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Arguments Against Universal Healthcare in America
The prospect of universal healthcare in America brings out a great deal of arguments from both sides of the political spectrum. I thought I'd take a closer look at some of these arguments. While it might be a good idea to take a closer look at each one individually, the purpose of this article is to provide an overview.
Civilized nations across the globe utilize various forms of universal or nationalized healthcare insurance programs. Germany, the first country to implement national healthcare, did so in the 1880's, decades before America would see the serious development of any kind of health insurance at all.
All of these national healthcare systems in other countries have their own unique ways of accomplishing the goal of universal healthcare. Some have banned private healthcare insurance companies altogether. In other countries, the goal of universal coverage is met through legislation and regulation of the healthcare companies, and by requiring citizens to enroll in one way or another.
Other countries allow private insurance companies to exist as competition, or as supplementation to the national plans to provide additional coverage. Additionally private insurance carriers act in some nations in a complimentary manner to cover such medical services which are not covered under the governments' plans, such as cosmetic treatments.
While, there are many different ways of accomplishing universal healthcare, it is clear that doing so has many important benefits to the medical and financial well-being of the citizens of these nations. Countries with universal healthcare plans generally experience significantly lower infant mortality rates, longer life spans, and a greatly reduced per capita healthcare cost. The general health of the nation as a whole is improved by the prevention of epidemics.
Still, many opponents of universal healthcare in America are not convinced. Indeed, some are adamantly opposed, and exhibit an extreme amount of anger at the very thought of either a publicly funded plan, or government regulation of for-profit healthcare corporations. While many of their stated reasons for this fierce opposition are based obviously on misunderstandings of the specific plans the United States Congress is now considering, some of their arguments are a bit more reasonable.
The Free Market Argument
One of the main reasons for opposition to universal healthcare is the argument of the effectiveness of free markets at providing better results and cost controls. It is generally believed in a free market society that less government involvement produces multiple competing organizations which are theoretically supposed to in turn produce lower costs and increased innovation. This is supposed to result in a better, more affordable end product for the consumer.
When the "end-product" is not a matter of life and death, this model generally works quite well. Even so, there is a fairly large group of Americans who are perfectly satisfied with their healthcare insurance the way it is. This group consists primarily of people whose health insurance premiums are subsidized by their employers, and who have never faced a serious illness - yet, that is. As long as these people stay relatively healthy, and don't face premium payments that consume a large percentage of their income, this group will remain satisfied with things the way they are.
However, there are also a great deal of people who face rising premiums which increasingly eat up larger percentages of their income. For this group of people, the free market model isn't working so well. While premiums are rising across the board, and on average have doubled over the last decade, sometimes even higher raises in premium are occurring, due to such things as simply having a coworker with an ill child, which thus produces higher rates for that entire company.
Other people have experienced the frustrating reality of paying their premiums for years only to discover when they or a covered family member become ill that the insurance provider will not cover the necessary treatments. And once the primary insured, or the spouse or a covered dependent becomes seriously ill, increased premium rates can often become unsustainable, and the insurance irreplacable due to industry wide preexisting condition clauses.
In addition to high premiums, there are large annual deductibles, and caps on how much an insurer will insure you for yearly, and over the course of your lifetime. In the cases of serious illness, these above average premiums, yearly deductibles and over the cap out of pocket expenses can bankrupt a family, and still leave them incapable of funding necessary treatment.
So what the free-market provides us with is usually a very satisfactory insurance program as long as your need for it isn't very strong.
We Have the Best Healthcare in the World, Don't Mess With It
France has the best healthcare in the world, as rated by the World Health Organization. They accomplished this through providing comprehensive universal healthcare and also the utilization of non-profit supplementary providers. The government of France subsidizes 70% of normal expences, but pays 100% of more expensive or long term treatment plans. The compulsory contributions are enforced via a 5.25% deduction from salaries, capital income and other income such as lottery or gambling winnings.
After France on the World Health Organization's list of rankings come 35 other countries before the United States comes in at 37th, just behind Costa Rica. While the United States does rate high in advanced medical technology and procedures, France, Australia, Germany, Sweden, Japan and the United Kingdom rate very well comparatively, and all of these countries have universal healthcare programs. The major difference then being that this advanced medicine is actually reaching the people of their countries, and not just those people who can afford to pay high premiums and/or high out of pocket expenses.
Further, we have fewer doctors per person, obscenely higher death rates among all age groups including infant mortality, and we pay about twice as much as all of the countries mentioned above on healthcare per person on average, including all the people in the U.S. who received no healthcare at all, making the amount even more astonishing. We are less prepared to handle medical crisis, with a lower doctor to patient ratio, and less beds and facilities available per citizen as well.
If Healthcare Workers Face Lowered Compensation, Less People Will Want to Enter the Medical Field
Medical specialists in America do enjoy a very healthy salary, and that certainly is as it should be. Their education costs are higher than most, they have fees, dues, and liability insurance payments to make, and many work long hours putting in extra time to stay abreast of current advancements in knowledge and technique. We certainly wish to maintain highly skilled practitioners, and though we may occasionally hear complaints about the high price of doctor's bills, I'm sure no reasonable person truly begrudges the high salaries of skilled and caring physicians.
That said, there is no evidence to suggest that a program for universal healthcare would limit salaries to such an extent that would cause a loss of skilled talent. Indeed, when compared with other industrialized nations which do enjoy universal healthcare, the United States has a low percentage of doctors.
France has 3.4 doctors per every 1000 citizens. Germany, with the oldest universal healthcare program has 3.5 doctors per every 1000 citizens, as well as even Sweden whose doctors do not enjoy a high level of compensation. Meanwhile the United States with its free-market driven health insurance corporations, has only 2.4 doctors per 1000 citizens.
We Don't Want the Government Deciding What Procedures We Can Have
Would you like to have those decisions made for you by a for-profit healthcare insurance corporation whose main concern is making money? Because that is what we have. There are countless stories of insured individuals being denied treatment, or coverage for treatment, for a variety of reasons.
It is important to understand that healthcare insurance providers do not care about the patient, they care about the bottom line. Our sufferings, illnesses and tragedies do not concern them. It is a business, just business.
Like in any well run business, the executive pay is great, really, really great. In fact the healthcare insurance industry CEO's enjoy an above average CEO compensation, somewhere in the high 7-8 digit range, and those extra digits do not represent cents. They also enjoy many pleasurable perks and lucrative bonuses such as generous stock options. The shareholders also make money. None of this has anything to do with whether a patient lives or dies. The premiums always come in, and the trick of the business is to make sure that as little of that income as is possible through hook and crook is paid back out in claims. That's business.
A 2008 survey of doctors in America showed that the majority of them favored a universal healthcare program. The reason cited was overwhelmingly the fact that private insurers interfere too much with necessary treatments even when the patient has adequate coverage, and the lack of coverage or adequate coverage to cover necessary treatment in other patients.
Why Should Healthy People Have to Pay For the Unhealthy
This is already the situation, up to the point at which insurance providers yank coverage for unhealthy individuals. As discussed before, an ill coworker -or covered dependent of such- raises the premiums for everyone within the group. If a coworker's child has leukemia, you're increased rates are helping to cover that child's treatments.
Even assuming that no individual covered through the group is ill, the premiums are still calculated to help cover high cost treatments for other individuals insured through the same insurance provider, whether or not those individuals are included in your specific insured group.
You might think you can escape this 'share the load' consequence by obtaining insurance outside of employment. However, insurance premiums for individuals are priced even higher, since there is no specific group to spread the costs among should that individual or one of his or her covered dependents become ill.
So while cost sharing is already in effect on insurance plans obtained through private insurers, the difference with a government sponsored program would be that your premiums will not be used to fund shareholder dividends or extremely excessive -astronomical- executive salaries, benefits and other perks. Nor would your premiums be used to fund lobbying purposes or influence politicians. Experts predict a substantial cost saving on these administrative costs of about 14%.
But The Government Can't Even Run the Post Office
The United States Postal Service has been in business for well over 200 years. They are the third largest employer in the country employing over 760,000 Americans with over 32,700 branches across the U.S. They are extremely efficient, very fairly priced and have adapted well to changes in the industry.
So let me get this straight. The governments of Australia, New Zealand, Argentina, Brazil, Canada, Chile, Colombia, Costa Rica, Cuba, Panama, Peru, Uruguay, Trinidad, Tobago, Venezuela, Brunei, China, Hong Kong, India, Kuwait, Qatar, United Arab Emirates, Saudi Arabia, Israel, Singapore, Japan, Malaysia, South Korea, Seychelles, Sri Lanka, Taiwan, Pakistan, Thailand, Austria, Belgium, Bosnia, Herzogovina, Bulgaria, Croatia, the Czech Republic, Denmark, Estonia, Finland, France, Georgia, Greece, Hungary, Iceland, Italy, Latvia, Liechtenstein, Lithuania, Luxembourg, Malta, the Netherlands, Norway, Poland, Portugal, Romania, Russia, Serbia, Slovakia, Slovenia, Spain, Sweden, Switzerland, Ukraine, and the United Kingdom can all maintain effective universal healthcare programs, but the good old US of A cannot? Rubbish! Indeed, even Irag and Afghanistan have universal healthcare these days, sponsored by the United States War Fund.
The Burden of Unhealthy Lifestyles
Again, you're already paying for it, to at least some degree. Employed, insured people also smoke and drink, and use illegal drugs, and practice unhealthy eating habits and suffer from a lack of sufficient exercise.
There is some legitimate cause for concern regarding increased premiums due to adding poorer people to the insurance pool. For example, it is certainly true that poor people cannot afford the cost of a healthy diet. Between trying to earn a living and taking care of their family and homes, and their inability to afford healthy foods, they may not have much time, energy or money for exercise programs or other physical recreation. Unless such people are employed by a company which subsidizes a high portion of their insurance premiums, they will likely be currently uninsured, adding a lack of proper medical intervention to their healthcare dilemnas.
In time, this leads to increased medical needs for conditions which may have been averted had proper medical attention been accessible to them earlier. Now faced with full blown, out of control illnesses, they often require a great deal of expensive treatments to try and fix what might have been prevented in the first place with adequate medical care. Again, through higher hospital costs and taxes, you are already paying for this as well.
Adding these individuals to the medical care pool earlier will cost less in the long run, and might just have the added benefit of providing them with the same chance for a healthy life that more fortunate members of our society possess.
Universal Healthcare is Socialism
Socialism in its simplest definition is when industry and resources are owned and controlled by the state or a collective of the people, for the theoretical good of all as opposed to being for the benefit of a few. In a socialist society, there is no private property, or only a very limited ownership, and an egalitarian approach to goods, income and access to resources.
The acheivment of universal healthcare would not qualify as making us a socialist society, it would simply mean that we have achieved equal access to medical care. That's why it's called 'universal healthcare'. It does not mean that overall socialism would follow. While some fringe type individuals would like to see America become a socialist society, it's pretty much crazy to think anyone else does, let alone politicians.
Jesus, by the way, was a socialist.
Establishing Universal Healthcare
I discussed briefly in my opening the fact that there are many different ways of achieving universal healthcare. The trick for each society is to discover what works for them, and what doesn't.
Though many economic and healthcare experts believe that the single payer system is the most efficient, self sustainable and the best option for us in America, many Americans remain opposed to the concept. In light of that, for us, other options are being considered instead.
It is important to note that it is believed that a great deal of the fear people have concerning a single payer system is due to propaganda put forth both discreetly and overtly by healthcare insurance lobbying firms whose employers would like things to remain the way they are. Currently congress is working on hammering out a compromise, but this effort is hampered by a still misinformed public, politics as usual, and the fact that at least some of the members of congress may be in the pockets of the healthcare insurance industry.
I'll be taking a closer look at different aspects of the healthcare debate over the course of the next few weeks. Feel free to offer suggestions or comments. I take criticism as an opportunity to learn, so don't be hesitant to say what you're thinking. Let me know how you feel, and thank you for reading.