Health policy making in politics

Universal Health Care

At least once a week news shows do segments about the rising cost of health care in America. There was a time when those who did not have insurance were those who did not work and they were provided with health care through the welfare system in many states. In recent years that has changed, and there are currently millions of Americans who are uninsured or underinsured for their health care needs. For those who do have insurance the cost of premiums or the co-pay percentages are cost prohibitive. Each week the Americans are showcased on the news shows who have terminal illnesses and cannot get coverage to pay for their care. The shows include those who work and have insurance, those who work and don't have insurance and those who don't work.

Regardless of personal circumstance today, Americans who are not among the elite and wealthy are facing a health care crisis of epidemic proportions. From the beginning of the crisis Americans have demanded the government use its influence to correct the crisis. Politicians nationwide use the health care crisis to promote their campaigns. During campaign times politicians spout their concern for the millions of struggling Americans, and promise once they are elected they will work diligently to correct the situation.

Once they are elected however, it never comes to pass. Various presidents have discussed the health care crisis with promises to work until all Americans have coverage with little success to date. One of the solutions that has been proposed through many channels is universal health care. Achieving true universal health care could end the troubles for the millions of Americans who are not adequately covered. While advocates promote the design and implementation of a universal health care policy, they agree it will take intervention on the federal government level to be successful.

The rising cost of health care is being passed on to the consumer. Workers around the nation are paying thousands per year in premiums, then having deductibles and on top of that having to pay co-pays that are often 20% of the bill. The national health care crisis has gotten out of control according to those who seek to change it. Recently there were 38 different health care reform bills pending in different legislative houses. There are thousands of health care plans and equally as many ways that those plans are implemented (We, 1994).

Currently hospitals and doctor offices are swamped with the need to submit bills to insurance companies, keep track of the payments and try and handle it all within a time frame that keeps the consumer happy. It is a tense situation at best.

Because of the growing public outcry for changes in the delivery and cost of health care in the United States several groups have begun to propose a universal health care plan. A universal health care plan would eliminate many of the problems that the current system faces (We, 1994).

Before one can begin to understand how the government could implement a universal health care policy it is necessary to understand what a universal health care policy would entail (We, 1994).

A universal health care system in short is a health care system that is delivered equally across the board regardless of one's economic, career, or social standing in the nation. Whatever health care plan that was administered through Americans work, state, or family availability would be standard regardless of the cost to implement the services that were required. A universal health care plan would mean that there would be only one plan that would be available to everyone who lived in the nation. The universal health care plan would be different than socialized medicine. Socialized medicine is the only health care plan available in Canada and it is paid for by the Canadian government (We, 1994).

It allows for every Canadian resident to receive medical care at no cost to them. A universal health care plan would not be fully subsidized by the government though it might become necessary for the government to pick up part of the cost. For a true universal health care plan to work however the government would have to be the overseer of its implementation and the collection of funds to pay for its existence and delivery. This would mean that each person would contribute financially to the total nation plan.

This could be accomplished with a formula that would include everyone based on region, sliding scales, income, and other circumstances (We, 1994). " A universal health care plan would provide equal access to all health care facilities, doctors and other needs to everyone.

Currently those who do not have financial means are often relegated to a very narrow path of medical care that often includes limited choices of physicians. Even when they find a physician willing to see them the physician, knowing they do not have money, will give them the bare bones minimum of treatment (We, 1994). The same patient with financial means might be offered alternative treatments and medications to ease their discomfort. There have been many allegations that those without means have been so mistreated by the medical community that they have been allowed to suffer and even die (We, 1994).

Those who are against universal health care often compare it to the socialized medicine that is currently being used in many countries worldwide. According to those who are against the possibility of universal health care there are many flaws in such a system. Those who need operations can wait years to get them according to the detractors (Health, 2000).

This is partially based in the fact that universal health care or socialized medicine lowers the salaries of doctors, while still demanding the rigors of medical school including the financial costs and the relentless demands on their time as they become doctors. The incentive is removed, and because of that there're far fewer willing or eager to go into the field. All of these factors contribute to the ability to receive needed surgeries especially when it comes to the elective surgeries.

Now, lawmakers are fighting over whether to allow those who already have insurance to sue their HMOs after they've denied them needed health care, and whether insurers should have to allow women to see their ob-gyns without first getting permission from their primary- care doctors (Shesgreen, 2001).

The patients' bill of rights is merely a symbolic acknowledgment of the public outcry against the system," said Dr. Quentin Young, a board member of Physicians for a National Health Program, which advocates universal health care. "I don't see it remedying the essential need of the American people for access to health care on a regular basis." In the years between the 1993-94 debate and the current one, the nation's health care problems have grown more acute (Shesgreen, 2001)

The cost of health care has skyrocketed and the number of uninsured has grown, standing now at more than 42 million. At the same time, the concept of universal health care has become almost taboo in Washington -- a scorned idea that even some proponents are reluctant to tout. "We have not talked about it since Clinton brought it to us in 1993," said Rep. Pete Stark of California, the top Democrat on a key health subcommittee and a sponsor of Clinton's plan (Shesgreen, 2001)

Political people are just afraid," Stark said of reigniting the ire of the health care establishment, particularly the insurance industry. "We were resoundingly humiliated by the Harry & Louise ads," Stark recalls, referring to the television spots warning viewers that Clinton's plan would allow Big Government to meddle in Americans' private medical decisions (Shesgreen, 2001)."

WHY IT NEEDS TO BE FEDERAL

But others say those baby steps will just delay the inevitable. Rep. John Tierney, D-Mass., said he and a handful of other die- hard proponents are still talking about universal health care. They just can't get anyone else to listen. "Unfortunately, things are going to have to get worse before people get serious about dealing with this issue," Tierney predicted. Both Tierney and Stark have introduced bills that would move the country toward universal health care. Stark's proposal would provide coverage to all uninsured children; Tierney's would award grants to states to develop universal health care programs. But neither lawmaker can even get a hearing on his proposal. Stark said it would probably take a leader of former President Lyndon Johnson's stature -- someone willing to risk enormous political capital -- to get universal health care passed. Young, of the Physicians for a National Health Program, sees another possible route to passage. He pointed to activity on the state level that he says could show Congress the way. But even Young's examples illustrate how tentatively policymakers are in approaching the issue.

In Maine, the governor recently signed legislation establishing a 19-member "health security board," which is required to draft a universal health care plan for the state by March 2002. The legislature can then enact, reject or ignore the plan.

In Massachusetts, proponents of universal health care are working to put a referendum on next year's ballot that would strip state lawmakers and the governor of their health insurance unless they enact a plan to cover everyone in the state. Last year, Massachusetts voters narrowly defeated a similar referendum that would have mandated universal health care, banned for-profit takeovers of hospitals and HMOs, and enacted a patients' bill of rights. The HMO industry outspent supporters of the measure $6 million to $80,000.

In Illinois, 17 counties have passed a nonbinding referendum calling on the state Legislature to enact a universal health care plan by May 2002. Young said he even takes heart from the patients' rights debate. Although the bill will do nothing to address the issue of the uninsured, he argues that it is a sign that pressure is building on lawmakers to act on broader reforms. "The public is fed up. I believe this whole explosion of support for the patients' bill of rights is symptomatic of that," he said. "This nation has a way of rising to the occasion when it can't avoid the consequences (Shesgreen, 2001)."

Universal health care can work in the United States if the federal government oversees its design and implementation to insure it is truly a universal plan. There are many benefits to the government starting a plan.

The United States is the only nation in the industrialized world that does not offer health care to each person in its residence as a right of their very citizenship. While 28 nations have single pay plans Germany has a multiplayer plan similar to the one proposed by President Clinton and one that could work in the U.S. today. Currently the United States is spending 40% more capita on its health care than any other nation is spending in the industrialized world (The Case For Single Payer, Universal Health Care For The United States (http://cthealth.server101.com/the_case_for_universal_health_care_in_the_united_states.htm).

Federal studies by the Congressional Budget Office and the General Accounting office show that single payer universal health care would save 100 to 200 Billion dollars per year despite covering all the uninsured and increasing health care benefits. State studies by Massachusetts and Connecticut have shown that single payer universal health care would save 1 to 2 Billion dollars per year from the total medical expenses in those states despite covering all the uninsured and increasing health care benefits (The Case For Single Payer, Universal Health Care For The United States (http://cthealth.server101.com/the_case_for_universal_health_care_in_the_united_states.htm)."

Despite the U.S. having more resources and a stronger economy than Canada the nation's health care system is substandard according to federal studies in both nations.

The United States government is already spending billions of dollars each year on welfare health care programs. This is not addressing the needs of those who do not qualify for welfare but do not have insurance or cove rage of any kind. Studies have concluded it is possible to provide a universal health care plan that is multi-paid and less expensive to the nation than the current welfare cases are. This universal health care plan must be handled and run by the federal government for several reasons. The first reason is that it will provide true universal coverage that is not a state by state decision.