Powell 1 Rosana Powell Prof.

Olmsted English 1010 May 1, 2006

THE ARGUMENTATIVE ESSAY: HEALTH CARE IN AMERICA

Our current system of health care is not working. The United States health care crisis leaves an estimated 41 50 million people in America without health insurance or adequate access to health care. Health care in America is regarded as a basic human right regardless of an individuals ability to pay for premiums or services. A health care system is known as the organization by which health care is provided to the public. This common yet broad definition also encompasses the health care systems in place around the world such as socialized medicine, two-tier health care, free market medicine and mandatory or universal health care. Two-tier and free market health care systems are currently seen in the United States, a two tier health care system is also seen in Australia and some parts of Canada. The countries currently utilizing socialized medicine are New Zealand, Britain, The United Kingdom and parts of Canada. Mandatory or universal health care is a concept being

introduced in states such as Massachusetts and California. Currently there is much controversy about which health care system is the most efficient and best model for the United States to follow. Implementation of mandatory health care in America would guarantee health care to all individuals regardless of social or financial status or health insurance. It would also greatly diminish the

staggering costs of health care we see with todays systems for everyone in America.

Socialized medicine is derived from a government regulated system of health care. This type of system provides health care for all citizens subsidized mainly from health-insurance taxation to the

Powell 2 public. Socialized medicine includes government operation of medical facilities and government

mandated health insurance plans. Under socialized medicine, the medical care providers such as doctors and medical facilities receive their salary from the government along with an additional allocation per patient for special services. In Canadas socialized health plan, many services are not covered and incur additional charges to the user. Some of the services not covered include dentistry, prescription drugs, optometry and various specialists. These additional charges can sometimes

make it impossible to afford and obtain medical care for the very poor or elderly and disabled public. Under this type of socialized health care, costs are on the rise and skyrocketing resulting in financial trouble and cut backs from the government on provided health care. This in turn erodes the quality of health care provided to the public from medical facilities and medical personnel. With costs rising and governmental cutbacks it in turn creates substandard care of patients and grossly extended waiting periods just for preliminary medical attention. Another victim of the lengthy waiting periods is

Canada's version of equal access to medical treatment. Even though medical emergencies allow some people to jump ahead in the waiting line, making others wait longer, a survey published in the Annals of Internal Medicine, found that more than 90 percent of heart specialists had "been involved in the care of a patient who received preferential access" to cardiac care because of non-medical reasons including the patient's social standing or personal connections with the treating physician.

As commented about socialized health care by Dr. Robert J. Cihak, of Kirkland, a senior fellow and board member of the Discovery Institute and a past president of the Association of American Physicians and Surgeons, states The Canadian system works fine for minor problems, but danger lies ahead as baby boomers age and more serious illnesses afflict them. Call it "Canadazation," the myth of high-quality, "free" care. Its real costs in human suffering are ones that U.S. proponents don't want you to know about. In an editorial by John Ray on socialized medicine for "The Australian Newspaper, he states When it comes to paying for their healthcare, Australians enjoy a system that

Powell 3 for the most part strikes a sensible balance between the laissez-faire market of the US, that leaves millions unprotected, and the dangerously bureaucratic and inefficient socialized medicine schemes of nations such as Canada and Britain. But this does not mean there is not room for improvement. It is rather ironic that in other countries that have socialized national health care, when an important leader of that country is critically ill, he is rushed to America for treatment or American-trained doctors are rushed to him. It is a testament to the fact that health care under a socialized system would do nothing but create increasingly substandard health care at increasing costs.

In 1984, the Canadian Parliament passed and established a socialized medical system and publicly-financed health care system. To ensure that this would maintain a true government monopoly, Canadian provinces outlawed private health insurance. As quoted by Lawrence Wilson, M.D. in the Freedom Daily Paper, While reform is obviously needed, the answer is not piecemeal socialism. Government-run systems in Canada, Europe, and elsewhere suffer disastrous

shortcomings.

Two-tier health care consists of a health care system that combines guaranteed public health care controlled by government, as seen in socialized health care, but also where a private health care system is allowed to operate parallel to each other. This creates two tiers of health care, one for the public at large and another for those who can afford to pay for better medical care. In addition to greater access to health care for all, it is felt that this two tier system will help alleviate the long waits encountered in the socialist medicine and eliminate the preferential treatment also seen with the socialist medicine. The public tier health care system is also referred to in the United States as Medicaid for the low income population and Medicare for the elderly. Medicaid was established in the United States in 1965 and was designed by the federal government to provide medical care to the low income population. Medicare is also federally funded and essentially all Americans are eligible for

Powell 4 Medicare when they turn 65 years old. Medicare covers medical expenses such as doctors visits, hospitals, pharmacies and other treatments.

Many times within a two tier health care system, the lure of the wealthier private health care system tends to draw doctors away from the public health care system and concentrating on the private health care system. Thus, it increases the general lack of care associated with public health care. Proponents of the two tier system argue that this system introduces more flexibility and

competition between the public and private sector encouraging each to operate more efficiently.

Australia has tried to resolve the difficulties between public and private health care by requiring medical workers to allot a certain amount of time to the public system. It is felt that this giving to the public upgrades and enhances the medical care on both public and private levels. However, this simply leads to increase competition in the private sector resulting in driving up wages to medical workers and increasing costs in the entire system. The free market medical system or purely private enterprise system is also practiced in the United States but is comparatively rare. This form of health care allows the doctor to focus on medicine rather than billing. The free market medical clinic does not accept insurance, Medicare or Medicaid. Interference from government, insurance companies or HMO administrators is avoided. The physicians are allowed to decide with their patients what treatment is appropriate on an individual basis. Operating and overhead costs are considerably lowered allowing much lower prices to the consumer from doctors and clinics. In essence, the middleman of health care is eliminated and the cost savings passed on to the consumer.

Dr. Ron Paul is quoted in Free Market Medicine as saying We can hardly expect more government to cure our current health care woes. As with all goods and services, medical care is

Powell 5 best delivered by the free market, with competition and financial incentives keeping costs down. When patients spend their own money for health care, they have a direct incentive to negotiate lower costs with their doctor. When government controls health care, all cost incentives are lost.

This form of free market medicine is unobtainable to the low income and elderly segment since no form of financial medical assistance is available. Free market medicine clinics close from the lack of funding and patients ability to pay for services rendered. Often these clinics are understaffed and under equipped due to the lack of financing required to start and sustain a clinic of this type. This in turn means that major medical or life threatening treatments must be turned over to the larger well equipped facilities and hospitals. Physicians in the free market medical clinics cannot afford to give away medical attention to those who cannot pay. Therefore, health care under this method is only obtainable to the wealthy. Mandatory health care or universal health care has recently been making headlines and gaining popularity in the United States. Universal health care provides that every citizen would be covered for all health care and administrative costs would be drastically reduced. The complaint against universal health care is that it will be economically unfeasible. A study of universal health care in Maryland actually shows that a system of universal health care which covered all Marylanders, including the estimated 760,000 uninsured persons in the state, would actually reduce the total health spending in the state by about $345.8 million. As noted by John R. Battita, M.D. in his article Make Healthcare a Right. Its Cheaper! Studies have shown that with a publicly

administered system, health care costs would have been reduced by two billion dollars in 1999 by the reduction of administrative costs along with other different medical buying techniques such as buying medications in bulk.

Powell 6 Mandatory health care would order health insurance coverage for every individual much like automobile insurance for drivers. Individuals would be required to pay for their health insurance aside from the low income families who would qualify for government assistance. For those who can afford to buy insurance but fail to would be faced with state tax penalties and fines. In addition, employers that do not provide coverage to employees would incur fines of $295.00 per employee per year and accrue surcharges for employees who use state-funded free care.

The state of Massachusetts is leading the way to implement this form of mandatory health care coverage and California is close on its heels. The Governor of Massachusetts, Mitt Romney,

supports this proposal and has said The mandatory health insurance bill, modeled on the states policy of requiring auto insurance, is intended to end an era in which 550,000 people go without insurance and their hospital and doctor visits are paid for in part with public funds. We insist that everybody who drives a car has insurance, and cars are a lot less expensive than people. Massachusetts leaders envision that the plan would work as follows: Uninsured people earning less that the federal poverty threshold would be able to purchase subsidized policies that have no premiums, and would be responsible for very small co-payment fees for emergency room visits and other services. Those earning between that amount and three times the poverty level amount would be able to buy subsidized policies with premiums based on their ability to pay. Though no maximum premium is set in the bill, legislators intent seems to be for it to top out at about $200.00 to $250.00 per month.

Bill Virgin states in the Seattle P-I News Source article Is the Cure Mandatory Health Insurance? Currently, every taxpayer pays for the care of those who are uninsured and need

emergency care. Requiring those who can afford health insurance to purchase coverage is fair. Projections of the individual mandate show that the vast majority of the uninsured will take coverage.

Powell 7 Experience and research has shown that voluntary measures arent enough. Regardless of the price of insurance, some people choose to hedge their bets on health insurance by going without. By requiring everyone to have coverage, those who are healthy and currently uninsured will enter the insurance risk pool and thus help to stabilize the cost of premiums for the currently insured. No health care reform proposal without an individual mandate has ever been projected to enroll more than half of the uninsured.

In order to enforce this new law, residents would be required to provide details regarding their health insurance policy on their state income tax returns starting as early as 2008. This would alleviate the hospitals having to enforce this requirement. Officials said The hospitals will treat uninsured patients as before. In an article for The New York Times, by Pam Belluck, The bill does what health experts say no other state has been able to do: provide a mechanism for all of its citizens to obtain health insurance. It accomplished that in a way that experts say combines methods and proposals from across the political spectrum, apportioning the cost among businesses, individuals and the government. This is probably about as close as you can get to universal.

The Massachusetts legislation would also establish a program called the Commonwealth Health insurance Connector. This entity would link individuals or small businesses with health

insurance products. Using this program, individuals would be able to purchase health insurance with pre-tax dollars. This insurance connector would also give the individual a source for helping to make a better informed decision where health insurance is concerned. The universal mandatory health insurance bill will definitely be inspiring to other states about how there this compromise. Massachusetts found a way to get to a major expansion of coverage that individuals could agree on. For a conservative Republican, this is individual responsibility. For a Democrat, this is government helping those that need help.

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Most would agree that health care is a basic human right and should be available to all Americans. However, with the growing numbers of people around the world without health care, it is obvious that the tried methods of socialized medicine, two-tier health care and free market health care are not working. With mandatory or universal health care, the staggering number of people without health care would be wiped out and replaced with an optimistic outlook for the future of health care for all Americans. Following the lead set by the states of Massachusetts and California and implementing a universal, mandatory health care plan would allow all Americans the ability, right and access to needed health care equally. With the introduction of mandatory or universal health care, Americans will be able to rely on adequate health care always being available and obtainable.

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WORKS CITED

Weinberger, Steven E. MD; Smith, Lawrence G. MD; Collier, Virginia U. MD. Annals of Internal Medicine Release date: April 6, 2006 www.annals.org.

Cihak, Robert J. MD.

Board member of the Discovery Institute and a past president of the

Association of American Physicians and Surgeons

Ray, John. "The Australian Newspaper Editorial Health Fund Reforms Will Benefit All Australians Publish Date: April 30, 2006 http://www.theaustralian.news.com.au/

Wilson, Lawrence, M.D.

Editorial Freedom Daily Paper, Publish Date:

January 5, 2006

www.freedomdailypaper.org

Paul, Ron MD.

Ron Paul Archives Free Market Medicine, Publish Date:

May 5, 2005

www.lewrockwell.com/paul/paul

What are Medicare and Medicaid? www.medicaid.gov

Battita, John R. M.D.

Make Healthcare a Right.

Its Cheaper!

Publish Date:

December,

2001www.about.com

The Washington Post Company Massachusetts Bill Requires Health Coverage. Publish Date: April 4, 2006 www.washingtonpost.com

Powell 10 Virgin, Bill. Seattle P-I News Source Is the Cure Mandatory Health Insurance? Publish Date: April 11, 2006 www.seattlepi-nwsource.com

Belluck, Pam The New York Times, Massachusetts Sets Health Plan for Nearly All. Publish Date: April 5, 2006 www.nytimes.com