Term Paper on "Health Care Reform"

Term Paper 6 pages (1922 words) Sources: 3

[EXCERPT] . . . .

Health Care Reform:

For quite some time, the debate on the health care reforms has been centered on a number of key issues. These key issues have included the question on whether there is an essential right to health care, who should have access to health care, the circumstances that grant access to health care, the method of government support for health care, the quality achieved for the figures spent, the sustainability of the expenditures and the role of the federal government in bringing about such change.

Given the fact that health care in the United States is offered by many separate legal entities, health care facilities are mostly owned and managed by the private sector. Apart from programs such as Medicaid, Medicare, TRICARE, Children's Health Insurance and Veterans Health Administration, health insurance is mainly provided by the private sector. In 2001, it was estimated that about 15% of United States population is totally uninsured while an additional 21% of the population is under insured. This means that up to 36% of the country's population are unable to cover for the costs of their medical needs.

Within the same year, statistics revealed that 62% of all of United States personal bankruptcies emanated from medical debts. Notably, the number of the uninsured and underinsured has increased since then. Consequently, more money per person in the United States is spent on health care than in any other country in the world. Actually, the greater percentage of the country's total income is spent on health care. Nonetheless, despite this greater percentage of expenditure in health care, many argue that the health care system does not deliver equivalent value for the money spent. Therefore, there is a great need for health care reform that will ensure right to health care, efficiency, access, cost effectiveness, fairness and quality.

History of Health Care Reform:

The plan of acquiring insurance to protect against illness came up in the early twentieth century due to the fact that advancements in the medical field placed a greater demand on these medical services. Though available, these medical services were beyond the reach for many and this problem greatly intensified with the beginning of the Great Depression. In an effort to deal with this discrepancy, the Committee on the Costs of Medical Care was formed to carry out a study in a period of five years. In 1932, the committee eventually concluded that the leading expenses were rigorous among a small group of people who have the most serious medical problems. The commission also recommended the establishment of a system which would rely on collective responsibility through the creation of health insurance.

During the same time, European countries faced similar questions and consequently settled on a remedy which involved government intervention. This remedy successfully spread the financial risk amongst the whole population and considered health care as a right rather than a privilege. In the United States, the fear of communism, despotism and Nazism stirred up opposition toward government involvement in the economy and the private sector thwarted any near-future possibility of universal health care. Harry Truman's attempt at national health insurance in the 1940's was supported by some labor unions. However, these unions were satisfied by their ability to include health care in their combined bargaining agreements and permitted them to bargain a low standard premium rate for all members.

Though it became a name which provoked ridicule, Blue Cross/Blue Shield was the first private entity to widely apply the concept of insurance by the establishment of a community rate which allowed all group members to pay the same amount for equal benefits. In addition, this entity practiced some form of guaranteed issue which meant that they accepted to provide coverage for anyone willing to pay the premiums, irrespective of their conditions. This private entity was a nonprofit organization, benevolent in nature and was granted tax exemptions from the government because of their work on behalf of the elderly and the needy.

The Medicare-Medicaid Bill was enacted into law by President Johnson in 1965 though it only covered hospitalization during its inception. However, the Medicare-Medicaid bill served to puff up the insurance rolls with its costs rapidly exceeding projections and played a role in the reduction of poverty (Kakasuleff par, 15). The rapid increase in the bill's projections was partially due to the fact that the program had achieved its objective of bringing more of the elderly and poor into the mainstream health care.

Since the early 1970s, there have been great attempts to establish comprehensive health insurance. Health care reform has been a major concern for the United States recent administrations. This push for the health care reform has been a political campaign agenda for many of the recent presidential candidates. While some administrations have been successful in pushing for some significant changes in the current health care system, other administrations have failed in their efforts to do so. For instance, though Health care reform was a major concern of the Clinton administration, the 1993 Clinton health care plan proposed by a group headed by First Lady Hillary Clinton, was not enacted into law.

On the other hand, during the 2004 presidential election, both George W. Bush and John Kerry campaigns presented health care proposals. As the United States president, George Bush signed into law the Medicare Prescription Drug, Improvement and Modernization Act. The Act included a prescription drug plan for elderly and disabled American citizens. During the 2008 presidential campaigns, health care reforms was a top issue considering the fact that health care costs seem uncontrollable even with 46 million Americans uninsured.

Challenges to Health Care Reform:

Throughout the years, American citizens have generally been supportive of the need for reforms on the current health care system. Although many still believe that America is on the brink national health care reform, the country has however been on the brink of health care reform many times before. Despite proposing significant changes to the current health care system, President Obama has found it difficult to enact these proposals into law because of a number of reasons which include:

Political Affiliations:

This is one of the major reasons that have served as a challenge to president Obama in the enactment of significant changes in the health care system. Throughout America's history, political affiliations have always surfaced when it comes to making changes in the health care system. Despite the fact that many Americans support health care reforms, they are divided on the method to be used in the health care reforms based on their political affiliations.

For example, in 2008, when a poll was conducted to identify what Americans thought about the country's health care system as compared to other countries, the difference in views based on the political affiliations was quite evident. Sixty-eight percent of Republicans believed that the country's health care system was the best as compared to forty percent Independents and thirty-two percent Democrats. The same poll also revealed that over half of Democrats would support a presidential candidate who advocates for reform on the health care system as compared to thirty-seven percent of Independents and nineteen percent of Republicans. The political affiliations have emerged as a challenge to President Obama because the Republicans have remained skeptical while the Democrats are relentless in their pursuit of health care reforms (Iglehart par, 1).

While the proposals by President Obama continue to attract the support of a sizable majority of Democrats, the Republicans have opted to be skeptical about the plans. The push for the reforms has been reduced to a political battle as the prospects of adopting the proposals by the Democrats increasing provided that they could agree on the approach. As the Democrats continue to favor the government's role in health care, though divided, the Republicans favor more market-based solutions. Republicans also fear that the management over healthcare choices is the genesis to control citizen's lives.

Ideological Differences:

President Obama has also found it difficult to implement the proposed significant changes to the health care system because of the ideological differences between the political parties. With the views of Americans divide based on political affiliations, Republicans are considered to be center/conservative while Democrats are considered to be center/liberals. Consequently, they disagree with each other with the conservatives' ideology being that the government should have less control over citizens' lives.

Due to the fact that conservatives' ideology also strongly believe a person's success and advancement is solely attributed to dedication and hard work, republicans find it difficult to feel obligated to pay more taxes for health insurance for people who they feel have bad work ethics as proposed in the health care bill.

These ideological differences also come to the surface as America was instituted on the principles of total minimalist government both economically and socially. Therefore, the country was anticipated to be run as capitalistically as possible. Consequently, Republicans believe that America's constitution firmly prohibits the federal government's interference into the citizens' personal and economic decisions, including healthcare.

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