Free Healthcare in America: Pro's and Con's - Essay Example

Free health care in America: pros and corns Introduction Incessant debate over the ‘healthcare reform’ has become the center of American politics and a highly significant issue for media as well as for researchers. Despite the widespread public dissatisfaction and grueling debates, the ‘health care’ still remains a hot button issue and a burgeoning societal problem. The US healthcare system is unique (notorious?) for its special characteristics. The United States spends a higher proportion of its gross domestic products on healthcare services than any other industrialized nations do. Among the industrial nations, U.S. is the only country that does not have a universal healthcare policy for its citizens. Although American healthcare service is believed to be the best, the dramatic increase in cost, high drug prices, fraudulent activities, healthcare abuse, and unfair coalitions have left the system extremely fragmented. Many people are of the opinion that the United States must follow free healthcare policy which would ensure coverage to all segments of the society irrespective of their socio economic disparities. On the other side, the opponents of free health care staunchly stick to the general structure of the system, and the ‘reform’ according to them is the hidden agenda of socialist concept. Attempts taken to regulate the industry have been brutally defeated by special interest groups such as politicians, insurance companies, hospitals, pharmaceutical industries, and private medical sectors. These groups proved them to be the perpetrators finally by defeating Clinton’s Healthcare Plan 1994. Current system As mentioned above, unlike other wealthy industrialized nations, the United States, does not offer some form of universal health care to its citizens. It has a free market for healthcare organizations, medical practitioners, and pharmaceutical groups which has been accused of promoting illegal activities and misconduct in this service area. Although hospitals are highly equipped with the advanced technology and modern facilities, majority of people do not have the access to adequate healthcare service due the escalating cost of drugs and services. To illustrate, the study proves that ‘as many as 1,95,000 people may well be dying in American hospitals each year because of avoidable medical errors, and as many as 1.5 million may well be misdiagnosed’ (Coates, 2007 p.62). Furthermore, around 50% of people are estimated to be uninsured or underinsured in the States. It is obviously an alarming ratio for a developed country like United States. As compared to any other country in the world, the United States spends a higher proportion of its gross products on healthcare services; 13.7% in 1999 (Stat.2001.cited, Steven Jonas, 2003 p.2). It shows the exceeding level of exploitation prevailing in the U.S. medical field. As Wolinsky (1985) states, U.S. healthcare system is not a system because a real system does not exists there (Cited, Shi L. & Singh D.A.2007). Single payer system and universal healthcare system The single payer system can be referred to a system in which the medical expenses are met from a single source, usually a government fund. Under this system people have the complete medical coverage and free access to healthcare. The fund for this purpose will be raised through taxation or other methods. The National Healthcare System (NHS) in the United Kingdom can be a good example for single payer system. Since this system is totally administered by government the opponents of this system refer to this as ‘socialized medicine’ and argue that it is against the social privileges of the citizens. Single payer system has been one of the familiar subjects discussed at healthcare reform campaigns in the United States. Although the terms single payer and universal healthcare system are used interchangeably, in real sense both have special characteristics of their own or have the combined features of both. Single payer system provides healthcare expenses from a single government fund; whereas universal system would combine government fund, private insurance companies, and other charitable organizations. Universal health care was first instituted by Otto von Bismarck in Germany, in the 1880s, as part of a widespread system of reforms. Experts as well as people are deeply at odds regarding the pros and corns of these both systems. Some are in favor of universal system whereas others argue that combining various agencies would not be effective. Moreover they believe that healthcare is the initial responsibility of the government and therefore it has to be administered by government in order to meet the healthcare needs of American people. Conservative view of healthcare reform Democrats, Republicans, Liberals, and Conservatives all do agree that American healthcare system needs to be reformed. At the political level debate the argument field is split in to two as liberal camp and conservative camp. Liberal view is that the US should adopt universal system like Canada or United Kingdom. Conservatives are against this view because they believe that ‘socialized medicine’ would hamper the effectiveness of healthcare and moreover it would become a burden to the government. According to the conservative perspective, healthcare system has to be renewed by promoting competition between health insurance and pharmaceutical companies. Furthermore, health care reform has to be implemented by enacting serious reforms in taxes and insurance regulations other than imposing heavy burden on government. According to them socialized medicine would affect the current quality of American healthcare service and therefore, the reformers have to consider the alternatives to make the healthcare more affordable and accessible without hampering the free market and medical advancement. Although since 1920s Federal government has been taking several attempts to establish some forms of national health insurance schemes, both Liberal and Conservative camps with the influence of interest groups defeated those plans (Jonas, 2003). Cost of healthcare The cost of healthcare was rocketing every year between 7 and 10 percent from 2000 to 2002 (Gardner, 2001. cited; Kronenfield, 2004). As compared to all other countries in the world the United States has the highest rate of medical expenditure. The situation has been rapidly evolving due to a number of factors such as free healthcare market, profit driven pharmaceutical companies, healthcare abuse and corruption. Per capita expenses increased from $30 in 1940 to $ 143 in 1960; and $348 in 1970 to $1067 in 1980. Further it increased up to 2,737 by 1990 (Waldo, Levit & Lazenby, 1986, 1991.cited in Kronenfield, 2004). In 2003, the United States ranked first in total per capita expenditure at an average of $ 5,711 (Jonas, 2003 p.187). As mentioned earlier, majority of people are lacking health insurance in the US. Moreover among the insured individuals many are having only group insurance coverage proposed by their employers. In most of the cases, premium amount is deducted from employee’s compensation and coverage lasts until the individual stops working with the employer. In addition, employers in USA are reluctant to offer health insurance to their employees because of the escalating healthcare expenditure and unaffordable insurance premium. Besides the uninsured individuals there is another category of citizens who are medically uninsurable. Studies have estimated that 0.5 to 1.0 percent of the U.S. population belong to this group who in fact are very high beneficiaries of healthcare service (Kronenfield, p.55). Healthcare abuse Both, the Liberal camp and Conservative camp have conveniently left out two major aspects of the issue; ‘healthcare abuse and pharmaceutical corruption’. Major concern of the debate over health care reform is based on the increasing health care expenditure and health insurance. No genuine study was conducted to evaluate the root cause and therefore all the Congressional efforts have been so far dealing with certain symptoms of the actual ‘disease’. The rampant increase in medical cost and the unaffordable insurance premium are only those symptoms. U.S. hospitals are highly leveraged with advanced technology and medical equipments. In contrast, the technical application has been utilized to extort money from the customers by prescribing unwanted medical check-up and experiments. Spending high sums on healthcare and ranking last in the quality are the dual facets of the current U.S. healthcare system. Excessive pharmaceutical fees and exorbitant physicians’ fees are the indicators of prevailing corruption in the system. Any sincere effort to address the healthcare crisis can not leave these two factors aside. Private medical practitioners and profit determined healthcare organizations take advantage from the fragmented system. Studies show the depth of prevailing medical fraud in the country. Since 1986, judgments and settlements under the U.S. False Claims Act have totaled $12billion with most of these being against well known drug makers (Campos & Pradhan, 2007). Pharmaceutical Regulatory System has failed to prevent pharmaceutical fraud in the U.S. healthcare. Deceptive actions such as illegal off-label marketing and copying color, trademark and packaging have created an unpredictable environment in the service sector. Hence, in addition to the unaffordable expenditure, people are under the threat of low quality medication and fraud. Improper use of Emergency Room (ER) and the misuse of 911 services are other two areas that are highly affected by healthcare abuse in the U.S. Most of the emergency rooms are heaving with excessive number of patients and struggling with insufficient number of nurses. Emergency rooms are being misused either by hospital operators or by people who are not in a condition to be admitted there. The use of ambulance service for no true emergency has become a very common abuse in the States. People simply ring to 911 as if it is a short cut to enter healthcare system without consulting a primary physician. ER abuse adversely affects many genuine cases, rejecting accommodation or being kept waiting for many hours outside. Such kind of felony or abuse might be pointed out as the drawback of free health care. Several steps have been taken by Federal government to investigate and prevent health care abuse. The Health Insurance Portability and Accountability Act of 1996(HIPAA) established a national Healthcare Fraud and Abuse Control Program (HCFAC) under the Department of Health and Human Services (HHS). Several billions of dollars have been confiscated from fraud pharmaceutical companies as the accomplishment of FY 2007. For instance, ‘InterMune, Inc., agreed to pay $30.2 million to resolve allegations that it marketed its drug Actimmune, for uses not approved by the FDA, and Jazz Pharmaceuticals paid $20 million to resolve criminal and civil allegations relating to the illegal marketing practices’ (FY 2007Report). ‘Cell Therapeutics, Inc. of Seattle, Wash paid $10.5 million to resolve allegations that it off –label marketed its anti-cancer drug Trisenox to treat various forms of cancer for which the drug had not been approved by the FDA’ (FY 2007Report). ‘Federal Government won or negotiated approximately $1.8 billion in judgment and settlements, the Medicare Trust Fund received transfers of approximately $797 million and $266 million by Federal Medicaid’ (HCFAC, FY2007 Report). Social structure and health care American health care system is exceedingly determined by class, education, socio-economic status, employment, and ethnicity. Although technological advancement has improved the life expectancy of Americans, it does not necessarily mean the progress in health care. Only wealthy people or people with high earning jobs have access to American health care. People with more education and better economic status are found healthier than middle class people. In fact all benefits of modern health care go to educated, upper class people. Less educated and low income people are more vulnerable to chronic diseases than the educated wealthy people are. Admitting the cultural, religious, racial and ethnic diversity as an undeniable part of the society the government has relied on the concept of multiculturalism which is supposed to enhance cultural equality and cohesion. The United States of America, like many Western and Middle East countries has become one of the major destinations of immigrants. African countries hold the upper hand among the immigrant source of America. The great collection of immigrants include refugees, people came for higher education, those in diplomatic services, skilled labors, athletes, efficient scientists and physicians. Yet many of the policies enacted on this concern have brought controversies too. The critics argue that the so called equality doctrine would promote social segregation instead of cultural tolerance. Minority ethnic groups often confront with problems for getting adequate health care services. Working class people are not sufficiently offered health care protection. The recent recession and current economic environment have deteriorated job insecurity. To point up, ‘in august 2005, 46.6millions Americans lacked any health insurance, and may be twice that number spent some months in 2003 and 2004 without health coverage of some kind’ (Coates, 2007 p.61). According to Jonas (2003), racial and ethnic status is linked to quality of service received. For example, African Americans, in general, receive less intensive hospital care, fewer preventive medicine procedures as compared with whites. The author also states that African Americans have also been found to have higher rates of end-stage diabetic conditions such as amputations, indicating poor quality ambulatory care. Hence, health insurance and advanced health care remains unapproachable for lower class and impoverished Americans because of the high premium rates and huge hospital bills. The case is almost same with the elderly and disabled among whom majority are medically uninsurable. Proponents of the free health care system believe that people of this category could be protected well only under a universal or single payer system. According to them UK or German model of health care systems are acceptable. Unfortunately, neither the proponents of free health care nor the conservative program of increased competition has made a sincere attempt to introduce an ideologically faithful healthcare policy in the United States. However, American health care reform has become highly significant socio-economic and political issue that needs to be rapidly addressed. WHO (2004) states that essential medicines save lives and improve health when they are available, affordable, of assured quality and properly used (cited, Campos & Pradhan p.29). The quote is more applicable to the U.S. health care system than to any other system in the world. Although the Federal government is moving ahead with healthcare reform proposal, in addition to this, there are certain health priorities that HHS reminds the American people. They are; 1. Responsible sexual behavior 6. Substance abuse 2. Mental health 7. Physical activity 3. Injury and violence 8. Overweight and obesity 4. Environmental quality 9. Tobacco use 5. Immunization 10. Access to healthcare (Source; Healthy People 2010. cited in Smith Wertheimer & Fincham, 2005 p.2). Conclusion To conclude, the U.S. healthcare industry has to be regulated with appropriate social welfare policies and strategies in order to ensure the public safety. Healthcare abuse and corruption are the basic problems that have to be swiftly addressed in order to save the sector from the throttlehold of medical mafia. Since majority of the country’s population strive for free health care, a ‘nation conceived in liberty’ can not move further with an endangered healthcare ethics. The existing profit- orientated healthcare system has to be regulated effectively in order to ensure the envisioned welfare and justice to the citizens. Works Cited Coates. A Liberal Tool Kit: Progressive Responses to Conservative Arguments. Greenwood Publishing Group, 2007pp.61-62 Campos & Pradhan. The Many Faces of Corruption:Tracking Vulnerabilities at the Sector Level. Illustrated, World Bank Publications, 2007 pp.29-30 Health Care Fraud and Abuse Control Program Annual Report For FY 2007, The Department of Health and Human Services and The Department of Justice, November 2008 pp.1, 11 Jonas S. An Introduction to The U.S. Healthcare System. Illustrated edn.5, Springer Publishing Company, 2003 pp.2, 187-189 Kronenfield. Healthcare Reform in America: A Reference Handbook. ABC-CLIO, 2004 pp.14-15 Shi L. & Sing D.A. Delivering Healthcare in America: A system Approach. 4th illustrated, Jones & Bartlett Publishers, 2007 Smith, Wertheimer & Fincham. Pharmacy and the US Healthcare System. Illustrated edn.3, Informa Healthcare,2005 p.2 Read More