Health care in the USA is a subject that, over the years, has inspired numerous debates, ideas, and controversies in regards to the correct method with which to better protect the health and safety of American citizens. Since the start of the 2008 election campaigns, the issue of health care in the USA has become a pivotal point that has the potential to make or break the progress of various candidates’ journeys towards the white house. Since the release of filmmaker Michael Moore’s movie SiCKO, the American public has become even more aware of the options, or lack thereof, provided by the health care system, leaving many taxpayers and voters calling for a solution.
The controversies are all based on the fact that, although the US can lay claim to having one of the best medical service industry in the world, they also have the highest costs associated with medical treatment and care. With critical operations such as heart bypass surgeries costing as much as US$130,000, many Americans are finding themselves unable to bear this heavy financial burden. This is contributing to the fact that medical treatment has become the number one reason for declaring personal bankruptcy in the USA. In no uncertain terms, the choice that many Americans are facing is to receive necessary treatment and suffer extreme financial consequences, or not receive treatment and suffer severe illness and possibly death.
In conjunction with the already high costs of treatment experienced throughout the United States comes the issue of rapid medical inflation across all sectors of the health care industry. Intensive government regulation, inflated drug costs, and rising equipment expenses are all leading to rapid prices hikes and having hard hitting impacts on the American public.
As mentioned above, since the start of the Republican and Democratic debates, candidates on both sides of the political divide have been asked what they would do to address the causes of skyrocketing health care costs. As you would expect from such a diverse field of candidates, there have been a number of solutions.
1. Unilateral Universal Health Care (similar to Britain’s NHS)
- Universal health care is a position that has taken hold primarily in the Democratic camp. The main sponsors of this solution to America’s health care crisis are Clinton, Edwards, Gravel, Kucinich, Obama and Richardson.
Universal health care is the idea that every one should have equal access to quality health care services. While in theory this idea seems to work, many nations that have universal health care coverage (the UK, for example), have seen that, in reality, it can take a patient an extremely long time to receive the care that they need. In addition, facilities are limited and doctors and health care professionals are overburdened by their patient load. This all leads to the rejection of such a reform in the USA.
Critics cite that any such universal health care system would have to be regulated extensively by the government, leading to slowdowns in the patient treatment process. They also stress that America currently has one of the most highly-regulated health care industries in the world and that the regulation of the health care industry provides benefits to health care providers of up to US$170 billion. In actuality, this costs taxpayers approximately US$340 billion. However, there are a number of benefits to universal health care. One of the major profits is fact that, no matter what happens, an individual will always be assured of the help and care that they need.
The second major option that is being suggested by candidates is:
2. Mandatory purchase of health insurance
- Mandatory health insurance was initially proposed and instituted in Massachusetts by Republican candidate Governor Mitt Romney. It has since gained credence with a number of state legislatures including that of California.
Mandatory health insurance requires that every citizen in the USA would have to purchase a health insurance plan to guarantee themselves health care. The big issue that proponents of mandatory health insurance have faced is the fact that this proposal is not very different from the legislation currently in place in the form of HMOs Medicare and Medicaid. The only real variation is that Americans would not have the choice to opt out of coverage. Opponents have responded to the plan by asking whether the coverage would be the same as the low protection offered by current programs, and have cited the fact that individuals could purchase a plan with virtually no protection to remain inside the law. One favorable aspect of mandatory health insurance is the fact that there would be no tax increases, while there would be with a universal health care scheme.
The last major suggestion on the table is:
3. Insurance Tax Credit
- Originally offered as a viable option to the health care issue by Republican candidate Dr. Ron Paul, this option has gained support from fellow candidates Rudy Giuliani, and John McCain.
Insurance for tax credit is remarkably similar to the mandatory health insurance suggestion but with a few significant changes. With this option, no one would be forced to purchase health insurance, however, the individuals that do will be given a tax credit (or rebate) for the costs of their health insurance premiums. Dr. Paul states that many families are currently spending close to US$1000 in annual insurance premiums, without being rewarded for not being independent of government support or the health care industry. This option means limited government involvement in an individual’s health care choices, and that people will only gain credit for what they pay. In Dr. Paul’s plan there are no forced insurance policies, benefits are given to families with children and those with terminally ill dependents, and social security fees are waived for individuals suffering from a terminal or oncological illness.
When all of the above are compared, in terms of realistic, short-term legislation, the insurance for tax credit option seems like the most viable option. By leaving choices in the hands of the individual citizen and the open market, consumers are able to make informed decisions about the type of coverage that they want. By giving individuals that have purchased health insurance a rebate at tax time, the government recognizes that protection is, indeed, necessary.
Programs like Medicare and Medicaid are responsible for roughly two thirds of all public health spending, and the United States currently has the highest per-capita health care expenditure in the world. Looking at that, it is clear that universal coverage is not an option that will correct the inflation inherent in the health care industry, but rather create higher taxes and close up the market.
These are just some of the major options that have been suggested in recent months during the campaigns. Ultimately, it is up to the American voters to decide which position they desire. However, there are solutions that have more credibility than others, and throwing money at the problem will not make it go away. Take some time and research the positions, it may have more effect on you than you know.