year. This
trend of declining health coverage needs to be reversed by making health insurance
affordable for hard-working, low-income families because they make up the largest
segment of the uninsured. With the absence of nationalized healthcare coverage the less
fortunate have a serious difficulty obtaining the care they need and deserve. I would
suggest government subsidies sufficient enough to provide a basic plan that includes
hospitalization and physician benefits, as well as discounted prescription drugs. It is my
belief that the massive codification of our health care system has made the accessibility and
costs less conducive to the needs of deserving Americans. Also I believe that the difficulty
of implementing reform to universal coverage is due in part, to the apathy among the
majority of people who are currently receiving health coverage. ?Two-thirds of the
American people say they favor universal coverage, but the minute you start to spell out
what that means — subsidization for the people who are poor and who are sick, and that
the plan has to be compulsory — they are less supportive? (Kolata 6). Most people are
less likely to support a program that does little in changing their own healthcare coverage
while increasing their taxes. The best way to open the avenues of healthcare coverage is
to reduce the amount of government regulation over state initiated inquiry into more
effective managed care regulation which would result in better 21st century health
management. Nonetheless there should be a social responsibility to provide health care to
everyone because it is something all people should care about and recognize as a problem
worth solving.
Bibliography
Patel, K, Rushefshy, M, Health Care Politics and Policy in America M.E. Sharpe, Inc.
Armonk, NY, 1995
Kolata, Gina (2000) “A conversation with Victor Fuchs: An economist’s view of
health care reform,” New York Times, May 2, Section F; p. 6.
Markus, Gregory B. Poltical Science 300 Lecture. University of Michigan, 27 November
2000.