United States health care - Essay Example

The US healthcare system is one of the more important and persistent of the problems confronting the nation's politicians and governments, whether state or federal. As Starr (1984) explains, these problems are a direct outcome of the fact that the United States has neither a universal nor a social medicine coverage system. Consequent to the absence of either, not only does the United States stand out as unique in the midst of other Western democracies but as different from the majority of countries. Most countries have adopted those aspects of the welfare state system which outline the provision of healthcare, among other services, as a right of citizenship and a duty of states (Starr, 1984). While the United States has opted for a privatized healthcare system and stands form against the concept of social medicine, the ever escalating numbers of the uninsured highlight the imperatives of expanding the Medicare and the Medicaid systems to include the uninsured. Social medicine, or socialized healthcare, is the primary healthcare delivery paradigm in a vast majority of democracies, including the United Kingdom. According to Starr (1984), within the context of socialized medicine, a single institution, funded by taxpayer money, provides for the healthcare needs of all citizens, including the provision of emergency and non emergency surgery. Membership in this system, implying access to all levels of healthcare, when and if needed, is a right of citizenship. Consequently, as is the case with Great Britain, all citizens have public healthcare overage. Socialized medicine and public healthcare coverage are founded on the principle of equality. Maintaining that citizens should not be distinguished one from the other as regards their ability to access basic, and imperative, services such as education and healthcare, this system extends all citizens, irrespective of their socio-economic status, equal access to healthcare (Starr, 1984). Consequently, within this system, all citizens are regarded as having healthcare coverage and all are awarded equal access to healthcare. The United States has opted for a privatized healthcare system, rather than a socialized, public one. As Smith (2005) explains, this means that citizens are extended private healthcare insurance through employee benefit programs, whereby employers pay the full or the partial cost of medical insurance or by paying the premiums themselves. In other words, citizens are not covered by the state but chose from any number of HMO's and healthcare coverage plans, following from which they pay the insurance themselves. If, however, their healthcare is included within their employee benefits package, as is often the case, the employer selects the HMO and the healthcare insurance plan. The primary problem with the US healthcare system is a significant number of citizens are not covered. The unemployed, part-time workers and minimum wage employees are, needless to say, not covered through employee benefits programs, with the implication being that they have to pay for their own healthcare insurance. This last is highly problematic because by the very nature of their employment situation, they cannot afford the cost of healthcare. The outcome, as touched upon in the preceding, is that a significant and ever increasing number of America citizens are not insured. The number of uninsured American citizens comprises an important indicator of the magnitude of the nation's healthcare problem. As noted in a Modern Healthcare (2006) publication, in 2001, 14.6% of the population was uninsured. In 2004 this figure had risen by 1%, so that the total number of Americans without coverage had reached the 45 million mark, inclusive of which is over 8 million children ( By the numbers,' 2006). Commenting on these figures, Zigmund (2006) notes that thy are indicative of the fact that a significant proportion of the population does not have access to healthcare when, and if, needed. Accordingly, in direct comparison to the United Kingdom's socialized healthcare system in which all citizens have equal access to healthcare, the healthcare in the United States has devolved into a have and have-not system. While few would deny that healthcare insurance is definitely a problem in the United States, many would argue that it is not as dire as some believe it to be. The reason lies in the presence of programs such as Medicare and Medicaid, on the one hand, and in a general consensus over the imperatives of providing emergency healthcare services to all citizens, including the uninsured. In order to better clarify this, it is important to note, as does Lubell (2006) that both Medicare and Medicaid extend basic healthcare insurance to all of the elderly, the poor and the disabled, thereby functioning as a response to the problem of lack of insurance. Added to that, most states have laws which outline the rights of all citizens to basic healthcare in instances of emergency, irrespective of whether or not they have healthcare insurance (Lubell, 2006). Again, and insofar as emergency care is concerned, the aforementioned functions as another solution to the problems which arise from lack of healthcare coverage. While, as evidenced in the preceding, the absence of healthcare insurance does not necessarily imply total lack of access to healthcare, this does not mean that the healthcare problem in the United States is not a serious one, in need of a solution. The fact is that Medicare and Medicaid are limited to specified demographics and state laws specifying access to healthcare are relevant to emergency care. This means that a significant percentage of the population remains, even within the context of the aforementioned programs and state laws, without access to medical services and healthcare, simply because they cannot afford it (Lubell, 2006). Considering the nature of the defined problem it seems that the Unite d States would benefit from the implementation of a social medical insurance system. Such a healthcare reform proposal was, indeed, forwarded by Senator Clinton, only to meet with an uproar and outright rejection (Pendleton, 2005). The reason lies in that the United States, as Smith (2005) explains, is ideologically opposed to the concept of social medicine as an inherently undemocratic system which does not provide healthcare receivers with a choice regarding their healthcare provider. Another reason lies in that it is viewed as excessive government intervention in the market, signifying as it does governmental control over healthcare and medical insurance. Accordingly, regardless of its validity as a potential solution, the fact is that the ideological climate within the United States renders social medicine an unacceptable reform proposal. Although the socialization of medicine may not be a viable proposal in the United States, the fact is that the unemployed should be extended healthcare insurance as, indeed, should all uninsured American citizens. More often than not, the best solutions are the simplest ones and it is with this in mind that the essay concludes with a proposal to extend healthcare coverage to the uninsured through state programs funded by taxpayer money. Quite simply stated, this would involve the extension of the Medicare and the Medicaid programs to embrace the uninsured and, in so doing, ensure their access to basic healthcare. This is a viable solution insofar as it involves the exploitation of exiting programs as a solution to a persistent problem, rather than the design and implementation of a new system. It is, thus, that this research concludes with the stated proposal. References By the numbers.' (2006) Modern Healthcare, 36(38). Lubell, J. (2006) Changing Medicare, Medicaid ' Modern Healthcare, 36(48). Pendleton, J. L. (2005) . Transparency: Necessary, but not sufficient.' Journal of American Physicians & Surgeons, 10(2). Smith, S. L. (2005) Teaching the history of public health and health reform.' OAH Magazine of History, 19(5). Starr, P. (1984) The Social Transformation of American Medicine. New York: Basic Books. Zigmund, J. (2006) 46.6 million and counting.' Modern Healthcare, 36(35). Read More