2002, More Than 43 Million

¶ … 2002, more than 43 million Americans were without adequate health care. In the Coverage That Matters, 2001, et. al study, (as cited in Un-insurance Facts and Figures: The Institute of Medicine of the National Academes, year unknown). Furthermore, the U.S. was, at that time, the only developed country, other than South Africa, that did not provide health care for all of its citizens. In Stephen M. Ayers' study (as cited in the U.S. Healthcare System: The Best in the World or Just the Most Expensive, 2001) . Insufficient health care can ultimately create more serious issues for the uninsured person; the effects of which can spread to the person's family, society in general, and ultimately the economy. For example, increased or worsened health conditions can lead to psychological or emotional stress on the family. Additionally, loss of employment, increased debt, or even bankruptcy can result in emotional stress and hardship on the individual and the family.

Adverse effects on the economy are not as often anticipated as a result of lack of health care. However, when under-insurance leads to loss of work, increased debt, or bankruptcy, the economy is affected because ultimately banks and other economic institutions are required to absorb the unpaid debt. Furthermore, businesses that rely on consumer spending will ultimately lose revenue because the consumer is unable to patronize the business or obtain credit. The consumer will suffer financially from bad credit ratings which will affect their finances for years to come.

In Michael Moore's documentary Sicko, the Smith family was interviewed and featured as a working middle class family whose lives were greatly affected by under-insurance. Mr. Smith suffered three heart attacks and his wife was diagnosed with cancer. As a result of the medical deductibles, the Smiths could no longer afford their home and ultimately moved into their daughter's basement. This example demonstrates a problem with the current health care system -- lack of affordability -- which could lead to severe financial hardship and ultimately loss of livelihood and lifestyle.

In Sicko, another problem with the current health care system was examined -- lack of treatment. Mr. Tracy Pierce was suffering from kidney cancer. He did not have health care and was denied health insurance as a result of his illness. Mr. Pierce ultimately died not having obtained the necessary medical care. The health care industry frequently denies treatment to those in need due to pre-existing medical conditions; many individuals are dropped from their private plans because to retain would be too costly. Moore, Mike (2007). Sicko. Retrieved from http://www.documentarywire.com/sicko/.

It remains to be seen, especially in light of the ramifications on the individual, family, and economy, why the U.S. suffers from the problem of prevalent under-insurance, when most other countries such as Canada, England, France, and Cuba do not. One explanation based on the implications of Sicko, is that in the U.S., the health care system is a business. There is an ongoing financial tension existing between the revenue for health care system vs. The medical needs of Americans. If a patient becomes too expensive, the threat exists that the person will lose her medical benefits; if a person is a too much of a financial risk, the threat exists that the person will not obtain benefits at all.

In comparison with countries offering universal health care such as Canada, England, France, and Cuba, the U.S. health care system is more expensive and less effective. In the Organization for Economic Health and Development 2000 study, a Comparison Analysis of 29 Countries (Paris: OECD 2000), as cited in the article, the U.S. Healthcare System: The Best in the World or Just the Most Expensive (2001). One explanation for this phenomenon is that the lack of treatment that results from being under insured causes worsened health conditions which in turn are more costly on the health care system. In Coverage That Matters, 2001, et. al study as cited in Un-insurance Facts and Figures: The Institute of Medicine of the National Academes, (year unknown).

In Sicko, the countries that have universal health care -- Canada, England, France, and Cuba -- were spotlighted. In Cuba, a comparison of prescription medications revealed that in Cuba a patient would pay $0.5 for a prescription compared to $120 in the U.S. For the same medication. In Canada, it was determined that there is no pre-approval process required to obtaining health care and no deductibles. In England, it was revealed that the medication on average costs $10 per prescription for working adults while everyone else could obtain the same medication at no cost. Furthermore in England, pre-natal care is free, emergency room visits are free, and travel costs to get to the health care facility are reimbursed. In France, health care and day care are free of charge. Moore, (2007).

Compared to countries with universal health care, the U.S. has a higher infant mortality rate, a shorter life span, and a more expensive system of healthcare. In the World Health Organization's the World Health Report 2000 -- Health Systems: Improving Performance (Geneva: WHO, 2000) as cited in the article, the U.S. Healthcare System: the Best in the World or Just the Most Expensive (2001). Still, the U.S. is one of the last countries to officially implement a national health care plan.

Tamaskar & Rising in their 2003 article, Theoretical Models for Delivering Universal Health Care: an Analysis of Important Concepts, addressed the methods by which countries with universal health care such as Canada, England, France, and Cuba implement their health care systems. Each method of implementation has its pluses and minuses, two of the systems -- single payer accounts and medical savings accounts will be examined in further detail.

By definition, a single payer account, as found in Canada, is one in which the costs of medical care are financed by one source -- usually the federal government. Citizens visit private physicians who are reimbursed by the federal government. American Medical Student Association. (2003). Theoretical Models for Delivering Universal Health Care: An Analysis of Important Concepts, (Unknown Ed.). Reston, VA: Tamaskar, Prashant and Rising, Josh. The benefits of this type of program are numerous: Each patient receives health care regardless of age, health, employment status, socioeconomic status, or inability to pay -- this system ensures that the healthcare will be equally provided for all. Tamaskar and Rising, 2003.

Like all programs, however, the single pay plan has its disadvantages. One disadvantage revolves around politics and the fact that many individuals are not convinced that the government should be in control of healthcare. Critics of this plan refer to the fact that a plan such as this, in which the government is involved, would result in increased taxation. Bureaucracy, lack of choice of participating physicians, and low quality of care are all concerns surrounding a single pay plan system. Tamaskar and Rising, 2003.

Another plan proposed by Tamaskar & Rising is the medical savings account approach -- a relatively new approach to universal health care. The premise behind this system is that health costs are inflated because people are over insured -- when a person has insurance they seek medical care for even the most minor conditions. A medical savings account will help curtail this phenomenon by requiring that person deposit money into a tax free savings account set aside for medical care. The advantages of the plan are that it will result in individual using medical benefits more wisely. Another advantage is that people are more likely to avoid injury or health risks because they are directly paying for medical care. Tamaskar and Rising, 2003.