In the United States of America, as of 2022, healthcare exists as a hybrid system, with some participants relying on privately purchased insurance, while others receive their healthcare through systems administered by the government, such as the Veteran’s Administration, Medicare, or Medicaid, or the Health Insurance Marketplace. A hybrid system, such as the one the United States relies on, can be excessively bulky, leading to waste, and according to William C. Hsiao, a professor of economics at Harvard University, this broken system that is outrageously expensive often has the worst outcomes of civilized nations (Beckert-McGirr and Zhao 2021). Additionally, many Americans still fall through the cracks when it comes to having insurance. According to the CDC, at the end of 2021, over 9% of Americans did not have health insurance, which means that 31.1 million Americans potentially lacked the ability to receive appropriate health care services (“CDC Reports on Uninsured in First Six Months of 2021: AHA News” 2021). The United States stands at a crossroads wherein a decision should be made to modify this healthcare system. Two potential systems frequently discussed as far as possible implementation are socialized medicine and nationalized medicine.
Socialized medicine, as a concept, has unfortunately been equated with socialism, a form of government, rather than being considered a way that healthcare might be administered more efficiently. Under socialized medicine, the government would own medical facilities and pay the wages of medical providers and then these services, providers, and facilities would be available to all Americans. The United Kingdom has operated a largely successful socialized medicine system for the British people since the end of World War II and although the system has suffered from low funding, the overall design of the NHS offers viable alternatives to America’s bloated and often inefficient system. Jim Edwards, an author for Business Insider with dual citizenship, has had an opportunity to compare the two systems on many levels. He concludes that aside from longer wait times on occasion that overall, America’s medical system cannot compare to Britain’s (Edwards 2015). Socialized medicine does require appropriate funding. Typically, the funding is derived from tax revenue, with a higher amount of the tax burden paid by wealthier individuals but much concern remains, primarily from conservative politicians, that such a system would result in greatly increased expenditures for the government. Christopher Cai, writing on behalf of the National Library of Medicine, carefully studied the data from nineteen studies on the cost of a Medicare for All system in the United States and concluded that a minimum of 3.5% would be saved in costs on a yearly basis (Cai 2020).
Nationalized health insurance systems differ from socialized medicine in that participants use publicly purchased insurance policies to pay privately owned care facilities. By removing privately owned health insurance companies from the picture, the entire process becomes streamlined. Profit is no longer the motivation so claims are paid and because all paperwork belongs to a single source, administrative processes run much more smoothly. As with the socialized system, the largest risk to the system is extensive waiting times once patients who have delayed care have the means to receive said care, and the system becomes temporarily overwhelmed. Financing such a system results in similar challenges to a socialist medicine system as the primary payer again is the federal government, augmented by tax money. However, Tedros Adhanom Ghebreyesus, from the International Monetary Fund, observes,
“Safeguarding people’s health relies on resilient health systems that ensure everyone has access to the good-quality services they need, without facing financial hardship. This is what we mean by universal health coverage (UHC).”
Thus, just months before the COVID-19 outbreak, all WHO participating countries ratified the Political Declaration on Universal Health Coverage (Ghebryesus 2021). In the end, nationalized health coverage might be slightly more tolerable to those opposed to health care for all but in reality, neither option seems likely due to insurance and medical lobbyists who fight on behalf of a system that is hugely profitable to them.
Healthcare insurance in the United States continues to be a highly contested political issue with the concern of government expenditure taking center stage. At the time that President Obama revealed his Affordable Care Act, in an effort to expand healthcare coverage, one out of six Americans did not have health insurance; this statistic represented over 50 million Americans (Yang 2022). Despite this startling statistic, conservative politicians fought the implementation of his plan. Thanks to the Affordable Care Act, 41% of previously uninsured adults now have health insurance but too many Americans still lack access to affordable health insurance and necessary health care (ASPA 2021). Forty-three countries around the world provide universal health care for their people, and the United States needs to take a leadership position in ensuring that all Americans have access to basic health care.
The Declaration of Independence guarantees each American the right to life, liberty, and the pursuit of happiness. Having inadequate or impossible to afford health insurance or healthcare costs makes the American dream impossible to pursue for those who are impacted. Right now, in the United States, the average yearly cost for employer-provided insurance for a family is $28,000, of which the family in question will pay around $16,000 (Arno and Caper 2020). One could argue that pursuing happiness while reduced to poverty due to medical expenses or being physically disabled by a preventable condition without the funds to treat said condition, becomes an impossibility. By providing adequate health care, the United States government could greatly improve the quality of life, especially in at-risk populations, and thus make this pursuit possible. Furthermore, caving to corporate greed at the cost of people’s lives surely does not live up to the Founders’ vision for America. Furthermore, on December 10, 1948, the Universal Declaration of Human Rights, drafted by Eleanor Roosevelt, was adopted by the United Nations. Notably, this important document states, “ “Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care…” As a country, America has a responsibility to meet the needs of her people and in doing so, also meet the expectations of those who drafted seminal documents defining the meaning of the United States as a nation.
Economically, the benefit of having a system that gives more to the people of America cannot be overlooked. The United States funnels much more money into its healthcare system than most other countries in the world. Despite this, the people are expected to pay twice as much per person on health care spending. America also ranks near the bottom of the list of general health indicators, such as infant mortality rates and other preventable deaths. (Arno and Caper 2020). Health care represents more than just a governmental expense, though. America’s people stand as one of her greatest resources, and by taking care of this resource, America can ensure that her workforce continues to be a force to be reckoned with over time. Many studies over the years have illustrated that a lack of insurance is directly related to an increase in the odds of earlier death. Furthermore, those without insurance are less likely to seek care for conditions such as depression that directly impact their ability to be productive. (Woolhandler and Himmelstein 2017).
Undoubtedly, change needs to be seen in the American healthcare system. It being a hybrid system contributes to economic waste; a socialized medicine system, such as the one that Britain has, could allow for American citizens to have more readily available access to healthcare. And with nationalized health insurance, the 30 million citizens without insurance could be more readily covered. With insurance consistency, America’s statistics regarding healthcare indicators could be more in line with what a global superpower should look like. As it stands, the healthcare system that the American government uses is predatory to its residents. It tries and fails to benefit from those who cannot possibly participate in it. With significant revisions, the common good can be bolstered, and the principles outlined by our founding documents can be upheld.
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