Universal Healthcare in the United States - Term Paper Example

Universal Healthcare in the United s al Affiliation Universal Healthcare in the United s Introduction Universal healthcare is often known as universal care or health coverage; usually referring to a given health care system that is responsible for the provision of health care, as well as financial protection (health-related) to all citizens present. Organized within a given jurisdiction, it revolves around the provision of specified packages (of benefits) to all members of a given society. In such a case, the end-goal or aim is to provide financial risk coverage/ protection, in addition to improving general access to health services; thereby improving overall health outcomes of the citizenry present. To be noted is that as a concept, universal health care does not simply imply the coverage of individuals for all risks i.e. one-size-fits-all conceptualization. Rather as Navarro (1989) portrays, it is determined by three fundamental dimensions – those covered; services that are covered, and what amount of total costs (accrued), are covered. Health care systems are in a majority of states funded through mixed models of funding. Generally, revenues accrued from taxation do compose the primary funding source, with most countries supplementing the revenues with specific levies. This is essentially by way of a mix of private and public contributions thereby ‘spreading’ the costs over a larger population. Compulsory insurance is a key avenue of enhancing universal healthcare, usually enforced by way of legislation in given jurisdictional arenas. This may thereafter, necessitate citizens to purchase their insurance; but in many cases (in effect), it is the government that provides such insurance, as part of its social welfare responsibilities. Examples of compulsory insurance contexts are exemplified by both the U.S. Patient Protection and Affordable Care Act, and the Swiss Healthcare system. History of Universal Healthcare in the U.S. In the U.S., the crusade for some form of universal healthcare (government-funded) is traceable to the 20th Century with advocacy of the same facing different obstacles despite close success. While other developed states had initiated some form of social insurance, proponents in the U.S. continued facing hurdles, especially as a result of the federal government (then), leaving each state to its own doing. The different states in turn left such matters to voluntary and/ or private programs, based perhaps on the lack of national legislation. It is however during the Progressive Era that major undertakings took place, with reformers working on enhancing social conditions for the growing working class (Navarro, 1989). Unlike European counterparts, the U.S. as a leading developed nation did not have powerful working class support for broader social insurance measures. This was vivid in both the camps of the U.S. Socialist and The Labor parties. The lack of support for universal benefits programs and sickness funds, or health insurance displayed the fragmented nature of American politics and policy formulation. Pertinently so, unlike Europe, in the U.S., the first proposals in support of health insurance did not evolve out of anti-socialist sponsorship; within the political debate. In essence, while President Theodore Roosevelt was in support of health insurance, majority of the reform initiative took place outside government circles. This was despite the Roosevelt’s ideal that no nation could be strong, where its populace was poor and sick. However, successful administrations were mainly conservative in nature, hence postponing for almost two decades, further political mileage in terms of political debate and discussions. Thus, the sort of presidential leadership, which might have been conducive for enhanced involvement of national government; in the provision and/ or management of social welfare lacked during this time. In 1915, after campaigns led by the American Association of Labor Legislation (AALL), the – AALL Bill – was drafted. Physicians were further included in the bill’s formulation, hence the American Medical Association’s (AMA) support of the proposal. Opposition was however evident from the American Federation of Labor (AFL) and the then-existing Private Insurance industry (Vladeck, 2003). America’s Healthcare System: A Comparative Analysis To be noted is that while a majority of European nations is relatively inferior to the U.S., in terms of economic, geo-political and social wellbeing, various problems continue plaguing the industry. This makes the system present, inferior to that found in various European nations, as well as that of Canada. From the aforementioned, one is able to understand the lack of a universal healthcare system undertaking. This is especially as witnessed in Europe, which was based upon income stabilization, as well as the protection against wage loss of sickness. The system preferred this as opposed to the payment of medical expenses; which still is the foundational basis of current health cover in Europe. The current form of health cover in the U.S. has indeed undergone through different phases; through great opposition, to the present state that it is. Currently, in the U.S., there is the Patient Protection and Affordable Care Act (2010) and the U.S. National Health Care Act (2009); both of which further strive in the provision of universal health coverage. Both became necessary because a greater population in America was, and continues being uncovered thereby influencing in the overall, both national health and insurance sectors. Thus, disparities with regard to ease of access to health and care are greater in the U.S. than in most of its developed counterparts. Currently, as the most expensive, it however does cover fewer individuals as opposed to the case in most Industrial nations. This is perhaps as a result of the huge numbers of ‘for-profit’ entities, which are primarily tasked with this critical social element (Vladeck, 2003). Thus, the existing nursing homes, dialysis companies and private hospitals/ clinics/ facilities do make huge amounts of money; however not through their delivery of proper care to those needing it, but rather in support of corporate interests and profit margins. It is upon these challenges that the two aforementioned Acts were formulated and subsequently enacted. Regarded generally as ‘Obama care’, the prevailing system is but a compromise with both the powerful insurance and drug (medical) industries; which essentially control America’s healthcare system. As a result, Medicaid, a segment of the Obama care program provides greater coverage, which is good for the general public. However, this has been through enhancing the private insurance industry, by way of increased monetary input (Navarro, 1989). Hence, the U.S. is by global standards quite peculiar being the most expensive, while it is less efficient and effective than most counter-parts in the developed world. This is blamed on ‘the same old reasons’ that were, and continue being influential in the U.S. These may be inclusive of: - ideological differences; interest group influence; entrepreneurship spirit present in American medicine; anti-socialism/communism; public policy fragmentation, and the association of public programs with dependence, charity and personal failure. The middle class, which is a powerful social segment, has also been removed from the advocacy course, through alternative provision of Blue Cross private insurance plans instead. In Canada, the system present is that of – a single-player – where all Canadians receive the same cover under national law. So too is Denmark, amongst other European states where government-sanctioned healthcare prevails. Thus, a patient in these nations would not encounter a billing office in a majority of hospitals, as one would find in the U.S.; but rather the medical system receives payment through centralized federal and state funding. All health care facilities are continuously funded, so that medicine is available to all individuals equitably (Navarro, 1989). Current Problems with the United States Healthcare System In the American system, the presence of problems cannot be pointed to a single entity, but rather a collection of explanations. These can be divided into 2 main categories i.e. historical-cultural and political-structural explanations. Concerning historical-cultural explanations, Americans are more negative towards government and governance in general. This is perhaps as a result of the absence of traditional aristocracy, which grew out of individual independence and self-realization from the earliest times of settlement. In addition, the lack of an American ‘self-identified’ working class provides another point of focus; as in a majority of European nations, it is the working class and labor parties, which strove towards greater national healthcare realization. The lack of a labor party in the U.S., which in variants of forms was instrumental in enhanced healthcare within the greater European region, may be as a result of the great abundance of quasi-free or free land earlier in its history. Thus, a substantial proportion of low-income (relatively) working Americans owned real property, hence the self-identification of most Americans with the middle class. Fundamentally so was the fact that it permitted geographic mobility; thereby making the term ‘exit’, an acceptable alternative to ‘voice/ agitation’; amongst those parties with grievances. The lack of a labor party, which would have been pivotal in enhanced universal suffrage, can be primarily attributed to the aspect of race and racism. Thus, White workers could not be brought together with African and Latino workers on a level platform, on which they could further their issues (Vladeck, 2003). It is upon the above that politically, the Madisonian system was built, separating powers amongst the various government arms amongst other constitutional features. With the U.S. being a large and diverse nation, having not ethnic, religious or class status identity, national political movements could not be solidly built. Subsequently, most of America’s politics is localized; hence, the divergent views across the different states. This is despite the global homogenization of culture that is driven by mass media, with the U.S. becoming more heterogeneous in terms of social and political aspects, and increasingly so with its health care system. The localized tendencies of American socialization, as enforced within the prevailing Madisonian system, have resulted in weak political parties. Thus, it is on rare occasions such as in 1965, 1995 and recently in 2009/10 that U.S. politics have produced much bearing on health policies and pertinent issues. Despite the above, the successful; abate partially, of Obama care may attest to the American unity that is so often elusive. As a direct result of strong parties being absent in the American political arena, the power of money has become even greater (Vladeck, 2003). It is on this basis that individuals and group-entities; having significant economic financial strength, have and do continue opposing America’s form of universal health care. Politics and money hence entail part of the ‘investment formulae’ that is the basis of the U.S.; as is portrayed when powerful lobby groups protect and progress stakes. Having a political system that is so sophisticated, avails obstacles in the form of few advantage aspects and a middle ground especially in terms of policy issues. Consequently, in the U.S., an administration may be elected out of office, but still with very little difference in policy issues. It is these uniquely American aspects, which have made universal health care in the U.S. quite different in terms of effectiveness and efficiency from those of Europe and Canada (Navarro, 1989). Respiratory Therapy under the Obama-care Health Plan Following the implementation of the two aforementioned health care and medical provision acts, respiratory therapy as a whole, will witness tremendous growth and inclusion within the larger American populace. Of core importance, is the ACA – the Patient Protection and Affordable Care Act that represents one of America’s most comprehensive and largest reform initiative. This is since the advent of both Medicaid and Medicare in 1965, with the act seeking to extend coverage to a huge populace of the American society, which is largely uninsured. Numbering to the estimated 50 million plus individuals, this is a great paradox; comparable to other developed nations of the world. This will be pivotal to slowing down the increase in health care costs while at the same time, improve the overall quality of health care; through initiating change in the delivery system. These will be achievable by way of eliminating insurance companies’ ability to reject patients due to the presence of pre-existing conditions (Navarro, 1989). As is known, respiratory ailments are often categorized under pre-existing conditions; given the fact that most of these are usually genetic-based and hence develop when individuals are in their younger and/ or elderly stages. Through expanding eligibility to Medicaid by millions of Americans, as well as allowing children to remain within their parents’ health insurance cover packages, pundits are of the view that respiratory therapy will become enhanced and available to a greater majority. Further still, is the call for the creation of health insurance exchanges that are state-based. This will enhance both transparency and competitiveness of the small-group and individual markets for available insurance. Under the AARC, the – Medicare Respiratory Therapist Access Act (2013) – seeks to enhance the greater recognition of respiratory therapists and the therapy field itself. While current law does recognize a variety of allied health workers, the increasing changes made within pulmonary services delivery over the past decades, make it a prime opportunity to acknowledge the crucial role of RTs within the Medicare sector (Vladeck, 2003). The need for a paradigm shift is necessitated by the fact that patients suffering from various respiratory ailments i.e. chronic lung cancer cannot be able to self-manage their ailments, primarily because of the high costs involved. Towards this end, many as a blessing view Obama care, as it will enable Medicare beneficiaries to be able to positively respond appropriately to the self-management of their ailments. This will be through better provision of requisite tools essential in catering to these conditions at an affordable price, thereby painting a brighter future for patients and the medical field at large. References Navarro, V. (1989). Why Some Countries Have National Health Insurance, Others Have National Health Service, and the United States has neither. International Journal of Health Services, 19(3): 383-404. Vladeck, B. (2003). Universal Health Insurance in the United States: Reflections on the Past, the Present, and the Future. American Journal of Public Health, 93(1): 16-19. Read More