In modern America we have a serious crisis. An incredibly large number of Americans are without health insurance, and even fewer are able to afford quality health insurance so that they can full take advantage of the benefits that they deserves.
Healthcare is not a want, healthcare is a need and a right [Hodgson]. Our current insurance based system of healthcare relies on the individual to pay for his or her medical care using insurance companies who will actively work to avoid paying for medical costs in order to make money.
Healthcare, while a profitable industry, should not be viewed as a business pursuit, treating people as sources of income rather than human beings deserving of adequate medical treatment and relatively pain free lives. Socialized medicine provides a viable alternative.
It has been implemented in numerous industrialized and developing nations. The system, of course, has its flaws, but in reviewing the literature I have noticed that the harms such a system creates are relatively small, especially when the system is implemented correctly, and all care is taken in doing so.
I therefore see socialized medicine as the ideal towards which the current American medical system should work towards so that we can provide accessible and affordable healthcare to the citizens of what should be the greatest nation in the world.
Healthcare has become an industry and the United States leads the way in profiting off of it. We have forgotten the very reasons why we should have access to good healthcare.
This seems like such an obvious question—but it is one that it seems a growing number of people and companies in America have forgotten. For all of human history, we have used our ingenuity and reason to improve all aspects of our lives. Primarily, we have achieved many of our great advancements because we were able to live longer, healthier lives. Imagine if Albert Einstein had died at forty (the common age for humans before our advances in health treatment), rather than at age 76. A great body of some of the best scientific work to ever be produced would simply have never existed.
But Einsteinian levels of achievement are not all that healthcare gives us. It gives us the ability to live lives that are free from a great deal of physical and emotional pain. We no longer have to worry if we are going to live through the next day or even wake up the next morning—we live securely knowing that our lives are protected to such high degrees that we can experience things past generations never would have thought possible. But again, it is not even the extremes of life that healthcare allows for, we are also able to enjoy the simple pleasures of life longer—family, friends, the ability to eat, drink, and be merry.
In modern America, however, healthcare has become an industry. Yes, whenever such large sums of money are being used for any purpose, no matter how noble, they are a significant economic factor. However, rather than focusing on providing quality healthcare at an affordable price, healthcare and especially health insurance companies are looking for ways to increase their profit margins. Healthcare in the United States is now more of a business than it is a service, and the quality of care necessary to live a quality life is only accessible to the select few who are able to pay enough to afford it.
To repeat what Hodgson says, healthcare is not a want, it is a need and a right. Citizens should not have to pay an increasingly large amount of their own money for a healthcare system that, as of the last overall healthcare ranking by the WHO in 2000, ranked 37th [Photius WHO statistic]. The United States is the only industrialized nation with no universal healthcare system [Health PAC].
And so, there is a crisis in America. Yes, there are other issues besides this crisis like global climate change, equality in gender, sexual preference, racial bias, what Michelle Obama is wearing today, etc. However, this particular issue is something that affects all Americans regardless of race, class, or gender.
Currently, and indeed for a long time, Americans spend more on healthcare than any other nation. This is a trend that is only going up. In 2000, we spent 13.2 percent of our GDP on healthcare services, but in 2006, that number went up to 15.3 percent. The per capita average also went up from $4,570 to $6,719 in the same six year period. No other nation even comes close. The average British citizen, for example, paid $3,332 in 2006—less than half. And Cubans, who have the same life expectancy as us, and twice as many physicians (density per 10,000 population) spent $362 (source: WHO).
So where has all this money gone? The statistics show that the United States is at least on par with (and in most cases behind) other industrialized nations in all the various healthcare statistics (again, from the WHO). “American medical care may be the most expensive in the world, but that does not mean it is worth every penny” (Abelson). According to the WHO, there were 45.7 million Americans who were without health insurance. As of 2008, this statistic has worsened, with roughly 75 million Americans either without health insurance, or lacking adequate coverage for basic needs (Abelson). The statistics are shocking.
Why does healthcare cost so much? And why, even though we spend so much on it, especially when compared to other countries, are we not at the top of the list as having the best care in the world? These are the dilemmas American lawmakers are facing as they evaluate the current medical crisis. Thankfully, however, the issue has not gone unnoticed.
Americans are beginning to realize that the current healthcare system is broken, and is in dire need of repair. Unlike virtually all other healthcare systems in other industrialized nations, our healthcare system still relies primarily on the ability of the individual to pay for his or her own healthcare services. Even the wealthiest of clients would have trouble paying for all of their medical costs by themselves, so early on in the United States, we adopted a form of health insurance.
Initially, the health insurance was meant to protect against accidental injuries or disabilities that might occur in the normal course of work—for example in a railroad or a factory. However, this idea was eventually expanded to include all other forms of healthcare.
The basic way in which health insurance works now is that a person will pay a premium to a healthcare company—a monthly fee paid to the insurance company that gives the person healthcare. The amount a person pays is based largely on how much risk and cost is potentially associated with a given individual. A healthy, middle-aged person working a desk job is going to pay far less than an older, obese person who is still working construction because there is a higher chance that the old, obese construction worker will need medical treatment.
Ideally, when the person did require medical care, the insurance would pay for it in its entirety, and the person would go on paying their premiums, and perhaps pay a little extra if the cost of services exceeded how much they had paid in total on their account. However, the system does not work this way.
There are now co-pays and deductibles—fees a person must pay before they will receive any medical treatment or compensation from their insurance company. On top of this, there are millions of ways an insurance company can avoid paying for medical treatment. For example, if you failed to inform them of a preexisting condition (even if you did not know about it) when you applied for coverage, they can cancel your policy or refuse to pay for the necessary treatment [Sicko].
The American medical system has geared itself towards profit—raising premiums, deductibles, copays, and the rest as much as possible while providing the absolute minimum of healthcare services. Other countries, however, have recognized the need for cheap, accessible medical services, and work to provide them to their citizens. Other nations, however, have adopted different priorities.
The United Kingdom has what they call the National Health Service, with each member nation (England, Scotland, Wales, Northern Ireland) having their own individual branch. The NHS is run and funded by the UK, and has an extensive Constitution that dictates all of the principles and rights UK citizens are guaranteed.
I would like to give you a condensed version of the seven principles that guide the NHS:
- The NHS aspires to the highest standards of excellence and professionalism.
- NHS services must reflect the needs and preferences of patients, their families and their carers. Patients, with their families and carers, where appropriate, will be involved in and consulted on all decisions about their care and treatment.
- The NHS aspires to the highest standards of excellence and professionalism.
- NHS services must reflect the needs and preferences of patients, their families, and their carers.
- The NHS works across organisational boundaries and in partnership with other organisations in the interest of patients, local communities and the wider population.
- The NHS is committed to providing best value for taxpayers’ money and the most effective, fair and sustainable use of finite resources.
- The NHS is accountable to the public, communities and patients that it serves.
[source: NHS Constitution]
The NHS had come under fire in recent years for the generally outdated nature of the system. In January 2009, however, the NHS responded in a big way—these principles are at the beginning of an entirely new ninety page Constitution intended to revamp and rejuvenate the system.
All of the statistics I have used, however, were from before this new Constitution was published. This shows that even with the flaws that were prevailing in the system before its revamping, it was still more cost effective than the United States system, and more effective overall at providing healthcare to all its citizens.
As the British system evolved its guiding principle was to provide this exact sort of freely available healthcare to all its citizens through the government. The American healthcare system, by comparison, was privatized and as it evolved was woven more and more into the Capitalist structure of our society.
Industrialized nations are not the only ones who use socialized healthcare systems to bring aid to their citizens. As effective as such systems can be in wealthier countries, they can be just as effective, if not more, in nations where the standard of living and access to healthcare are low, and the need for even basic services is very high. Such systems, if properly implemented, can easily distribute basic levels of healthcare to all the citizens.
When modern healthcare systems evolved in Latin America in 1930s, the developers and scholars supported collective approaches to healthcare. Latin American social medicine, LASM, as it came to be called, stressed the importance of political, economic, and social determinants, as well as holistic approaches to health care processes [Briggs]. For example, when LASM scholars study trends and general statistics concerning various aspects of medicine in Latin America, they prefer to look at race and class based differences in access to healthcare, rather than race and class based differences in rates of disease. The assumption, of course, is that with greater access, there will be lower disease, and this has largely rung true. As I have mentioned in other places, Cuba has the same life expectancy as the United States which is largely due to the extremely high access to healthcare all of its citizens have, rather than any issues of quality or the wealth of the individual.
Briggs analyzes the effects of a socialized healthcare system in Venezuela, especially as it has implemented the LASM approach. The results are surprising. Only 4% of participants in their study reported anything less than an average experience with the healthcare system (26% had No Opinion, 29% ranked it as Good, and 33% thought it was Excellent). 55% felt that the definition of health is a constitutional right (16% said a Lack of Sickness, 8% Access to Healthcare, and 21% thought otherwise or had no response).
Briggs’ main argument centers on the ability of Venezuela (and indeed most of Latin America) to adapt the idea of universal healthcare to its individual society, and it is for this very reason that it has worked so well. Had Venezuela attempted to take a carbon copy of, say, a European universal healthcare system and apply it straight to themselves, there likely would have been failures all across the board. Rather than this, they took the basic principle of providing open access to healthcare and looked at how they could do it best within their own society—the analysis of race and class based access to healthcare rather that disease, for example.
While the approach Latin American nations have taken towards implementing universal healthcare systems is broadly different from that of European iterations of the same idea, the general success that all of these nations have seen is further proof that the deep flaws within our own healthcare system would be best solved by a shift towards our own version of a universal healthcare system. It is even more shocking when we take another look at the statistics.
Perhaps the most shocking statistics that reveal the depth of the problem we face in the United States are those that reflect the American access to healthcare. More than 40 million adults in 2005 stated that they did not receive needed health services because they could not afford it. However, from 2007-2008 in England, the number of people who did not receive treatment for medical needs was 0—everyone, 100%, received medical treatment [HealthPAC].
The obvious question, then, is why, in two nations that are so similar in our modern cultures, can have such a disparity in access to healthcare? The answer, however, is quite obvious. Our systems have evolved with two different priorities in mind. Any nation that has adopted a universal healthcare program has advanced the notion of equal access to healthcare for all of its citizens. It has become increasingly apparent that the United States has spent most of its time with different priorities.
We have come to view healthcare as an industry in the same way we view anything else—the car industry, the textile industry, or anything else. The cost of healthcare is viewed as capital, and the amount of money a company can secure, the higher their profit margins, the better. As companies have gotten better at turning profits, patients have suffered.
The need for change has become abundantly clear. Thankfully, others have noticed the problems in our system, and have begun to work towards change.
Several states have attempted, over the years, to pass initiatives that would provide all of its citizens with health insurance. Then first lady Hillary Clinton tried and failed in the early 1990s to pass a bill that would have implemented a universal healthcare system in the United States. In 2002, Oregon introduced a similar bill [Haynes]. Most of these bills have not gotten very far, but they hint at a growing trend.
In February of 2005, John Conyers introduced H.R. 676—a bill that would establish a universal healthcare system in the United States. It would put current health insurance companies out of business, but proposes that the best solution for dealing with the obviously massive problem would be to hire them as government employees and physicians. The bill failed to pass the first time it was introduced, and it (along with similar bills) have been reintroduced several times [govtrack].
There is any number of solutions out there to fix our current health problems. The main point, however, is that there is nearly unanimous agreement that change is needed—almost no one believes that our current healthcare system will be able to address the rising medical needs of our society.
I have tried to remain as neutral as possible in evaluating all of the different solutions to our problem. There is a clear trend, however, that has become apparent in all of my research. Universal healthcare systems work.
There are, of course, flaws with these systems. The system in place in Canada, for instance, is in the same place that the United Kingdom was only a few years ago [Gratzer]. It is in dire need of an update, just like our own. However, most people still would prefer to have their universal system—they acknowledge that healthcare is a right, not a privilege.
Countries all over the world have adapted universal healthcare systems to meet their needs. Cubans spend an amazingly small amount of money per capita on healthcare when compared to the United States, who spends more than any other nation. The United States is not a healthier nation in spite of the amount we spend, however.
Venezuela is a particularly good example of how a universal healthcare system run by the government can work. They overcame many of the social inequalities in implementing their system. They tailored the system to work within their own culture, and the citizens are happy of this—they, like nearly everyone else, think that healthcare is a constitutional right.
The United Kingdom should serve as the best example as they are so similar to the United States in so many other aspects of society. All of their citizens, all of them, receive the healthcare they need, and do not have to balance health and the ability to pay. Statistics like these amaze me, and seriously test my neutrality.
The bottom line is that we need to stop viewing our healthcare system in the Capitalist terms that it has come to be seen in. Healthcare, like so many other countries have realized, is a right. People should not be able to profit off of treating other people for their diseases. Putting healthcare in the hands of the state is, I believe, the best way forward for the United States.
Yes, we are sure to face many difficulties in the shift from the old system to the new. But we should rest assured knowing that our citizens will be as healthy as any other nation. We are the richest nation in the world, and currently spend more than any other nation on healthcare. Universal healthcare would solve many of these problems.
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