McKeller5232ResearchPaper
Universal Healthcare for America
Catherine McKeller
English 102, Section 5232
Argument/Advocacy/Persuasion Research Paper
APA Format
July 14, 2007
Abstract
Universal Healthcare for America stresses the need for the United States to convert to a
publicly funded healthcare program. The paper briefly explains the current healthcare
coverage system in the U.S. The cost of American healthcare, and the numbers of those
insured, is compared to other nations worldwide. The cost of the current system to many
people throughout American society is explored, including employers, employees, and
healthcare providers. The paper describes the inefficiency of private insurance
companies and the lack of care given to those who are insured under them. The paper
also notes several negative consequences the current healthcare system has on society in
the U.S. The paper tells of how the U.S. rates versus other nations in its quality of
healthcare. It outlines how a universal healthcare program would resolve some of
America’s current healthcare problems. The paper argues that a universal, publicly
funded program would be superior to the current system that uses private insurance
companies.
Universal Healthcare for America
Use your mind map instead of an outline.
Thesis: The U.S. needs to replace its current private healthcare system with a universal
healthcare program due to its benefits in cost, availability to all and increased efficiency.
Outlines normally start with Roman numerals and capital letters.
1. A brief explanation of who is insured in the U.S. and how.
a. Uninsured
b.
Insured via government (Medicare, Medicaid, etc.)
c. Privately insured
2. The cost of healthcare in the U.S. is more expensive vs. in other nations.
a. Cost per capita
b. Cost to government
c. Insurance: how much to pt vs. administrative cost
3. The current insurance system has a negative effect on employers & employees.
a. employees
i. high deductibles, etc
ii. high cost even covered procedures
iii. some ineligible
b. employers
i. reducing benefits to employees
ii. fewer raises offered
iii. cheaper- managed care
4.
There are unnecessary costs to providers in the U.S.
a. High administrative
b. Lots unnecessary employees – paperwork and denied claims
c. Decrease care due to high volume needed
5. Insurance companies are inefficient.
a. High administrative
i. Cost of marketing, managed care, etc
b. Maximize profits
i. Avoid high risk
ii. Increase price, decrease coverage
iii. Pay little as possible to provider
6. There is a negative financial impact to society with the current system.
a. No preventative; sick become sicker, more expensive
b. Cost uninsured to community / taxpayers
c. Increased load Medicare & other govt. funded programs
d. Bankruptcy due to medical care
e. Businesses handicapped vs. other nations
f. Fewer workers (disability & illness)
7. America is inferior in its quality of healthcare.
a. Statistics of US worse vs. other nations
b. Poor receiving little / no care, treated unfairly
8. A universal program is better in cost and efficiency.
a. More preventative = less expensive long run
b. Lower administrative costs
c. Cost covering uninsured vs. money saved by low administrative costs
d. Better for US business
e. Compare to Medicare (publicly funded)
9. A universal program is better financially and morally.
a. Universal more ethical
b. Quote Reinhardt
The United States is a wealthy nation, yet there are millions of Americans who
cannot afford adequate healthcare. The current healthcare system uses a tremendous
amount of money, yet is grossly inefficient. There is only one practical solution to this
escalating problem; The U.S. needs to replace its current private healthcare system with
a universal healthcare program due to its benefits in cost, availability to all and increased
efficiency.
Americans (under 65 years old) fall into one of three categories: the uninsured,
the privately insured (either through an employer or privately), and those insured under
government programs. There are approximately 45 million Americans, about 15.5
percent of the population, who have no health insurance at all (Clemmitt, 2007). (See
Table 1. Clemmitt, 2007.) The uninsured consist of a variety of people including the
unemployed, those between jobs, students, those who are not eligible for insurance at
their current job, and those who simply cannot afford health coverage (Chua, 2006).
[which article?] A common belief is that the uninsured do not have jobs. This is a
misconception. Studies show that 80 percent of those without insurance are actually
employed (Chua, 2006). Americans covered under private insurance consist of about 61
percent of the population (Clemmitt, 2007). The remainder, about 23.5 percent of the
population, is covered under government programs such as Medicaid, for low income and
disabled, the Veterans Administration (VA) for military veterans, or others (Clemmitt,
2007). Once an American turns 65 he/she is automatically eligible for Medicare, the
government run insurance program for the elderly.
Table 1. Americans without Health Insurance (Clemmitt, 2007)
The United States is the only industrialized nation without a universal healthcare
program and spends far more on healthcare than other nations (Chua, 2006). A 2000
study by the World Health Organization (WHO) found that nations with a publicly
funded healthcare system spent less per person on healthcare than those without
(Wikipedia, 2007). In 2003, the U.S. spent $5,635 per person, while other industrialized
nations averaged $2,307 per person (Chua, 2006). This amount of spending reflected
15percent of America’s Gross Domestic Product (GDP), which is much higher than other
nations that averaged 8.6percent GDP (Chua, 2006). See Table 2 for a comparison of
U.S. spending versus that of several other nations (Clemmitt, 2006). The U.S.
government predicts that at the current rate of increasing healthcare prices, this spending
could reach $12,300 per person by 2015 (Clemmitt, 2006). Even without a publicly
funded system, forty-four percent of healthcare spending comes from the government in
some way (via Medicare, Medicaid, merchant seaman benefits, or the VA, for example)
(Wikipedia, 2007). Other industrialized nations have about 72percent of funding coming
from the government (Chua, 2006).
Table 2. U.S. Spending vs. Other Countries (Clemmitt, 2006)
The high cost of American healthcare greatly impacts both employers and
employees. The cost of healthcare rose 87percent between 2000 and 2006, while
inflation only rose 18percent (Clemmitt, 2007). Employees with insurance are faced with
high deductibles, high premiums, and increased out-of-pocket payments. This means that
having insurance does not necessarily enable a person to receive medical attention, for
the patient must still be able to afford the treatment. Employees with no insurance
cannot afford medical care at all or are ineligible due to pre-existing conditions. Some of
these people apply for government assistance (Medicaid), but are turned down due to the
decreased funding of Medicaid programs (Chua, 2006). The ever-increasing costs are
causing employers to cut out or reduce benefits to employees. This is causing healthcare
to become a growing problem for the middle class, since wages are increasing much
more slowly than the price of insurance premiums (Clemmitt, 2006). Working
Americans are losing employer-sponsored coverage and do not have the financial means
of purchasing private coverage (Chua, 2006). Employees who do not lose coverage
altogether are often forced to pay a higher percentage of their insurance, or are denied
cost-of-living wage increases since the money the company allows for raises is instead
put toward insurance premiums (Chua, 2006). Even insured Americans do not receive
effective healthcare. Many are subject to the cheaper managed care systems, systems in
which the insurer has the final say (as opposed to the healthcare professional) as to
whether or not medical treatments are necessary and will hence be paid for (Bure, 2004).
Healthcare providers spend a remarkable amount of money on costs incurred due
to the increasing price of private insurance. More personnel are required in order to keep
up with the paperwork needed to bill hundreds of different insurance companies. Several
of these claims are ultimately denied and personnel are needed to argue with the
insurance companies for payment (Harris, 2006). This greatly increases administrative
costs. Doctors wind up seeing more patients in less time in order to keep up with costs,
inevitably resulting in lower quality of care (Clemmitt, 2006).
Insurance companies’ rates are disproportionate to the services provided, mainly
due to inefficient usage of funds. Insurance companies have an extremely high overhead
due to high administrative costs (Clemmitt, 2006). Insurance companies are inclined to
avoid any “high risk” (potentially costly) clients in hopes of paying out as little as
possible. Managing care, marketing, underwriting and lobbying are all required to avoid
high-risk clients to maximize profits and cause these high administrative costs (Sullivan,
2006; Clemmitt, 2007). This leads to insurance companies steadily increasing the price
of premiums while at the same time decreasing coverage (Angell, 2004). Insurance
companies will immediately keep a percentage of the incoming funds for themselves,
often 10percent - 25percent, then use revenues to run the company, then pay the
healthcare provider. This means that nearly 50percent of the money paid into premiums
does not go to the doctor or healthcare provider (Angell, 2004). This is obviously not the
ideal situation if the desired outcome is to provide patient care with as little financial
waste as possible.
America’s lack of adequate healthcare to so many citizens has a negative financial
impact on society as a whole. Uninsured and underinsured Americans are less likely to
get preventative treatment, which inevitably leads to worsened prognoses and illnesses.
This ultimately leads to more expensive treatment, hospitalization, and disability (Chua,
2006). This is a financial strain not only to those getting treatment, but also to providers
and to the community. Uninsured Americans use approximately $125 billion a year in
healthcare services, but are only able to pay for 26percent of that (Clemmitt, 2006).
Providers who treat those who are uninsured and underinsured are often forced to write
off a majority of the costs which can lead to increased prices for patients who are able to
pay. Providers in poorer areas can be forced to relocate to more wealthy areas to improve
business, leaving the poorer neighborhoods with too few healthcare providers (Chua,
2006). Uninsured Americans are an unnecessary burden to tax payers. Those who reach
Medicare age, or qualify for disability, and are able to finally seek treatment are much
worse off and require more care than had they been getting medical attention all along.
In addition, those who are in need of mental health treatment often do not receive it until
they wind up in the legal system, again becoming an unnecessary tax burden (Clemmitt,
2007). According to the Institute of Medicine, the high numbers of people who avoid
receiving early medical help due to financial reasons increase their rate of death by
25percent, which equals an extra 18,000 deaths per year that could be avoided with
satisfactory care early on (Chua, 2006). America’s current healthcare system is a strain
on the economy. Costly health care is one of the main reasons for bankruptcy in the
United States. In a 2005 survey, 46.2percent of the people that filed for bankruptcy
attributed the cause to a medical reason, 70percent of these people did in fact have
medical insurance at the time of bankruptcy (Chua, 2006). Businesses feel the strain
when having to pay the ever-increasing premiums for employees. This business expense
brings up the cost of American goods, which makes global competition more difficult
(Clemmitt, 2006). The millions unable to work due to illness and disability then further
wound the economy (Chua, 2006).
America’s high spending on healthcare does not result in better healthcare. In
fact, America falls below other industrialized nations in studies of the health and
treatment of its citizens. The U.S. has higher rates of infant mortality and a shorter life
expectancy (Bure, 2004; Chua, 2006; Wikipedia, 2007). American life expectancy is
rated 24th by the WHO against comparable nations (Clemmitt, 2006). America was also
found to have fewer doctors, nurses, and hospital beds per person than other comparable
nations (Chua, 2006). This is in addition to the fact that only a percentage of the
population has healthcare coverage at all. The WHO rated the U.S. 37th in industrialized
nations in overall quality of healthcare (Clemmitt, 2006). In 2000 the WHO ranked the
U.S. the worst in “fairness in financing,” with the poorest people receiving the worst
treatment (Bure, 2004). In addition, America was rated by the WHO 15th in
“attainment,” 37th in “performance,” and showed the U.S. to have only a 40percent
satisfaction rate amongst its citizens (Bure, 2004). Due to healthcare in the U.S. being
available based on a person’s ability to pay, many problems in quality of care arise: the
sickest and poorest (the citizens who often need the most care) are least able to receive
treatment, treatment centers are forced to minimally care for those who are unable to pay
then be rid of them before using up too many resources, and many citizens are turned
away altogether and disrespected for their financial and medical conditions (Balkin,
2003).
A universal healthcare program would save money and improve efficiency.
Providing all citizens with healthcare can provide an opportunity to stress preventative
healthcare, which results in decreased spending on expensive intensive treatment later on
(Wikipedia, 2007). The Institute of Medicine estimates that the cost of covering those
who are currently uninsured could reach $34 - $69 billion dollars by when? (Chua,
2006). However, the benefits and savings of cutting out private insurance companies can
more than offset this cost. A Harvard study showed that a universal system could save
$286 billion in administrative costs alone (Himmelstein & Woolhandler, 2006). These
savings would be sufficient to insure the uninsured and improve quality of care
nationwide. The savings could also be used to make up for formerly uncompensated
costs to providers. The economy would significantly benefit from the increase in overall
health and productivity of all citizens. With the money saved on expensive insurance
premiums, American businesses could lower prices and compete more fairly with
overseas companies. A report published by Dr. Kenneth Thorpe (an economist) analyzed
four possible ways to provide healthcare to all American citizens. The plan that saved the
most possible money was that of a universal healthcare program, which he calculated to
save $1.1 trillion in ten years (Chua, 2006). This plan involved extensive cost controls,
mostly in administrative spending. A single payer universal healthcare program would
nearly do away with administrative costs and unnecessary profits currently enjoyed by
multiple private insurance companies (Angell, 2004). It is feasible to compare Medicare
to a universal healthcare program, as Medicare is a current, and successful, publicly
funded healthcare program in the U.S. The administrative costs of Medicare are about
2percent, in comparison to 12percent - 30percent in private insurance companies (Harris,
2006). These administrative savings could be spread to all of the American population
with a nationwide publicly funded healthcare program (Bure, 2004).
The question of whether America should adopt a universal program goes beyond
monetary reasons and must be viewed on an ethical basis. The amount of unnecessary
human suffering endured in the U.S. due to illness and death is immeasurable. A
universal system would benefit the country financially, but would also be morally right
for a nation that values each of its citizens, regardless of his/her economic status. The
economist Uwe Reinhardt said, “The issue of universal coverage is not a matter of
economics. Little more than 1percent of GDP assigned to health could cover all. It is a
matter of soul” (Chua, 2006). According to the United Nations Declaration of Human
Rights (article 25), “Everyone has the right to a standard of living adequate for the health
and wellbeing of himself and his family, including… medical care” (Mueller, 2006). The
United States should uphold this declaration and model its healthcare policies around this
belief.
References
Angell, M. (2004). Government-funded single-payer health care would benefit America.
Health. Ed. Auriana Ojeda. Opposing Viewpoints. San Diego: Greenhaven Press,
Opposing viewpoints resource center. Thomson Gale. Glendale Community College.
4 July 2007
http://find.galegroup.com/ovrc/infomark.do?&contentSet=GSRC&type=retrieve&tab
ID=T010&prodId=OVRC&docId=EJ3010141252&source=gale&srcprod=OVRC&u
serGroupName=mcc_glendale&version=1.0
According to Angell, the U.S. currently considers healthcare a commodity and is
dependent on whether or not a person has the ability to pay for services. In this
article, she gives information on the business factors of healthcare, emphasizing the
cost of using a system with private insurers. Angell states that a single-payer system
would be more cost effective and responsible, as it would care for all citizens.
Balkin, K. (Ed.). (2003). Health care. San Diego: Greenhaven Press, 2006. Opposing
Viewpoints. Thomson Gale.
The book Health Care provides several differing opinions on the current state of
healthcare in the U.S. Multiple authors offer short articles on current issues such as
whether or not the U.S. is in need of reform, whether managed care is helpful/harmful
or necessary/unnecessary, how the issue of uninsured Americans can be addressed,
and suggestions on appropriate U.S. healthcare reform.
Bure. date America does not have the best health care system in the world. Health Care. Ed.
Karen Balkin. Opposing viewpoints. San Diego: Greenhaven Press, 2004. Opposing
Viewpoints Resource Center. Thomson Gale. Glendale Community College. 4 July
2007
http://find.galegroup.com/ovrc/infomark.do?&contentSet=GSRC&type=retrieve&tab
ID=T010&prodId=OVRC&docId=EJ3010142234&source=gale&srcprod=OVRC&u
serGroupName=mcc_glendale&version=1.0
In this article, Bure focuses on the downfalls of the current healthcare system in
the U.S. The author notes how many people are without insurance, and how the U.S.
compares to other nations in an analysis done by the World Health Organization.
Bure states that it would be in the best interest of the U.S. to use a single payer system
rather than multiple private payers.
Chua, K. (2006, February 10). The case for universal health care. Retrieved June 17, 2007,
from http://www.amsa.org/uhc/CaseForUHC.pdf
Chua details the inadequacies of America’s healthcare system which uses several
private insurance companies, and stresses the benefits of switching to a universal
healthcare system. Chua uses several statistics regarding the current situation in
America and estimated statistics should America reform its system. Chua argues both
the financial and health benefits to the public that healthcare reform would bring.
Chua, K. (2006, February 10). Overview of the U.S. health care system. Retrieved June 17,
2007, from http://www.amsa.org/uhc/HealthCareSystemOverview.pdf
Chua gives a summary of the current healthcare system in the U.S. Chua defines
both private and public healthcare, and details the main differences between the two
systems. Chua describes differences in the American system versus those in other
industrialized nations.
Clemmitt, M. (2006, April 7). Rising health costs. CQ Researcher, vol. 16. Retrieved July 02,
2007, from CQ Researcher Online.
http://library.cqpress.com/cqresearcher/cqresrre2007040700.
Clemmitt writes about the cost of healthcare in the U.S. Clemmitt discusses the
effects of rising costs on the insured, uninsured, businesses, insurance companies, and
healthcare providers. Clemmitt discusses where the money comes from, and how it is
used by providers and insurance companies. Clemmitt gives differences between the
U.S. system and that in other nations.
Clemmitt, M. (2007, March 30). Universal coverage. CQ Researcher, vol. 17. Retrieved June
17, 2007, from CQ Researcher Online,
http://library.cqpress.com/cqresearcher/cqresrre2007033000.
Clemmitt gives several details of problems with the current U.S. system of
healthcare, both in regards to cost and to the health of the nation. Clemmitt details
how universal coverage is used and works in other industrialized nations. Clemmitt
goes into detail of how finances can be used to have universal coverage, and how this
would be more efficient than private coverage.
Harris, N. (Ed.). (2006). Does the United States need a national health insurance policy?. At
Issue Series. San Diego: Greenhaven Press, 2006. Opposing Viewpoints. Thomson
Gale.
This book gives several short articles written by several authors with differing
views on whether or not US healthcare needs to be reformed. The authors discuss
such things as private healthcare vs. public healthcare, personal health plans,
employer based health plans, the power of insurance companies and health care fraud.
Himmelstein, D. and Woolhandler, S. date National health insurance could save billions of
dollars. Does the United Stated need a national health insurance policy?. Ed. Nancy
Harris. At Issue Series. San Diego: Greenhaven Press, 2006. Opposing Viewpoints.
Thomson Gale.
Himmelstein and Woolhandler cite a study done by Harvard University on the
excess waste caused by the current U.S. healthcare system. The study gives dollar
amounts that could be saved, and why, by switching to a universal system. It also
offers many useful ways this saved money could be spent to improve healthcare in
America.
Mueller, R. date America should model its health care system after those of other developed
nations. Does the United States need a national health insurance policy?. Ed. Nancy
Harris. At Issue Series. San Diego: Greenhaven Press, 2006. Opposing Viewpoints.
Thomson Gale.
Mueller focuses on the financial aspect of the argument for the U.S. adopting a
universal healthcare plan. The author specifically notes the unjust treatment of the
poor in the U.S. when it comes to healthcare. The author argues that universal
healthcare is the only effective way to treat all Americans equally despite
socioeconomic status.
Sullivan, K. date A national health insurance policy would be superior to market-based
plans. Does the United States need a national health insurance policy?. Ed. Nancy
Harris. At Issue Series. San Diego: Greenhaven Press, 2006. Opposing Viewpoints.
Thomson Gale.
In this article, Sullivan explains why America’s use of private insurance
companies is more inefficient than a universal plan. Sullivan details the extreme
administrative costs incurred by the current system. He proposes how a universal
plan would cut down on these unnecessary costs.
Wikipedia home page. (June 2007). Publicly-funded healthcare. Retrieved June 16, 2007,
from http://en.wikipedia.org/wiki/Publicly_funded_health_care
The Wikipedia website gives an unbiased explanation of publicly funded
healthcare. It gives examples of countries that use publicly funded healthcare and those
that do not. It explains where funding comes from for these health plans. It also gives
arguments both for and against publicly funded healthcare by its supporters and
opponents.