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.