Universal Healthcare Constitutionality Research Paper Sample
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In America, one out of six citizens does not have health insurance. Research studies have proved that health insurance and poverty are the two strongest factors that assess health services (Guendelman, et. al, 1986). The lack of health care insurance has now become a problem of the middle-class population too besides low class. The reason for this is an increase in deductibles, cost payment and newly introduced managed network for care. The concept of a health care plan universally has been debated for many years. The establishment of Medicare and Medicaid brought some hopes regarding a better health care plan for Americans. Medicare and Medicaid have, however, not shown any changes since they were first introduced that is 1965. The foundation of America was on the grounds of ‘unalienable rights.’ But still the number of uninsured population is rising. The Obama health care reform, Affordable Care Act, suggests that this plan will save $2,500 every year for a typical family. But there is a lot of analysis and criticism. It is considered that this will not reduce but rather increase the cost for a typical family. Many amendments are considered in this act so as to provide better health care facilities to the citizens.
Universal Health Coverage:
WHO has laid goals of universal health coverage which is to ensure that every citizen have a right to receive health services they deserve without suffering from financial constraints when paying for these services. To achieve these goals an efficient health system is required, a system is needed for financial services, easy access to medicines and technologies and a significant number of trained and motivated health workers are required (WHO). It is the responsibility of government to protect the health of their citizens, and this can only be accomplished by the provision of adequate social and health measures (Constitution of WHO).
Hayes, S. C. (2013) has written an article on Universal Healthcare in America in Journal of Health Ethics. The writer has emphasized that lack of insurance is linked with the low level of the health care system (Mayberry, et al., 2002). The people who are uninsured are mostly those in emergency rooms, and these emergency rooms can not treat chronic diseases. The individuals without insurance are not able to go for the follow-up of their treatment. They are not able to get preventive care, are diagnosed at an advanced stage of disease and get less therapeutic care (Bell, 2000). This problem is not only faced by poor class, but 75% of these people are those who are earning through a full-time job or belong to a family where someone has a full-time job. In such families, parents, children, and elderly people all are uninsured. Some medical practitioners are considerate enough to treat patients on the phone for follow-up cases or do not even charge if they know that the patient has financial problems. They even get some patients who ask for a prescription for a longer time so that they will not have to make frequent visits (Bell, 2000). Policy decisions should be made on those values that are prevailing in a society like financing and providing health care facilities. There is a debate over justice and crises; those in favor of justice argue that every individual have a right to get health care facilities, those with crises ration argues over using the limited resources they have to benefit people. According to a survey, it was found that America was ranked last in ten on the level of public satisfaction with health services, with Canada being first.
The Patient Protection and Affordable Care Act (PPACA):
Healthcare constitutions in America have a long history. Many constitutions have been proposed, but they are rarely accomplished. On 23rd March, 2010 the Patient Protection and Affordable Care Act (PPACA) was passed by President Obama as a result of his efforts in a rally in Pennsylvania in which he emphasized on the need of health care reform and calling on Congress to give a final vote on reform. This Act was amended, and the Health Care and Education Reconciliation Act of 2010 (H.R. 4872) became the law on 30th March, 2010.
The Affordable Care Act will be fully implemented by 2014. This act will restructure health insurance private companies, especially for those who are purchasing coverage on their own and for small business. This will be done partly by supporting the creation of ‘American Health Benefit Exchanges’ in states by which it will be easier for small businesses and individuals to approach private insurance plans. Attention is drawn towards section 1501 of Title1 of ACA, which says that every individual should have a health insurance that meets the minimum coverage requirements by 2014. This will lead to the imposition of taxes on individuals who are not purchasing required health insurance for their own use or their families.Section 2001 of Title II of ACA proposes that by 2014 or earlier, young non-pregnant people having income less than 133% of the federal poverty level will become eligible for Medicaid. The federal government will cover 100% of Medicaid cost from 2014 to 2016 of these newly eligible people and by 2020 the percentage will drop to 90%. The significant growth of Medicaid eligibility over the years is represented by this change.Besides this, the health reform adds new laws and has made them compulsory for Medicare-like to cover services in birth centers and tobacco cessation services for the pregnant women. The law has also expanded state options to provide home and community-based services as a substitute for institutional care. It has given financial incentives to the states to implement this. In financial changes in Medicaid, the new health reform law has decreased disproportionate share hospital allotments, increased some pharmacy compensations and has increased payment for primary care physicians.
Many reforms and ideas are proposed for future with significant arguments on the single paper system and for a reduction in the medical care sector, the fee for service. The PPACA includes a new agency that is meant to do research work on reform ideas and is called the Center for Medicare and Medicaid Innovations. If the results of the pilot projects by CMS are successful, then they could be considered for implementation in the future.
There are many proposals for implementation of universal single payer and health care system in US. None of these proposals have gained political support more than 20% in the Congress. It is argued that hundreds of billions of dollars can be saved every year by preventive healthcare expenditures. This can occur because universal health care when funded publically will benefit employers and customers. The employers will benefit more from potential customers; they will have to pay the lesser amount and will be exempted from costs of healthcare benefits. Advocates argue that inequalities will be reduced among employers. It is found that preventive care is more expensive but advocates estimate that preventive health care will save 40% of national health care expenditures. An analysis by Physicians of a National Health Program on the single payer bill has evaluated that saving of $350 billion every year will occur. The Commonwealth estimates that $570 billion will be saved if United Stated adopts the universal health care system and there will also be an improvement in the mortality rate. The recent enactment in Vermont since 2011 on single payer system can serve as an exemplary model which supports the federal single payer health care system.
In January 2013 the “Public Option Deficit Reduction Act” was introduced by Jan Schakowsky and 44 U.S. House of Representatives. It was meant to create public health insurance option and hence to make amendments in Affordable Care Act of 2010. A government-run insurance plan with 5% to 7% lower premium as compared to private insurance companies was proposed in the bill. It was estimated by Congressional Budget Office that the public debt in United Stated would decrease to $104 billion over the next ten years.
A need to balance supply and demand of doctors was considered.In United States, the supply of medical doctors is regulated by Medicare Graduate Medical Education program. The effective cost in medical care can be decreased by making adjustments in the rates to establish balance in income between medical practitioners.
The current prime system known as fee for service is used by medical insurers. According to this the medical practitioners are paid for the services they provide for medical procedures. It is argued that many of the practitioners will have incentive to go for tests which are not required by the patients so that they can earn more money. This is mostly not for the benefit of patients and in fact they may get harm from these exhausting tests. The fee for service encourages the doctors and pay them for surgeries and on prescription of medicines but do not take into account that changes in behavior like quitting smoking will have a better outcome for the health of patients and it will cost them less. The hospitals which do not provide better treatments result in a greater patient turnover, and the fee for service policy rewards them too. CMS projects are considering a new system called “bundled payments” according to which the medical practitioners will not be paid for their services but the better outcome with respect to the health of the patients. The hospitals and doctors with better results will benefit more.This will not only the better health of citizens but also low-cost expenditure in treatments.
Today all the industrialized nations have established a system based on providing health care facilities to their citizens, except United States. U.S. is declared as a model of democracy and best in providing human rights, but it is ironic that this very nation has failed to provide its middle and lower class citizens a universal health care coverage.There is a need to consider and re-evaluate all the values and policies. A detailed analysis should be made about the issues and then decisive measures should be made for the benefit of citizens. The Committee on the Costs of Medical care, in 1932, stated that the index of civilization is measured by the quality of medical care provided (Committee on the cost of medical care, 1932). At present 52 million people are deprived of health insurance and among them 8.1 million are children. These deprived individuals cannot earn, play and live a life that rest of the citizens with health insurance does and so they become physically and economically weak.
Barr, Donald A. Introduction to US health policy: the organization, financing, and delivery of health care in America. JHU Press, 2011.
Bell, Howard. "Case Study: The Uninsured." New Physician 49.6 (2000): 18-29.
Davis, Patricia A. "Medicare Provisions in the Patient Protection and Affordable Care Act (PPACA)." Congressional Research Service, Library of Congress, 2010.
Elmendorf, D. "HR 4872, Reconciliation Act of 2010. Congressional Budget Office and Staff of the Joint Committee on Taxation." (2010)
Falk, I. S. "Medical Care in the USA: 1932-1972. Problems, Proposals and Programs from the Committee on the Costs of Medical Care to the Committee for National Health Insurance."The Milbank Memorial Fund Quarterly. Health and Society (1973): 1-32.
Guendelman, Sylvia, and Joan Schwalbe. "Medical care utilization by Hispanic children: How does it differ from black and white peers?." Medical care 24.10 (1986): 925-940.
Hayes, Sandra Carr. "Universal Healthcare in America." Online Journal of Health Ethics 1.1 (2013): 5.
Hoffman, Beatrix. "Health care reform and social movements in the United States." American Journal of Public Health 93.1 (2003): 75-85.
Mayberry, Robert M., Fatima Mili, and Elizabeth Ofili."Racial and ethnic differences in access to medical care." Medical Care Research and Review 57.4 suppl (2000): 108-145.
World Health Organization."Constitution of the World Health Organization." (1995).
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