The Time Has Come for United States to Reform Its Health Care Policy.

When Barack Obama pronounced his candidacy for the president of the United States, one of the issues that he tried to highlight in his presidential campaign was the reformation of the current health care system from a consumer-driven to a more universal or government-funded health care system. The consumer driven health care that the U.S government implements today is a system that required a customer or patient to have a health insurance policy to protect them from catastrophic medical expenses when receiving medical treatment. According to Quadagno (2006), the U.S. is the only western developed country unable to provide universal coverage and treatment to the majority of its population. Moreover, the U.S. spent almost $2.2 trillion on health care in 2007, making the U.S. the country with the highest expenditure on health care in terms of GDP and per capita basis (Kaiser Family Foundation, 2009). Some consumers and policy makers argue that the concept of “consumer-driven health care” is excellent because it preserves patient choice, protects the privacy of patient and also helps to increase cost saving. Indeed, it is true that the current health care plan has helped millions of Americans through difficult times. However, the system is not practical anymore because it has exponentially increased the cost of medical expenses, significantly decreased the quality of medical treatment and has negatively affected Americans in terms of justice and ethical issues.

One of the main reasons given for the continuance of the current health care system is that it can reduce the cost of medical expenses. Indeed, it might be claimed that the concept of risk pooling and collectivism that was implemented in the current health insurance has helped Americans to cut the cost of medical expenses. At some stage in the mid-90’s, during Bill Clinton’s presidency, the U.S. claimed some success in reducing the cost of nations health care by attempting to control the nation’s health care system expenses with managed care. However, nowadays, United States has persistently failed to control the costs of medical expenses. According to the Kaiser Family Foundation (2009), in 2006, U.S. per capita medical spending was $6,567, an increase of 10% over 2005. This was 87% higher than Canada; 52% higher than Switzerland’s, the nation with the next-highest spending per capita on health care; and 144% higher than the OECD[1] median of $2,904 (See Figure 1). Many Americans view and blame the increasing costs of health treatment and the failure to provide universal access of health care as indicators of a severe flaw in the U.S. medical care scheme. Based on a study conducted by Donelan et al (1999), only 17% Americans are satisfied with the current health care system while 79% believe that the system needs vital changes or absolute reform.  All of this data and statistics clearly shows that the U.S. needs to reform its health care system to maintain the sustainability of its social, politic and economy situation.

Figure 1: Health Expenditure per capita for OECD Countries (OECD Health Data, 2008)

Figure 1: Health Expenditure per capita for OECD Countries (OECD Health Data, 2008)

Some critics may argue that it is common and acceptable to see huge increases in health care costs due to global inflation and increase in the price of raw materials. However, the price of health insurance premium in U.S has been increasing progressively each year ever since the 80’s at rates that significantly surpass total inflation rates and not equivalence with employees’ incomes rate (Owen, 2009). In 2000-2006, the total inflation rate and employees’ incomes increased at a rate of around 19%, but shockingly, the price for health insurance premiums for an average American family of four increased by 87% (Kaiser Family Foundation, 2007). The extreme escalation has made medical coverage exorbitant for many companies and individuals.  When many businesses cannot afford to adequately cover its employees, it will impair the existing health care situation in U.S. because currently, most Americans depend either on their employer or on government-sponsored social insurance program to provide them with health care coverage. Mark Pauly, a famous economist, asserts, “Higher medical costs do not harm employers or owners but do reduce money wages for workers. . . . Lower costs benefit workers, not employers; they add to take-home pay, not profits” (quoted in Iglehart, 2007 by Pauly, 1997). Furthermore, the economic turmoil and global financial crisis that the U.S. is facing right now has worsened the health care system. It is the right time for the U.S. government to reform its health care system to curb the escalating costs of medical expenses.  

Even though U.S. spends a higher segment of its gross domestic product for health care than any other country, the quality of its health care is appalling. As stated by WHO report on quality of health care in 2000, U.S ranks 37 out of 191 countries (WHO, 2000). Some critics may argue that the health care ranking that WHO published does not really reflect the true situation in U.S. Blendon et al (2001) reports that most of the top nations in WHO’s ranking are rated poorly by their citizens, including the low-income and elderly. However, there are more reliable supporting data and statistics that really show the poor quality of health care in U.S. According to report that was published by Institute of Medicine in 1999, almost 100,000 people die in U.S. hospitals each year because of avoidable medical error (Bodenheimer, 2002). CIA (2009) in its fact book that was published in 2009 reports that the average life of expectancy in the U.S. is 78.11, ranks at 49 out of 224 nations in the world and lower than other developed nations such as Japan, Australia and Canada. One of the main reason why the quality of U.S. health care is deteriorates is most people does not have access to medical care. People that do not have adequate health insurance coverage are more prone to suffer bad health effects compare to those enjoying full access of health care. These data and information evidently validates that U.S. suffer from severe and extensive quality problems in its health care system.

 Critics characterized that the U.S. health care system as a “paradox of excess and deprivation” (Enthoven & Kronick, 1989). The phrase “excess and deprivation” refers to the situation in U.S. when people with adequate health insurance may possibly obtain inappropriate and unnecessary health care services while those with inadequate insurance or without insurance, may be deprived of needed medical attention and care. Some Americans do not have full access to high quality health care because they are “underinsured, uninsured or have government-sponsored insurance program coverage that many physician will not accept” (Bodenheimer, 2002). For people with low or middle earnings, uncovered services that the health insurance deducts from their income or does not cover will negatively affect substantial amount of their financial situation. In brief, the American health care system is an unethical and injustice structure because it is driven by an unequal group of interests with two objectives that are conflicted with each other: providing health care to the sick, but in the same time “generating profits for the persons and organizations that assume the fiscal risk” (Iglehart, 1999). This injustice situation has left almost 47 millions of Americans (15.8%) population without proper health insurance coverage (Chockley, Pirani, & Kushner, 2006). If U.S. government does not take any further action to curb this situation, Americans will have a very huge gap for access of health care between the wealthy and underprivileged people.

            U.S. government has taken some action to ensure that people who are not adequately insured have access to health care; the government has implemented Medicaid, a cooperative federal-state plan that provides medical insurance coverage to certain groups of low-income individuals and people with disabilities that do not have insurance coverage. Some authorities believe that Medicaid has helped underprivileged Americans to have better access on health care. However, recent study shows that Medicaid has negatively affected taxpayers who fund it and people that enjoy Medicaid benefits. Cannon (2005) reports “Medicaid discourages work and charitable effort among the taxpayers who fund it, while discouraging self-sufficiency and encouraging dependence among beneficiaries.” Even though U.S. government has taken some action to prevent its health care system from collapse and burden its citizen, the actions are not sufficient. In 2005, almost half of the people that file bankruptcy in federal courts fingered medical causes as the contributor (Himmelstein, Warren, Thorne, & Woolhandler, 2005).  The current situation that let wealthy people to waste resources of health care and allow underinsured individuals to suffer bankruptcy are totally injustice and need to be change.

Quality needs equality. In order to achieve high quality health care, the U.S. government must be able to make the current health care system more justice and fair for its citizen. The current health care system needs to be reform because it has increased the cost of health care spending, decreased the quality of health treatment and has negatively affect Americans in terms of justice and ethical issues. It is believes that the movement towards more universal health care system can help Americans to cut cost of medical expenses and make health care more accessible for everybody in the country. Almost every developed country has able to provide universal and high quality health care to its citizen. It is the time now for government to make bold move to put U.S. at the same level with other developed nations. President Obama once said, “We’re closer to that significant reform than at any time in recent history,” he has repeatedly said. “That doesn’t make it easy. It’s hard.”

Bibliography

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[1] OECD is the acronym for Organization for Economic Co-operation and Development. An international economic organization originated in 1948 in French after World War II. There are 30 countries in OECD and most of OECD members are high-income economies with a high Human Development Index (HDI) and are regarded as developed countries (OECD, 2009).