Should the United States adopt a Universal Health coverage system? Germany, the Netherlands, Japan, and in the United States Hawaii, all use a system of health care that is universal, comprehensive, and private. In, 1993, President Clinton proposed a plan for universal health insurance. Since then opponents have managed to oppress the plan while assuring the public that while they supported the idea in principle, they just wanted to package it in a better way. Major changes in the present healthcare system will have consequences for nearly all Americans, as would the decision not to reform the system. The politics of health care involves at least four different interrelated aspects. The United States should adopt a Universal Health-Care system based on; the rate at which health care costs have risen in recent years, the large number of Americans without health insurance coverage, the disproportionate care based on racial and a socioeconomic divide and an aging population. The aspect of the healthcare issue that is most visible is the cost of medical care in the United States. The cost of health care in America is the highest in the world when measured either as a percentage of gross national product or as cost per person. The health care costs in the United States are estimated to approach $2 trillion dollars by the end of 2000. This is more than $3 billion per day, or $3600 per person. Healthcare costs in the United States have increased three to four times the rate of inflation. An average American who spends 11.1% of their income on medical care can expect that number to increase to a staggering 17% in the next fifteen years. One can attribute skyrocketing health care costs to the administrative costs of insurance companies. There are about 1500 insurance companies using a bewildering array of forms and procedures in processing claims. One estimate is that this administrative system costs more than $100 billion per year. This means that between 10 and 15 percent of health care expense’s result from the costs of processing claims for reimbursement. More than any other aspect of the healthcare issue, it is cost that is driving the debate about the need for reforms. The second aspect of the healthcare reform issue is coverage. Most Americans have reasonably good healthcare insurance, provided most often by their employer. However, a significant number of Americans, estimated at around 49 million, have no healthcare insurance. Most are working people (and their dependents) whose jobs do not provide health insurance as a fringe benefit. Other uninsured individuals are unemployed or work part time. Businesses have reacted to rapidly rising health care costs by reducing insurance coverage and benefits and by increasing the employees’ share of health costs. Extension of health benefits to millions of uninsured Americans will have significant implications for the allocation of health care in the United States. Another aspect of healthcare reform is the disproportionate care based on racial and socioeconomic divide. Most elderly and retired citizens are insured through Medicare. Extremely poor citizens are insured through the Medicaid program. Medicaid cost coverages for the poor are rising, and state governments are scrambling to find the money to pay them. Under financial pressure, states have changed eligibility requirements to make it more difficult for the poor to qua
lify for Medicaid. The result is that less than 42 percent of poor people are eligible for Medicaid, even though their family income is well below the poverty level. The poor, which represent not only minorities but the “working poor,” further suffer from the lack of preventive medicine and prenatal care. American minorities lack healthcare coverage the most. It is estimated that 40 million minorities have no healthcare insurance. Unlike Americans who are employed in well-paying jobs with good fringe benefits including health care insurance, minorities who are self-employed, who work part time, or who work in low-paying, low-benefit jobs have very limited coverage or none at all. Many of these minorities would have great difficulty paying for private health insurance, even if it were available. The last aspect of healthcare reform is the issue of our aging population. As more Americans live longer, the number of elderly citizens has increased, producing a greater demand for health care. Elderly people have more illnesses, need more health care, and require more costly health services. The average elderly American spends up to $350 monthly on medications alone. The aging of America’s large middle-aged generation (the “baby boomers” born shortly after World War II) will produce another surge in demand for health care early in the twenty-first century. Because of the impending aging of the “baby boomers” the Medicare system cost is estimated to triple. Opponents of Universal Health Care reform claim that the plans are economically unsound, that competition would be eradicated and that Medicaid would need to be rationed. Why then is Hawaii’s universal coverage not led to soaring healthcare costs? Insurance premiums in Hawaii are below average and only about half the cost of the most expensive states. The insurance industry has been successful in preventing natural competition and the laws of supply and demand from operating. Insurance companies enjoy windfall profits by exploiting consumers who have no choice but to pay the higher prices. Opponents prey on public fears that a government run plan would eradicate competition in the health care industry. A deceptive ploy, for no competition ever existed to begin with. And yet another tactic to oppress universal healthcare reform is that care through the Medicaid system would need to be rationed. They claim that health care for the poor will be allocated based on the ranking of various services on a priority list and on the amount of money available. Opponents claim, for example, organ transplants would not be paid for by the state. A ludicrous claim intended to invoke fear that, ironically, the people most in need of health care would suffer. Unfortunately, the forecast is for rising numbers of uninsured Americans. Several bills in Congress have attempted to plug the holes that now exist in the leaking roof of our current health care system. Perhaps if the uninsured reached a critical mass, as they might in a bad recession, Congress would move more swiftly to a resolution. By instituting a Universal Health Care coverage system healthcare costs would decrease, all Americans would have health insurance, care given would be proportionate to all races and economic classes and our aging population would have the Medicaid resources needed in the future. Every other developed country offers universal care. We’ll get there someday, but a lot of suffering will occur first.