Universal Healthcare

Universal Health Care in the United States

The self-employed business woman opens the envelope in her hand with trepidation. It is the annual renewal notice regarding the premiums of her individual health insurance policy. She draws her breath sharply when she sees the figure of $17,928.00. The justification for the cost: the advancing age of the woman, and rising health care costs. She is now faced with a difficult decision. She can drop the current policy; find one with limited coverage, with lower premiums or make sacrifices to pay the full premium. The sixty-three year old woman will even consider not carrying any insurance and hope that she can stay accident and disease free until she reaches the age of sixty-five when she will be covered by Medicare.

Sadly, this hypothetical situation is the norm rather than the exception. Hard working Americans are faced with paying sky-rocketing premiums, buying sub-standard policies or forgoing insurance all together. Many of the aging population are faced with choosing between food and medicine. Families are dealing with the knowledge that one sick family member could potentially wipe out a life time of savings, or worse, force the family into bankruptcy.

The United States is the only industrialized country that does not guarantee access to health care as a right of a citizen. "While other countries have declared health care to be a basic right, the United States treats health care as a privilege, only available to those who can afford it. In this sense, health care in America is treated as an economic good like a TV or VCR, not as a social or public good" (Chua 1-2). In other words, the American health care system is entrepreneurial based where profits need to be made. As a result, the cost for health care continues to increase. By implementing a universal health care system in the United States, all citizens would be guaranteed access to health care without the fear of financial difficulty; health care providers would be able to treat patients more effectively; and the costs to provide quality health would decrease overall.

In 2004, over forty five million Americans were without health insurance and many more were underinsured. Most Americans purchase health care coverage through employer programs and there are government health care programs available for low income individuals/families. However, many of the uninsured are employed where no health insurance is offered and are not eligible for the government programs (The Uninsured: A Primer 1 - 2). These individuals will postpone seeking medical attention and are less likely to receive preventative care. People are gambling with their health because of their inability to pay for medical care, and many pay dearly for taking that gamble.

In the United States, lack of health insurance equates to lack of access to health care. The inability to afford health insurance is the primary reason millions of people go without health insurance. The Kaiser Family Foundation, a non-profit, private foundation focusing on major health care issues, surveyed individuals without health insurance. Seventy percent stated insurance was too expensive. Seven percent were unable to get coverage or were refused due to poor health, illness or age, and another ten percent didn't feel they needed insurance or didn't know how to get insurance (The Uninsured: Reasons for Not Having Insurance).

Who are the uninsured? The federal program, Medicare, provides individuals sixty-five and over with medical services. Therefore, the uninsured are people under the age of sixty-five. The Kaiser Foundation reports 82 percent are from families were someone is employed (Knowledge: Who are the Uninsured). Hence, the majority of the uninsured are hard working taxpayers who are not guaranteed access to medical care. When health care is required, these people will have to pay directly out of pocket. Some of the low income families may qualify for state insurance programs like Arkansas' ARKids First which provides health care coverage for the children of Arkansas. However, the parents of these children will continue to have no access to health care without fear of financial hardship.

Carrying health insurance does not guarantee the insured will always get the services they require. Due to escalating prices, many of the insured may opt to purchase less coverage with higher deductibles to avoid the larger premiums and as a result become what is termed as underinsured. Many of these people will avoid medical care because of the high deductible that needs to be met before the insurance company will start paying for medical costs. Should they have a major medical emergency or problem, they may be denied coverage by the insurance company and have to pay for the expenses on their own. When a person has a prior health condition, many insurance companies will deny coverage or provide limited coverage. With limited coverage, the insurance company will only pay for expenses on new health conditions. The individual with a pre-existing condition will be required to cover the costs to treat the deemed pre-existing condition on their own (Everybody In, Nobody Out).

Universal access would allow the health care system to provide more effective care. For individuals who are fortunate to afford health insurance, physicians may be limited with what treatment they can provide to the patient that would be covered in the policy. Health care providers are asked to sign contracts with major insurance companies to provide services with set fees for the insurance companies' subscribers. They need to understand what the insurance plan will cover and physicians are often restricted by what tests can be run. Some insurance companies offer incentives to health care providers to keep costs lower and may influence physicians to run fewer diagnostic tests as well. If non-approved tests are completed, the health care provider will not get paid for the services from the insurance company and may bill the patient directly or end up writing off the costs (Chambers). Physicians also carry malpractice insurance which may influence how they practice medicine. Instead of focusing on what is best for the patient, the physician may decide his liability is too great and not perform the necessary treatment.

As previously mentioned, many of the uninsured and underinsured postpone seeking medical attention because of the costs, and are less likely to receive preventative care such as blood tests; screenings; pap smears; mammograms, colonoscopies; prostate exams, etc. This affects the timeliness of diagnosis of diseases and effective treatments plans (Chua 2). Many of the uninsured will end up with a chronic illness. "A striking twenty-five year survey of insured and uninsured