Universal healthcare has always been a hot debate point for policymakers for the past decades. Various arguments have already been laid out in favor of and in opposition to the concept of a government run, single-payer system. Fore example, in the article from the Insurance Specialists (2008) web page, the article lists several arguments made regarding universal healthcare. For instance, pros listed for the establishment of a universal healthcare system include Government Accounting Office (GAO) estimates of savings which are estimated to be enough to cover the 47 million individuals without insurance.
Another is the argument that under a Universal Healthcare system, patients will be able to see any doctor they so choose and that doctors under the system will still be able to make the same amount of money and possibly even more. Lastly, proponents argue that under the system bureaucracy would be reduced as doctors will only have to bill one payer and deal with one insurance claim. Cons listed in the same article include arguments such as that the US government is not better suited at administering the country’s health needs, citing how IRS and tax laws are handled by the US government.
Another con is that the new system would greatly limit choice and treatment options. Opponents also argue that when doctors become salaried, incentives will be stifled and eventually med school enrollments will drop. Lastly, they also argue that at the hands of the government which is highly notorious for bureaucracy, waste and inefficiency, small businesses and the self-employed will suffer and be forced to pay costs they cannot afford.
In a similar article written by Kao-Ping Chua (2006) and updated by Flavio Casoy (2008) for American Medical Student Association (AMSA), the authors lists arguments for universal healthcare which include three categorical cases: moral, economic and cultural. The moral case for universal healthcare, the authors argue, is the way the American system places health care – considered a basic right worldwide – as a privilege. Here the authors cite once again how healthcare is inaccessible and unaffordable, pointing to the numbers of the uninsured and the increased incidence of bankruptcies filed by the insured as evidence (p.
1-3). The economic case for universal healthcare, on the other hand, discusses fiscal ability towards and advantages of changing the system. The authors mention that though there are no visible economic returns for the massive outlay of money required to achieve universal healthcare, the hidden economic gains such as a healthier and long-lived work force must not be ignored. Furthermore, the authors also argue that “the amount of money it costs to cover all is literally a drop in the bucket of the U. S. economy. In the end, universal health care is a matter of budgetary priorities” (p. 7).
The last argument is made under the cultural case where according to the authors, surveys conducted in May 2005 showed that the current healthcare crisis acts as an obstacle towards what generally is perceived as “the American Dream” of having a close family, having the freedom of making decisions about ones life and the ability to provide for oneself and his/her family. IV. Discussion, Synthesis and Proposal All the literature reviewed for this paper all point to one thing: the US Healthcare System is in pretty bad shape. In fact it is already nearing, if not already at, breaking points.
Even a short glimpse at its history conveys much about the current situation it is in. Research and statistical data ranging from as early as 1998 up to the present all account for the same phenomena over and over again. Various details are fleshed out regarding how the current system is (primarily) very costly. Consistently it has been labeled as the most expensive system worldwide, suffering from increased costs rooted on medical and technological advances, pharmaceutical changes and mostly in part due to increased administrative requirements.
Oddly, these high costs had no positive bearing on the quality of care being provided and in fact, in some instances, even contributed to the declining quality of care the system is doling out. Already, despite improvements in IMR and DALE rates, overall health performance is still remarkably low in comparison to countries that perform economically less. Additionally, access is at an all time low, financing fairness is at its most unfair and consumer satisfaction is quite low.
It is because of this situation that consumers are clamoring for a change in the system and most eyes have turned to healthcare system models being used by neighboring countries. These countries, such as Finland, Switzerland and Canada, enjoy a system that is less costly and apparently more rewarding. The system being referred to here of course is the Universal Healthcare System these countries employ. What makes the system so desirable in the eyes of so many at the moment is its capability of providing coverage to an entire nation, eliminating the scourge of un- and underinsurance and their negative impact on society.
Universal Healthcare’s low subscription costs serves as a beacon of hope in the midst of today’s expensive and unsustainable healthcare costs. To quote: “recent surveys in the US have documented the growing frustration with our healthcare system, and an interest in exploring a single payer plan for health insurance with universal coverage” (Bureau of Labor Education, 2001, p. 7). As discussed in Chua and Casoy’s report (among others), transition towards universal healthcare will be an expensive process.
After all, moving towards the format means undoing decades of mistakes and abandoning a market system that has been in place for over half a century. However there are numerous proposed solutions that may ease transition towards or act as an alternative to the Universal Healthcare model. One way of handling the current situation is addressing the bottom line of the problem: cost. Consistently, most of the downturns of the current healthcare system is blamed on its uncontrollable costs and if there are any first steps to be taken, addressing the cost problem should be one of them.
Though for years this is exactly what HMOs and MCOs have been trying to do, it seems that solutions have always been pointed at the wrong direction (cost-shifting, service limitation etc. ). In an article written by Woolhandler, Campbell and Himmelstein (2009) entitled Cost of Healthcare Administration in the United States and Canada, the author’s discuss how administrative costs affects the pricing of healthcare systems. At present, administrative costs account for the bulk of healthcare costs but studies have shown that these do not in any way result in lowered costs or higher quality services.
Additionally, not much difference exists (in terms of performance) between for-profit and not-for-profit systems – making the existence of high administrative costs insignificant if it were meant to improve performance. As it seems, “much of administration [i]s superfluous, born of the quirk of the payment system rather than of clinical needs” (p. 772). This points out that the first step towards reducing the cost of healthcare can be achieved by optimizing the administration process and eliminating unnecessary bureaucracies that convolute the system.
This means either employing a better coordinated system that can smoothly handle file and payment transfers such as an electronic tracking system similar to the VistA system being employed by the VHA and Medicare. Technology can play a big role in smoothing out the knots multi-payer systems are bound to generate by increasing market effectiveness through improved access to information on quality and costs of care, thus promoting competition. Additionally it will develop better information on cost-effectiveness of health care technology and procedures.
(Davis et al. , 2007, p. 24). Another option is, removing the multi-payer system altogether and in its place institute a single-payer system similar to universal healthcare systems. Under this arrangement, administrative costs will be contained due to a reduction in duplicative administrative actions generated by multi-payer schemes. This will also greatly reduce fragmentation which is also a primary contributing factor to rising prices (p. 773). A third option is, of course, employing a universal healthcare system.
One way of going about this is, as proposed in the paper by the Bureau of Labor Education, “to simply expand Medicare, an existing and highly successful public program, which could be extended beyond the elderly to the entire population” (p. 8). V. Conclusion In conclusion, it is in this author’s opinion that the US healthcare system is indeed one of the least effective healthcare systems among developed countries. It is currently characterized by so many cons that any positive trait about the system is easily overshadowed.
Additionally, research indicated that the system has been this way for quite some time already and has not improved much in the past 50 years. This has lead to recurrent calls for reform and increased demands for a shift towards a system similar to that employed by other OECD and industrialized countries. Recent developments only highlight the systems shortcomings and, as it seems, the system may have finally reached breaking point and moving current practice towards Universal Healthcare standards may just be the solution to the problematic situation.