47 million people have no health insurance in the United States. (Burd-Sharps et al.7 ) An additional 25 million people are underinsured (which means that they nominally have health care, but do not receive all benefits in case of illness and treatment). (Schoen 1) The costs of health-care are sky-rocketing, the accessibility of health care is going back, the human consequences are severe and other industrial countries that have universal health-insurance are running better and cheaper than we do in terms of health care. Those facts have far-reaching consequences on our economy, the people and the country. These current conditions, these flaws in our health care system are morally and financially not sustainable. Does our health-care system really endanger people’s lives? Does our health-care system harm middle-class? Does our health-care system hurt businesses and our economy? Do we have comparatively one of the worst health care systems in the industrialized world? We, the people, have to get active when it comes to health-care as we grasp the current flaws and pressure politicians and the business community to address this issue. The U.S health care system has to be reformed, because the costs for health-coverage are sky-rocketing, the accessibility of health care is going back, the human consequences are too severe and other countries have better health care systems than the U.S.
The first reason why we have to reform health care is the fact that the costs of purchasing and keeping health-care is sky-rocketing and places a large burden on the economy, employers, employees, the taxpayers, and households (United States Department of Health and Human Services 1-2). In fact, we are spending $2.5 trillion on health-care in the year 2009, which is $8,160 a person and 17.6 % of our GDP. If no reform takes place that would cut costs on health care it is projected that the share of the GDP on health care will reach 20 % in 2018 (Pear “Overview” 1). “A failure to overhaul the U.S. health care system could result in 66 million U.S. residents being uninsured and individual and family spending on health care increasing by 68% by 2019.” (The Henry J. Kaiser Family Foundation 1). Our health care system is the most expensive in the world. (Musgrove et al./WHO 164) This stunning increase in costs leads to an expansion of public programs like Medicaid, a growing number of uncompensated care, and poses a threat to American middle class and business. (Holahan et al. 3). Rising health care costs will hurt the economy, because more costs will be placed on employers and employees. Employers will stop hiring new workers, layoff workers, see their profits shrinking, raise the prices for their products, delay wage-increases, commit their employees in more cost-sharing and/or will simply cut health care benefits for employees, which hurts the employees, the unemployed and the economy. (United States Department of Health and Human Services, 4-7) Only 63 % of the employers offered health insurance to their employees in 2008 (NCHC “The Impact of Rising Health Care Costs on the Economy. Effects on Workers and Families" 1) An average employer in 2009 is already charged by $5,884 per worker. These premiums will grow to $12,921 in 2019 if no reform happens (Holahan et al. 22) Besides, the currently thriving car brand Toyota has built a car plant in Ontario, Canada, where government covers Canadian workers with health care, instead of America, even though several southern states offered Toyota hundreds of millions of dollars of tax incentives, because they understand the difficult situation of their American counter-part General Motors that dedicates an ever-increasing portion of their resources towards employees’ health care. (Krugman 1) Individuals in households will be forced to make tough choices on whether to spend their money on medical drugs and treatment or other consumer goods. The reduction in consumer spending will, again, hurt the economy. The expansion of Medicaid programs due to larger overall costs and more enrollments will yield in more health care spending for taxpayers, which will refrain the government from spending in other important areas like education or infrastructure (which helps limit economic growth and long-term job creation) and/or yields in more amounts of debt that places a burden on future generations and limit the scope of spending for the government (as an ever-larger sum is dedicated for interest payments) (United States Department of Health and Human Services 4-5) Medicaid (public health program for low-income people) and CHIP (Children Health Insurance Program) are costing the taxpayers $251 billion in 2009 and will cost $519 billion in 2019. (Holahan et al.4) The expensive health care system makes the U.S also less competitive with other nations that spends less on health care. (NCHC "Economic Cost Fact Sheets: The Impact of Rising Health Care Costs on the Economy." 1) We have to reform our health-care system, because the sky-rocketing costs of health care places a large burden on the United States economy, businesses, workers, individuals, and taxpayers.
The second reason why we have to reform our health care system is that mainly because of those rising costs the accessibility of health care is going back, as the statistics indicate. The 47 million uninsured people may be eligible to go to emergency rooms, but they are inclined to postpone minor medical conditions until a more serious disease breaks out, imposing even higher costs on them and the health care system (“World’s Best Medical Care?” New York Times 1). Many people are forced to wait six or more days before they can see a doctor (“World’s Best Medical Care?” New York Times 1). Some people are not insurable by private insurances because of their pre-existing conditions. (Pareto 3) “The current system fosters the perverse irony in that those that least need it [health insurance] have an abundance of it, while those that need it most are often kept out.” (Pareto 3). Another problem in terms of access to health care are the people who have undercoverage. That means that they have health insurance, but have to spend more than 10 % of their income for costs of coverage or pay 5 % of their income in deductibles. (Schoen 1) “For those with annual incomes of $40,000 to $59,000, the underinsured percentage rate reached double digits in 2007.” (Schoen 1). This annual income would be considered as middle class, and demonstrates the fact that the current health care system endangers middle class. 53 % of the underinsured and 68 % of the uninsured went without needed care. (Schoen 1) 45 % of the underinsured and 51% of the uninsured reported difficulties in paying medical bills (unlike fully insured where only 21% complain about not being able to cover medical expenses (Schoen 1). Besides, the U.S. health care system is inherently unequal. The percentage of high income people being uninsured will rise from 5.8% in 2009 to 9.4% in 2019, while the percentage for low-income people will increase only slightly or remain the same (around 32.3%, mainly thanks to the expansion of Medicaid from 36.4% to 39.9% in the best case scenario) and middle-income people’s percentage of uncoverage will increase from 16.2% to 19.3% (which is in absolute numbers even more astounding: from 12.5 million to 16.8 million) if no health care reform is tackled.(Holahan et al.16-18). Because of the declining access to health care our health care system urgently needs to be reformed.
The third reason why we have to reform health-care is that the human consequences are too severe. According to WHO (World Health Organization) our health care system ranks 37th in quality, but 1st in costs, which places us right between Costa Rica (36th) and Slovenia (38th). (WHO 161) Because of the rising costs of health care and the reduction in accessibility towards it (and some other factors, including racial inequality and obesity), the U.S. life expectancy ranks 42nd (77.9 years) that puts us behind most European countries and Japan, but also behind Israel and Costa Rica. This rank is pretty high comparing to all other nations, but at the bottom end comparing to all other industrialized countries. (USA Today 1) "The starting point is the recognition that the U.S. does not have the best health care system. There are still an awful lot of people who think it does", Professor Murray from the University of Washington says (USA Today 1). Furthermore, the U.S. Infant mortality rate is 6.86 child deaths per 1000 babies being born in 2007, which ranks us 29th in the world tied with countries like Poland or Slovakia (MacDorman et al. 1). Racially, African American babies are twice as likely to die below the age of 1 than the average population, comprising 13.63 deaths per 1,000 babies in 2005, raising the question of racial inequality. (MacDorman et al. 1). In addition, some 18,000 (conservative estimate) to more than 100,000 people die from preventable deaths each year, largely because our health care system does not work for everybody (Navarro 2). The last point I want to make in respect to the human tolls we as society have to bear is obesity, which is partly individual’s blame, but mainly a socio-economic issue. Poor non-white communities have worse access to healthy diet than white communities (Harding 1). This ever-worsening problem of obesity (around a third of American people are obese ) (CDC 1) is exacerbated by the absence of universal health coverage that would allow people at least to get treatable diseases like heart problems or diabetes that are caused by obesity under control, or even to promote a healthier lifestyle. Because of these aggravating consequences for American people, we must reform our health-care system.
Finally, the fourth reason why health care reform is unavoidable and utmostly necessary is that other industrialized countries’ health care systems work much more efficiently and better than ours does. France has the best overall health care performance followed by Italy and San Marino (WHO 162-163). Even our neighboring country Canada (30th) ranks higher than the U.S. (42nd). (WHO 161) Why does France have the best health care system? Apart from the only problem that health care in France is also pretty expensive (which is 11.1 % of the GDP, but not as expensive as in the U.S.(OECD 1)), the coverage for all French people is existent. Every employee in France is registered in the securite sociale, an employee health-insurance. (NCHC France 1) All other people are obligated to be covered from couverture maladie universelle (CMU), which is for free for low-income people. (NCHC France 1) All French residents at least living in France for three months are eligible (and mandated) for the CMU-program. (NCHC France 1) Under these generous government-funded conditions the French live 80 years in average (Litchfield 1), and their infant-mortality rate (though not the lowest in the world) is 3.3 deaths in 1000 babies (CIA 1) Both figures are lower than in the U.S. Universal access to health care may not be the only reason why the French and other Europeans, Canadians, Japanese, Australians and others live longer than Americans, but it is a major factor. This final evidence, that other industrialized countries are running their health care system more efficiently in terms of granting every person a comprehensive benefit package and spending less money per capita than the U.S on health care, underscores the necessity of health care reform.
In conclusion, it is undeniable that we have a health-care crisis and need reform, because of the sky-rocketing costs, the decreasing accessibility towards health care, the severe human toll we have to endure, and other countries health care systems that out-perform ours. Part of the problem is that we have a very complex health-care bureaucracy, where 30 % of all health care dollars are dedicated towards maintaining the bureaucracy. (PNHP 1). President Obama has announced that the private health insurers will cut $2 trillion in costs over the next 10 years and government officials intend to establish quality, affordable health care with a public plan (Pear “Obama Push to Cut Health Costs Faces Tough Odds” 1 and HealthReform 1). The details of the bill in Congress have yet to be determined, but the difficulty of this issue shall not obscure the urgency of health-care reform. President Obama said, “But what’s brought us all together today is (…) that [health care] reform is not a luxury that can be postponed, but a necessity that cannot wait.” (Obama 1)
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