I am writing this memo to bring to your attention the need for universal healthcare for Americans. It analyzes the problems and providing necessary policy recommendations to address the needed changes in the general healthcare provision in the United States.
Summary of Issue
The weaknesses in the American healthcare system are exposed in the failed health insurance coverage. Approximately 47 million people in the United States lack health insurance cover, thus putting several lives at stake (1). The Medicare and Medicaid programs are constantly under threat from a section of Americans who see the burdens passed to the few Americans. The cost of seeking medication has shot up in the recently passed, and continues to go high, hence jeopardizing medical services accessibility. Research shows that there is unfairness in the medical resources distributed across the United States and that it is our country that has the child mortality rate among the OECD states (Martin et al. 13). It is obvious that something needs to be done- that something requires your support and leadership. The policy issues need to be strengthened to ensure universal healthcare is achieved, which will lead to all Americans getting access to proper unbiased healthcare services.
Fortunately, the recently passed stimulus package ($787 billion) that was proposed by your administration has proved to be the best approach to salvage the slumping economy. The package will have an enormous impact on growth in several sectors such as infrastructure and healthcare. It could reduce the damaging impact of unemployment, unable to get insurance cover due to lack of regular income.
The US healthcare system is in serious crisis at present. For a long time, politicians and insurance companies proclaimed that America’s healthcare system was the best in the world, but not until the real issues started to emerge. The weaknesses of the system have become more visible day by day and the citizens have never been more cynical about this claim like they do now. About 47 million people in the United States lack health insurance cover and the numbers keep on rising daily. An inconceivable fact is that out of the 47 million Americans who adversely lack health insurance coverage, 8.7 million are children whose parents cannot afford the associated costs.
It is evident that the United States’ most hailed health insurance program, Medicare, is increasingly getting enough share of attacks at a time when every sane American would want access to healthcare improved (Woolhandler 394). Notably, the critics of Medicare have decided to ignore the fact that about 40 million Americans, the majority aged 65 years and above have benefited a lot from the system.
The recently passed stimulus package bill could have never come anytime better. It has come at a time when insurance companies that had run into losses by paying huge amounts of dollars to investors and banks which had been sawing the wrath of economic meltdown first hand. However, the level of the economic meltdown is relatively huge; hence the stimulus spending may look too small to match the need.
Everyone is aware that the healthcare system is not working for all in the United States, and there is an increasing recognition that the continuously skyrocketing cost and lack of access is a major contributor to the rooted problem. At present, United States’ expenditure on healthcare provision is the highest in the world (Martin et al. 14). In 1998, the US spent a whopping $4,178 per capita on healthcare, a figure that more than doubles the average OECD of $1,783. Still, even the closest match in this trend, Switzerland spent only $2, 794, far too less as compared to the US’s. This fact is based on the cost of healthcare services per person or per capita, and on the total amount spent about the total GDP, making the system is the most expensive in the whole world.
Several factors can be cited to have led to the high cost of healthcare in the United States. One of them is the continuous increase in the costs of drugs and technology. The other is the extremely high cost of administration, emanating from the visibly complicated multiple payer systems in the United States. An astounding example is a statistical estimate indicating that between 19.2 and 24% of the total healthcare expenditure in the United States is spent on administration-related issues (Siu, Sonnenberg & Manning 1261). The recent increase in several profit-making healthcare providers has also led to an increase in the cost of healthcare. Research findings in 2000 indicated that the administrative cost for profit-making healthcare centers had risen by about 36% as compared to 25.4% for non-profit hospitals and 23% for public hospitals (Cronin 112).
Additionally, the uninsured in the United States (47 million) are major contributors to the rising cost since conditions that could have been treated at early stages regenerate into complex problems that become much expensive to treat, thus becoming a crisis in itself. Any untreated problem at the initial stages leads to extensive medical attention such as in the ICU or emergency rooms. Treating such cases is much costly and requires expensive equipment and advanced specialty care. Lastly, the aging populations who have continuously benefited from the Medicare system are under threat despite their rising cost of care.
Access to Healthcare
Among the developed nations, United States is the only country without comprehensive medical provision to all its citizens (Mathews & MacDorman 69). Instead, several privately owned insurance companies are left to rein with coverage that only targets the employed, and the constantly threatened public insurance for the elderly, Medicare (the only public insurance available in the United States), and a few others like military and veterans, and the disabled and poor, whose provision is dependent on the respective state across the US.
The recent statistical data indicate that about 47 million Americans do not have health insurance coverage, denying them access to healthcare services. It’s embarrassing that our country does not have universal coverage, even as millions of people are denied the most important human right on earth, health. This has become a matter of life and death for the alienated, as they have no alternative but to hope that things will change for the better shortly. It is a sad scenario, as depicted by the American Society of Internal Medicine statement: “people without health insurance tend to live sicker and die younger than people with health insurance” (Mathews & MacDorman 72). As if that is not enough, the fact that millions lack health insurance cover has presented far-reaching consequences. Many healthcare providers are pushed into the corner of the high cost of operations, hence shift to cost-related solutions like hiking medical service costs at the expense of taxpayers’ already strained pockets and too high insurance premiums for other average Americans with medical cover.
Health and Wellbeing of the Citizens
The health of a nation is reflected in its overall status as represented by its citizens’ wellbeing. However, one of the most common indicators used in measuring a country’s health status is the infant mortality rate, life expectancy. Sadly, United States’ infant mortality rate is the highest among the OECD states. According to CDC (2009) report, 12.5% of the United States births were premature, hence leading higher mortality rate. This is a far much bigger figure than 5.6% of Finland and Ireland (Himmelstein & Woolhandler 655). Currently, out of 47 million uninsured Americans, 8.7 million are children. These figures are scary but unfortunately, they are the reality we face in modern America.
Fairness in Healthcare Financing
This represents the measurement of the degree to which financial resources meant for healthcare provisions are distributed across the population of a country. Among the OECD countries, United States ranks poorly. In other words, as compared to countries like Germany and Sweden are considered the fairest in the distribution of financial resources towards the achievement of proper healthcare. The US is ranked the lowest fair (the most unfair) among these developed nations, as they were positioned at 55 in 2006 (Kramer et al. 16).
Before any form of recommendation is made following the above analysis, it is important to realize that there is some criterion that one would consider to be characteristics of a good and fair healthcare system. Recently, several studies have been carried out to compare various healthcare systems as practiced by various countries. An abstract idea of these studies shows that it is important to develop evaluation criteria for the United States’ healthcare system as well as other countries as has been shown among the OECD states. These evaluations have been made based on cost, access to health, and how one healthcare system of a country can go as far as helping achieve an overall healthy nation.
World Health Organization released what it considers standardized criteria to measure the goals and identify what good entails. This is after critical analysis of specific data from certain countries considered to have succeeded in attaining the basic standards. They are as follows:
- good health is making sure the entire population’s health is “as good as possible”;
- Responsiveness – the system can respond to the expectations of the people as far as “respectful treatment and client-oriented by health care providers”;
- Fair distribution of healthcare finances – the system must be able to support the fair and justified distribution of resources that support overall healthcare to the people. This means that the distribution of resources should not be hinged on one’s ability to contribute, but the cost of contribution should be based on an individual’s ability to pay, hence balanced distribution.
From this analysis, it is noted that the dilemma in healthcare insurance is based on how it can be fairly and effectively be funded to cater to the proposed universal healthcare for all Americans. There is a need to increase fairness in the funding of resources across the United States. Secondly, at present, the US healthcare insurance coverage is based on employment. Unfortunately, the system has left many people uncovered, hence high risks. I, therefore, propose a universal health policy that would ensure all Americans, regardless of their employment status are covered without necessarily passing the burden to the families of the employees. Through a shared cost of insurance across the nation, the private insurance companies will not have any excuse not to cover the uninsured, hence providing them with the opportunity to debate on the best way to spread the premiums, albeit within the policy guideline. The third recommendation is the need to set up policy legislation that would ensure public healthcare institutions are strengthened to effectively compete with private ones. At the same time, private hospitals with the tendency of passing the administrative costs to the people should be restricted, especially if the services are non-specialized. Lastly, the Medicare and Medicaid programs have proved very successful. The best way to help them to survive is to ensure more funds are allocated to aid the two programs. Considering the amount of stimulus package that will be spent, it is important when congress is made to reassess the proposal to match the level of economic decline.
This proposal is likely to generate powerful resistance from medical industry investors, particularly health insurance firms and employers who do not submit insurance premiums on behalf of their employees. These groups have their allies, the most powerful individuals with business interests in the healthcare industry. However, the greatest advantage is that majority of Americans have voiced their support for Universal Healthcare; these are the majority voters who did everything to get you in the oval office- not the few powerful ones who would do anything to protect their business interest.
I salute You, Mr. President, that despite the powerful political forces, the recommendations will be looked at critically, and that some of the most important reforms can be made to ensure every American is granted access to healthcare services without bias. I look forward to further collaboration as we share the best way forward in issues of national interest. Thank you for your kind attention.
Cronin, C. Next Congress to grapple with U.S health policy, competitiveness abroad. Bus Health, 4(2):55. 2006. Print.
Himmelstein, D., &Woolhandler, S. Cost without benefit: administrative waste in U.S. health care. N Engl J Med, 314:441-5. 2006. Print.
Kramer, M., Platt R., Yang, H, et al. Registration artifacts in international comparisons of infant mortality. Paediatr Perinat Epidemiol 16:16-22. 2002. Print.
Martin, J.A., Hamilton, B.E., Sutton, P.D., et al. Births: Final data for 2006. National vital statistics reports, vol 57 no 7. Hyattsville, MD: National Center for Health Statistics. 2009.
Mathews, T.J, MacDorman, M.F. Infant mortality from the 2004 period linked birth/infant death data set. National vital statistics reports, vol 55 no 14. Hyattsville, MD: National Center for Health Statistics. 2007.
National Center for Health Statistics. Health United States, 2008 with special feature on the health of young adults. Hyattsville, MD: National Center for Health Statistics. 2009. Web.
Siu, A.L., Sonnenberg, F.A., Manning, W.G., et al. Inappropriate use of hospitals in a randomized trial of health insurance plans. N Engl J Med, 315:1259-66. 2006. Print.
Woolhandler, S. Free care: a quantitative analysis of the health and cost effects of a national health program. Int J Health Serv, 18:393-9. 2008. Print.
World Health Organization. The World Health Report 2000- Health Systems: Improving Performance. Geneva: WHO, Print.