American healthcare systems and policy overview

American Health Care

Health Care Crisis or Unfounded Fears?"

What impact did the media play in bringing the health care issue onto the federal government/political agendas?

It is a common phrase, "Health care crisis" spoken almost daily by the media as well as the general public, defended against by health care interest and providers as well as many politicians, since it began to come to the forefront of the American mind during the Clinton administration. Though the questions are enduring and have been around far longer, as people began to notice on a daily basis that there was a population, rather large not being served adequately by health care. Yet, it really took the media pointing out the scope of the problem to create the phrase and develop a public idea about the situation. The media has in fact probably played the largest role in surfacing the issues surrounding health care delivery, that give many people pause, as the richest nation in the world still leaves many individuals largely un-served by the health care system of the richest nation in the world. The media, from the beginning formed an adversarial voice to drive the issue public and to ask politicians and policy makers to defend and account for the impact this has had on our culture, population and economy. The media brought to the American public scare tactics which drove the political arena to first defend the system as it is or was and second create stop gap legislation to "resolve" some of its issues. Scare tactics were largely employed by the media to bring health care to the front of the minds of those who make decisions about it, as well as the general public to pressure stakeholders into making changes that better served the population. Sweeping statements based on the situation, as it was seen by the scare tactic media like those that follow lead the charges and brought the issue to the political agenda.

The maternal mortality rate of women of color is three times that of white women. One-half to one-third of these deaths are unnecessary and could easily be avoided using preventive measures, given that they are primarily attributable to lack of prenatal care. Because they come so late to treatment, only 22% of women diagnosed with breast cancer at New York City's Harlem Hospital live five years, compared with 76% of white women and 64% of black women nationwide. A child in Chile or Malaysia is more likely to celebrate his first birthday than a black baby born in the Mississippi Delta. Black men in central Harlem are less likely to reach age 65 than men in Bangladesh. Estimates of HIV infection among homeless individuals go as high as 40%. After controlling for differences in age, sex, race and specific disease, the uninsured are as much as three times more likely to die during a hospital stay than the insured.

These statements went unquestioned by the population and created a situation where policymakers were at a distinct disadvantage, seeking to defend the system, at all costs and finally acquiescing to make changes.

What interest groups are stakeholders in this issue and what role have they played so far?

The policy makers, health care delivery giants and health insurers where quick to defend the system as it was. Saying things like:

Relax, there is no health care crisis. You can hear it from Clinton friend and foe alike. "Our country has health care problems, but no health care crisis," growled Senator Bob Dole in his televised response to the President's State of the Union Message. Days earlier, Democratic Senator Pat Moynihan said pretty much the same on Meet the Press.

Yet the public continued to demand changes. The changes they eventually got are still to be seen, as to their level of effectiveness. Changes that many see as temporary and not far reaching enough, such as when any sort of national health care plan was squashed by the stakeholders, fearing loss of revenue and convincing the public of the potential loss of availability for lifesaving care and difficult decisions that would bar many from demanding it the system instead created such things as a highly complicated and entirely privatized Medicare D. drug benefit, more than ten years after the debate had begun. The collective agenda of the stakeholders, was first to defend the system as it stood, which was not allowed by the public or the media, and then to make small changes that kept the system intact and reacted to the defensive stances of the stakeholders, such as their continual need to press the point that the system is good because it is based on the capitalism that founded our nation. This is why the rather small strides that have been made, thus far are limited to programs that are privatized, with literally hundreds of insurers buying in to the program and being allowed to limit its usage and benefits, as thy always have.

Which group has been most successful in influencing this issue and why?

Probably the group that has been most successful in influencing this issue are those moderates who wish to demand system change only within the systems that currently drive the health care dollar. The insurers and providers have been able to not only maintain a status quo but have also been able to keep growing prices and keep limiting services and availability.