Why America Won't Get the Health-Care System It Needs - Literature review Example

The dialogue between both extremes, in many ways, is unapproachable for the uninformed in America about future reforms to their country’s health care. The rhetoric each side uses is too rampant and too widespread that extracting facts is almost like a mining expedition. Sadly, each side presents reforms in terms of extremes: a single-payer, government-controlled health care system, or a free market solution without any government involvement whatsoever. Like all extremes, both of these answers are wrong for many reasons. All Americans seem to agree that the current course is unsustainable going forward, and compared to other countries in terms of spending and outcomes, the United States is terrible when it comes to quality and affordable health care. Rather than choose from extremes, the recommended course of action going forward should be to learn from and implement policies instituted by other nations who have enjoyed great success. Koreans, for instance, have access to lower cost quality preventative care than people in the United States, and do not need to find preferred health care providers. Because of government policies and industry initiatives, every Korean citizen benefits from the system. Knowing the success of the Korean system first-hand, rather than instituting a government-controlled health care system, the American federal government ought to structure the private health insurance system (through regulation) in such a way to help every single American acquire affordable health care. It is difficult to make an argument against both extremes of the health care debate without coming off as politically motivated by the other side. However, from a moderate perspective, consider the problems inherent to a free market solution first. Luke Mitchell comments that a market approach is the “most acceptable locus of reform” and that “in Washington, there is little that is considered wiser or more bipartisan than a preference for markets” (Mitchell). However, unlike other markets, where little government intervention may bring about efficiency, the health care system is not equivalent to the market for staples. The demand for not dying is unlimited. Moreover, as Mitchell points out, whenever a problem arises in our nation, the Federal government always finds a way to become involved, or to involve private industry but only with provisions from the government on how to act in the space. Regardless, the free market solution is overly optimistic for some and ideologically-motivated in essence. A so-called “free market” solution would likely face either of two alternatives. First, the solution would be transcribed into a bill, which would then be defeated in Congress and become stillborn legislation. Second, the government would take the lead on private industry reforms and find a place for a market in the context of a government-dominated health care and insurance private sector The arguments against single-payer are less clear, but still should make any American wary of such a system. Of course, as economist Paul Krugman argues, the single-payer system is more efficient, simple, and easier to administer than the current system. But that is only because the current system is as bad as it gets (Krugman): a combination of high expenditures and limited outcomes. However, the elimination of the private insurance industry is unacceptable, especially in the current climate of unemployment. Although some of these billing jobs would be absorbed into the government, the lack of competition and diversification in the insurance realm would mean that not all of these jobs would be retained (Sorteberg). This lack of diversification also poses a problem for cost containment in the single system. The argument that the health care market is unlike all other markets works just as well against the single-payer position as it does against the free market solution. Because the demand for health is unlimited, patients will use care services unnecessarily, and without cost barriers, this creates general inefficiencies. Using bureaucracy to control the allocation of services creates more inefficiency, as many free market economists have argued (Mises). Instead of focusing on either extreme, consider practical solutions that fit better with the infrastructure the United States already has. We must utilize the systemic assets the United States already has to create a care system that solves our problems, instead of the unique problems of citizens in other countries who seem for the most part to enjoy their single-payer system. A system that the United States can easily transition into from its current state of disrepair is one like the Korean care system, which focuses on the meaningful task of ensuring each citizen is covered by a quality insurance policy. Each citizen is required to have insurance, which models some of the plans coming out of the Congress with reforms to the American system (Mitchell). Essentially, the Korean government ensures universal health insurance by standardizing fees, setting premiums, providing administrative costs, and providing subsidies for the poor. Accounts are income-adjusted so that higher income citizens pay more, and all individuals are required to pay exactly half of their family premium. Corporations, consumers, and the government all collude to set operating budgets. However, the operation of the system is entrusted to private industry, and is dependent on mutually beneficial relationships between employers (who provide plans), insurers (who are heavily regulated), providers (a majority of whom are for-profit or owned by physicians), and the government (Anderson). Of course, there are some problems with this system. For instance, there is a conflict between patient expectations (unlimited demand for health) and the capabilities of the system to meet these demands (the supply). Without rigid cost controls (which could be set in an American plan), and little health facility planning, which also can be compensated for, the Korean system may face significant financial troubles in the coming decades. In addition, Koreans spend an inordinate amount of money on prescription drugs. Almost 32.6% of all healthcare expenses in Korea are accounted for by pharmaceuticals. Nevertheless, because of the well-documented and friendly relationship between the United States government and the pharmaceutical industry, it seems unlikely these costs would dominate in an American system. From personal experience, the Korean system is much more accessible than the current American one. For instance, when I was in Korea, it was much more convenient to get preventive care with much lower costs and the same quality of care as in the United States, and I could visit any hospital I wanted to go to without having to annoyingly find a preferred provider. Because the private sector and the government work together on creating accessible health care, each Korean citizen enjoys affordable and quality health care without excessive costs to the government and without putting the private insurance industry out of business (Anderson). Rather than having an entirely government-controlled health care system, the structure of a private health insurance system regulated by the government should be considered as a solution to help every single American to be able to get affordable health care by referring to other well-designed international models. The relationship between the government and private insurers need not be regarded as unavoidably unfriendly (Mitchell). However, the debate between a free market solution and a single-payer system is one of extremes and is too abstract and ideological for practical reform. Looking at the Korean system and other similar collusive models should give policymakers a decent framework within which they can construct a relationship between the government and the private industry to give each American insurance. Fortunately, elements of the Korean system, like insurance mandates, subsidies, cost sharing, and universal coverage have all found their way into the Max Baucus plan (Mitchell). But while this may be the case, it seems Luke Mitchell’s thought that “America won’t get the health-care system it needs” will always be the case, since policymakers will either fail to accomplish comprehensive reform amongst the rhetoric of both extremes, or to implement a plan that does not fit America’s needs. Works Cited Anderson, Gerard F. "Universal Health Care Coverage in Korea." June 1989. Health Affairs. October 2009 . Krugman, Paul. Why not single-payer? 7 October 2007. 16 October 2009 . Mises, Ludwig von. The Economics of a Socialist Community. 1981. October 2009 . Mitchell, Luke. Sick in the head: Why America wont get the health-care system it needs. February 2009. October 2009 . Sorteberg, Mary. The Case for Single Payer Health Insurance. 2007 10 August. 2009 15 October . Read More