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Cynthia Vasquez
Matthew Moberly
Writing 10
8 May 2015
A Need for National Healthcare
Abstract
In her proposal, A Need for National Healthcare, Cynthia Vasquez points to all the flaws in
Americas current healthcare system and proposes a national healthcare system that would fix
these issues. Vasquez develops this proposal by providing background information to the issue,
providing supporting data showing the issue in context, and finally suggesting and explaining the
national healthcare system she proposes that would provide healthcare to the currently 14 million
uninsured. The author purposes that there is a necessary need for reform of the healthcare
system. In a serious, implicating tone, Vasquez dispels to her professional audience that without
the necessary reform, the health of the country will decline as citizens neglect their health due to
healthcare costs.
Background/Problem
Currently in America, healthcare is run under a mixture of private and governmentprovided systems. Most people in America receive healthcare insurance through private
companies either through their employer or by paying for their own. For those who cannot afford
to pay for their own insurance, free government insurance is available. Despite the availability of
this free insurance, millions of people in America still go uninsured because they dont qualify

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for free insurance because they make too much to qualify for free insurance but do not make
enough to finance their own insurance. For example, in a summary of key facts called Key
Facts about the Uninsured Population, the Kaiser Health Foundation describes how, Many
people do not have access to coverage through a job, and gaps in eligibility for public coverage
in the past have left many without an affordable option. Even after ACA coverage expansions,
Medicaid eligibility for adults remains limited in states that did not expand their programs (Key
Facts about the Uninsured Population). The underlying problem is that people cannot afford
insurance and the problem only worsens as insurance premiums increase. According to Rising
Healthcare Costs, Government data show that the growth in premiums has tracked directly
with the growth in underlying medical costs. Thus, as health care costs increase, so do
premiums (Rising Healthcare Costs). According to the Kaiser Family Foundation and Health
Research & Educational Trust, in a 2013 annual survey called Employer Health Benefits,
Average premiums increased 5% for single coverage and 4% for family coverage in the last

year. Family premiums have increased 80% since 2003 and have more than doubled since 2002.
(Employer Health Benefits). As healthcare costs increase, premiums increased, increasing the
lack of affordability of insurance. To avoid rising healthcare costs, to save money people neglect
their health by avoiding the doctor except in extreme circumstances. A recent Harris Poll
conducted on behalf of SCIO Health Analytics, an organization responsible for collecting data on
how healthcare is delivered, reports that 1 in 5 insured Americans avoided a care due to fear
of costs and uncertainty on benefits coverage. Avoiding medical treatment due to lack of
knowledge and cost fears can lead to an increase in avoidable ER visits, inpatient hospitalization,
labs, high-tech imaging and work absenteeism, (Rising Healthcare Costs). To counter the
issues that the current healthcare system creates, a completely nationalized healthcare system

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should be implemented. Under this system, everyone would have access to medical care,
regardless of cost; people would no longer have to neglect their health and the government
would end up saving money.
Historically, this issue has been a constant issue for those in Congress who create
healthcare legislation. For many years representatives have pointed to the faults in the current
healthcare system and suggested change. In a 1993 speech Bill Clinton asserted that, Despite
the dedication of literally millions of talented healthcare professionals, our healthcare is too
uncertain and too expensive, too bureaucratic and too wasteful. It has too much fraud and too
much greed, (Clinton, Bill). United States House Budget Committee Chairman and House
Representative Paul Ryan asserts that government healthcare programs are currently driving the
explosive growth in our spending and our debt, (Ryan, Paul). Paul Ryan points that under the
current healthcare system, not only is healthcare unaffordable for citizens but for the government
as well. Even the President of the United States, Barack Obama stated in a speech during a joint
session of Congress that, Those who do have insurance have never had less security and
stability than they do today. More and more Americans worry that if you move, lose your job, or
change your job, you'll lose your health insurance too. More and more Americans pay their
premiums, only to discover that their insurance company has dropped their coverage when they
get sick, or won't pay the full cost of care. (Obama, Barack). This only further points to the
issue at hand: Americas healthcare system is unstable, unaffordable, and requires change.
With annual premiums for health insurance increasing yearly, maintaining a health
insurance plan is an expensive, unaffordable necessity. In 2013, the U.S. Census Bureau
estimated that annual premiums reached $16,800 for the average family (Medalla and Smith).
This creates a conflict because everyone should have access to healthcare when they need it but

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not everyone can afford it. To relieve this issue, the United States government provides free
insurance to those who cannot afford private insurance or are not covered under their employers
insurance. Despite the government providing free insurance to those who arent covered by an
employers insurance, according to U.S Census Bureau data, In 2013, the percentage of people
without health insurance coverage for the entire calendar year was 13.4 percent, or 42.0 million.
(Medalla, Smith). A problem affecting 42.0 million people in America is no small problem-it
needs a solution and fast.
Solution
Since private insurance fails to meet the primary purpose of healthcare insurance (to
make maintaining ones health more affordable and thus more available in order to promote
better health) a solution to Americas healthcare problem would be to have a completely
nationalized healthcare system. The current healthcare system, a mixture of some private and
some government insurance, would be replaced with one where all private insurance companies
get abolished and the government becomes responsible for providing healthcare insurance to
every American.
A nationalized healthcare system would be most beneficial because it would be more
affordable for the United States and for citizens themselves. On average, each person pays
$2,822 per year at $235.27 monthly for private insurance in the individual market (not through
their employer) and the government spends $8,233 on health per person (Kane, Jason). With
insurance costs rising each year, a nationalized healthcare system would be able to control for
increased medical costs which would decrease total spending for the whole country. An example
of this in action is in Canada where, Canadian hospitals receive prospectively determined global
operating budgets, removing incentives to provide unnecessary care while simplifying billing

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and administration, (Glen, Brandon). This portrays one way in which the American government
would save money. Because American hospitals would be run by the government, the
government would be able to create set limits on budgets for hospitals, decreasing medical costs,
simplifying the billing process, lowering spending. If America had a universal system, the
country could see costs more similar to Canadas expenditures. According to Marleise Rashford,
an RN, BSN, and Family Nurse Practitioner Graduate Student, in her article Healthcare System:
Is it Right for the United States?, when comparing the United States and Canada, The final
numbers for total healthcare cost for administration were $294.3 billion or $1,059 per capita for
the United States and $9.4 billion or $301 per capita for Canada (Rashford, Marleise). By
switching to a national system, the United States could potentially see huge savings, just look at
Canadas expenditures.
In Americas current system, portions of the bureaucracy are responsible for overlooking
and reviewing HMOs. Under a national system, administration costs would decrease because the
size of the administration would decrease as all the different complicated insurance networks and
coverage plans are eliminated and replaced with one government plan. According to National
Health Insurance Could Save Billions of Dollars, Harvard Professor David U. Himmelstein,
cofounder of an organization advocating for a single-payer national health insurance policy,
points that one of the major factors contributing to high healthcare costs is that, the United
States fragmented payment system drives up administrative costs for doctors and hospitals, who
must deal with hundreds of different insurance plans (for example, at least 755 in Seattle alone),
each with different coverage and payment rules, referral networks, etc. In Canada, doctors bill a
single insurance plan, using a single simple form, and hospitals receive a lump sum budget...
(Himmelstein and Woolhandler).

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In addition, a nationalized healthcare system would save lives and lead to overall better
health in America. Since, Twentynine percent [of people] report that because of the cost they
have postponed needed healthcare, 25 percent say they have skipped a recommended medical
test or treatment, and a similar share (24 percent) did not fill a prescription for a medicine,
(Health Security Watch) A system where everyone in America gets healthcare insurance,
would aid these unfortunate statistics. According to Niall McCarthy, a data journalist for Forbes
Magazine, On average, an American visits the doctor four times a year, substantially less than in
other countries. In Japan, people usually go to their doctor 13 times a year, (McCarthy, Niall).
By running the health sector under a national system, citizens would benefit by visiting the
doctor and getting the preventative services that they need. People should not postpone taking
care of their health simply because of cost; a national healthcare system would make it so
Americans dont have to choose between taking care of their health and being able to pay for
other expenses.
A nationalized system would lead to better health because people would finally be able
to get the preventative services and medical procedures they may have previously passed upon
because of price. This will lead to increased life expectancy. Which, although America spends
more on health insurance than any other country, America does not have the highest life
expectancy to match. A study found that a 19-year-old in Canada could expect to enjoy 2.7
more years of perfect health than a 19-year-old in the U.S," (Canadians healthier, outliving
Americans: study"). People in other countries where national healthcare is available tend to be
healthier in part because they have easy access to healthcare. This is not only seen in Canada but
in Japan as well where, According to Osamu Saigusa, Secretary General of the Japan Generic
Pharmaceutical Manufacturers Association, Japanese people can easily access healthcare

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services, making it possible for them to receive early diagnosis and treatment. This supports
them to maintain good health. Seeing that the people in both Japan Canada have benefitted from
national healthcare in that they live healthier lives, by switching to a national system, Americans
could also benefit from national healthcare. By switching to a nationalized system, not only will
America save money on administration costs, but Americans would become healthier overall
which would lead to a higher life expectancy.
Despite these benefits, others may argue that having a national system is not practical
because the system cannot sustain itself. Instead, opponents of a national system, propose a
mixed system involving a combination of private and government-aided insurance. Proponents
of a mixed system argue that because a national system would be too costly for the government,
a system that allows people to pay for at least some of their own insurance would be most
beneficial to save the government costs. These proponents argue that requiring the national
government to run and operate all healthcare operations would expand the government and lead
to massive administration costs. However, under the current very inefficient system only 1% of
the government budget is set for administration costs ("Budgeted net outlays) Given that
currently most of the current government expenses goes toward medical services and not
administration, under a national system where administration is downsized, costs would
decrease, not increase. According to Gerald Friedman, in a report providing evidence as to how
the United States could afford a single payer system Altogether, administrative savings from the
single-payer system, on providers overhead costs, and on administrative expense among
insurers, Medicaid, and employers, come to $476 billion in 2014. Adding in the savings on
prescription drugs of $116 billion brings the total savings to $592 billion, (Friedman, Gerald).

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Another argument against national healthcare is that to fund and support a national healthcare
system, taxes would have to skyrocket, making life unbearable with the heavy burden of taxes on
the family. Curtis Dubay, a senior tax analyst in tax policy describes the opposition to national
healthcare because of taxes by writing, higher tax rates on working and investing will
discourage economic growth both now and in the future, further lowering the standard of living
(Dubay, Curtis). However, taxes are nearly equal in Canada and the United States. According to
Rhonda Hackett in The Denver Post, Overall, Canada's taxes are slightly higher than those in
the U.S. However, Canadians are afforded many benefits for their tax dollars, even beyond
health care (e.g., tax credits, family allowance, cheaper higher education), so the end result is a
wash. At the end of the day, the average after-tax income of Canadian workers is equal to about
82 percent of their gross pay. In the U.S., that average is 81.9 percent, (Hackett, Rhonda). In the
end, although Canadas taxes are higher to help fund the national healthcare system, the
difference between the after-tax income between Americas and Canadians is fairly insignificant
in the big picture. With a difference of only .1%, the tax difference is negligible. Clearly, the
higher tax rate could not have that large of a negative impact on the economy- the tax increase
would not have to be much.
Conclusion
A national healthcare system is key to solving Americas expensive, ineffective,
and unpopular healthcare system. A nationalized healthcare system will provide healthcare to the
millions of uninsured and make receiving necessary medical care affordable and accessible. This
system could open more jobs in the medical field as more people seek the medical care that they
need. Other countries have shown that national healthcare systems can be successfully
implemented and can actually be a more cost-effective than combinations of private and

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government healthcare. Given that America makes the switch to national healthcare, millions
would benefit from accessible medical care. However, if the current system continues on, more
and more people will go uninsured every year and the health of the citizens of America will
decline as Americans continue to neglect their health because of medical costs. . It is imperative
that the severe problems within the American healthcare system are realized and fixed.
Americans need to fight for a system of health care that provides health care to all people. People
should not have to choose between health and paying the bills. The current healthcare system is
unjust, it needs serious fixing and fast.

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2011." The Health Care System. Barbara Wexler. 2011 ed. Detroit: Gale, 2011.
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"Canadians healthier, outliving Americans: study." The Canadian Broadcasting
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Clinton, Bill. Address on Health Care Reform United States Congress. U.S. Capitol
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A Year [infographic] Forbes Magazine. 4 Sept. 2014. 30 Apr. 2015.

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