Harrison " Peter Harrison Ms. Shin English 1010 13 January 2013 !

Universal Healthcare and the Affordable Care Act in the U.S.

Healthcare is something essential; it is something everybody most likely needs at some time in their life. However, many lack this, whether it is because of cost, or even that they simply dont want to buy healthcare insurance. This creates a large dilemma. Universal Healthcare is type of healthcare system in which countries seeks to provide healthcare services to all its citizens. Some point to Cananda as an example of a country thats implemented Universal Healthcare very well. Provinces do not receive full federal funds unless they adhere to the Canada Health Act. In 1984 the Federal Parliament passed the legislation despite much opposition from the medical community. The Act strengthened the application of the ve national principles which govern Canadian healthcare. The Act provided for nancial penalties for provinces that permitted hospital user charges or physician extra-billing. Canadian Citizens receive many benets such as: ! universal coverage: 100 per cent of the insured population must receive the same services on the same terms and conditions;

Harrison # !! comprehensive coverage: the plan must cover all insured health services; !! reasonable access: no barriers such as user charges or extra billing; ! portability of coverage: when Canadians move within Canada and sometimes abroad; ! public administration of the insurance plans on a non-prot basis. (States of Health: Canada--Where Health Is Wealth) Those for Universal Healthcare would argue that for Canadian citizens the benet far outweighs the cost. Proponents for and against Universal Healthcare in the U.S. debate over the cost, the legality of it regarding the Constitution, and whether the benet to some outweighs the cost it might put onto others. Healthcare and its cost are an issue that people and elected ofcials have dealt with for many years. Programs like Medicare and Medicaid were created in the 1960s in an attempt to close the poverty gap. They were some of the rst programs to set up long term goals to help decrease poverty and provide for those not covered. However, politicians had no idea their costs would grow as rapidly as they did. The Congressional Budget Ofce (CBO) of the United States government expects Medicare and Medicaid to continue growing, rising from 5.3% GDP in 2009 to 10.0% in 2035 and 19.0% by 2082. CBO has indicated healthcare spending per beneciary is the primary long-term

Harrison $ scal challenge. However, as Brown states, countries such as France, Great Britain, Canada and Germany spend a smaller portion of their budget compared with the U.S. and yet have universal healthcare, enabling them to provide healthcare for every citizen (7). The fact that the U.S. spends more on healthcare services than most countries, yet has fewer people covered, is where proponents for Universal Healthcare would argue for a change in the U.S. healthcare system. Riedel points out another issue about cost. He states that surging healthcare costs slow the rate of job growth by making it more expensive for companies to add new workers. They also suppress wage increase for current workers by driving up total compensation costs (9). Many people argue the cost of such implementation would adversely affect hiring as Riedel states. The legality of Universal Healthcare is also an issue. Some states have made attempts to provide coverage for its residents, however they faced tough legal battles. Benko brings up a state initiative healthcare reform that faced a legal battle which ultimately led to its demise (194). In 1993, Washington enacted the Health Services Act, a sweeping reform package aimed at insuring every state resident by 1999. The law would have required all employers to cover half the cost of a basic coverage plan for their workers, while the poor and unemployed would have been covered through state-subsidized insurance plans, nanced in part by a tax increase on cigarettes, alco-

Harrison % hol, hospitals and insurers. But in early 1995 just three months before the rst phase of the program was set to go into effect 90% of the law was repealed amid opposition from small businesses, insurers and a new Republican-led Legislature. On the national scale some would argue that the debate for healthcare coverage for all reached a climax as the Affordable Care Act, drafted by President Obama, came into strong oppositions from conservatives and Republicans. The Affordable Care Act was passed by Congress and the bill was signed into law by President Obama on March 23, 2010 (healthcare.gov). It was then challenged by several lawsuits involving both private citizens as well as several states. It was eventually brought to the Supreme Court which ultimately ruled it Constitutional. Another question with Universal Healthcare is whether the cost outweighs the benets. Some say that having everyone covered would greatly decrease costs spend on preventive health care. Others say that it would put too much nancial strain on citizens to have everyone covered. Although not Universal Healthcare, the Affordable Care Act is a step towards making sure all Americans are covered. However, some business and others oppose it saying it will hurt their business. In the article Small Businesses Fume, Now Seeing 'Obamacare' As Unavoidable Mark Guarino states The Affordable Care Act (ACA) of 2010 requires companies with more than 50 workers to

Harrison & provide health insurance to employees who work at least 30 hours a week, starting in January 2014. If they don't, they must pay the government $2,000 a year for each fulltime employee minus the rst 30 workers. The reform law puts companies with already-slim prot margins in a bind, especially if they pay minimum wage, says Adam Powell, president of Payer+Provider Syndicate, a health services consulting rm in Boston (Christian Science Monitor). Some businesses have so ercely opposed the Affordable Care Act because there are many costs associated with implementing health care coverage for all employees. They would argue that the cost of implementing such a program is far higher in cost then would the benets be to have all their employees covered. Others may point out that the benet of healthcare for all far outweighs the associated costs. Healthcare, whether universal or private is an issue many countries deal with on a daily basis. At the current time many countries, along with most European countries, have chosen the path of a more socialized medicine system. The U.S. and many Asian countries have, however, chosen to not go the route of a universal healthcare system. People on both sides argue the cost and nances, the legality of it regarding the Constitution and the cost benet ratio. !

Harrison ' Works Cited Congressional Budget Ofce. The Long-Term Budget Outlook Report. n.p. June 30, 2010. Web. 25 Nov. 2012. http://www.cbo.gov/publication/21546 Dove, Alan. "US Healthcare: Take A Number, Please." Nature Medicine 4.9 (1998): 991. Academic Search Premier. Web. 19 Dec. 2012. Guarino, Mark. "Small Businesses Fume, Now Seeing 'Obamacare' As Unavoidable." Christian Science Monitor. 16 Nov 2012: n.p. SIRS Issues Researcher. Web. 19 Dec. 2012 Houston, Muiris, and Maev-Ann Wren. "States of Health: Canada--Where Health Is !Wealth." Irish Times (Dublin, Ireland). Oct. 20 2001: n.p. SIRS Issues Researcher. Web. 19 Dec 2012. Rashford, Marleise. "A Universal Healthcare System: Is It Right For The United States?" Nursing Forum 42.1 (2007): 3-11. Academic Search Premier. Web. 9 Dec. 2012. United States. Dept. of Health and Human Services. Take health care into your own hands, The Health Care Law and you, Whats Changing and When, 25 Nov. 2012 !U.S. Government Healthcare Site. Web. 18 Dec. 2012