A critical essay on the state of healthcare in America
|The Ever-Growing Cloud of Uncertainty: The Healthcare Crisis in America
There is a travesty occurring in this country that continues to worsen as days turn into months and years, and it is costing all citizens whether they realize it or not. It looms over us like a cloud of gloomy smog, and if something is not done very shortly to dissipate it, it will continue to grow until it chokes every one of us. This abomination, this blight on modern society, has a name: the healthcare crisis.
It is a shame that in such a superpower as the United States is among industrialized nations that there is such a thing occurring. According to the U.S. Census in August 2006, “46.6 million Americans, (15.9%of Americans—about twice the population of Texas) were uninsured in 2005,” and according to the National Medical Expenditure Panel Survey, “One-third of adults (31%) and more than half of all children (54%) do not have a primary care doctor” (“Fast Facts”, 2006). And the Institute of Medicine made an announcement in 2004 that stated, “Lack of health insurance causes roughly 18,000 unnecessary deaths every year in the United States” (Sirota, 2006). A major reason for this? Rising healthcare costs. Just in the Metro Detroit area alone, costs have risen 8-10%annually, and they have risen even higher than that in northern Michigan—12-18% annually (Kosmetatos and Terlep, 2006).
The financial factor is becoming such a dilemma that it is almost as if people have to choose between going broke to get well or remaining ill and staying out of possible financial ruin. This is a huge problem, and there are indeed sources that can shoulder some of the blame. Governmental regulations are potentially one of them. “Duke University professor Chris Conover estimates that health care regulations cost Americans $1 billion over the benefits they provide. The total costs are $339.1 billion, yet the regulations provide only about $170.1 billion in benefits. This translates into a hidden tax of more than $1,500 to the average American household every year. It also makes health coverage unaffordable for about 7.5 million people,” mentions Harrison (2006). And the healthcare industry itself is a culprit. Sirota (2006) states evidence was uncovered in 2001 by the Sacramento Business Journal that “senior citizens who were receiving cancer treatment were being priced out of their chemotherapy by an HMO that had arbitrarily decided to raise its rates. ‘For many seniors on fixed incomes the choice is to die or take a shot at physical survival and life in poverty…We have the specter of an HMO effectively turning out the elderly to die.’” Americans pay for more of their medical care through third parties (86%) than patients in 17 other advanced countries, which Harrison feels is possibly the largest factor behind increasing costs.
Employers are feeling the brunt of this, too. An increasing number are turning to what is known as “consumer-driven plans”, meaning employees assume more responsibility when it comes to their healthcare budget (Joyce, 2006). Companies from as large as the Big Three to small firms are having to “share more of the burden with employees by requiring them to pay higher premiums, deductibles and co-pays” (Kosmetatos and Terlep, 2006). The biggest problem that is encountered as far as citizens in the workforce are concerned basically boils down to this: if employees are unhealthy, then productivity suffers. This, essentially, seems fairly common sense, yet the solution is not as clearly defined. Benefits are, understandably, a major concern for employees. Oddly enough, many employers do not seem to see that. Joyce relates, “In a recent survey by Watson Wyatt Worldwide, Inc., a benefits consulting firm, no employer thought healthcare coverage was a key reason top performers leave. When top-performing employees were asked the same question, 22 percent said they would consider leaving if coverage was lacking or too expensive.” So many employers are seeking other alternatives to combat the crisis. One of these is rewarding employees that take steps to improve their health, and attempt to urge those who do not by incurring penalties of some sort. Companies like the Detroit Newspaper Partnership LP, which oversees the business operations for the Detroit News and the Detroit Free Press, will charge non-guild employees who smoke $60 a month if they do not agree to enter a smoking cessation program beginning in 2007, states Kosmetatos and Terpel. Other companies, such as Black & Decker, provide its employees with up to $300 to spend on things like exercise equipment, gym memberships or on-site Weight Watchers programs; in addition, workers can get $50 to complete an online health assessment, mentions Joyce.
As nice as these perks may seem, they do not change the fact that the crisis still exists. And the million-dollar question remains: what can be done to combat it? One major argument that has been brought to the table, and is seemingly rather popular, is the notion of universal healthcare. According to a nationwide ABC/Washington Post poll in 2003, “Americans by a 2-1 margin, 62-32%, prefer a universal health insurance program over the current [private] employer-based system” (Sirota, 2006). And in 2003, the Journal of the American Medical Association published a proposal for government-sponsored universal healthcare that was actually endorsed by more than 8,000 physicians, including two former surgeon generals, mentions Sirota. Sirota goes on to say that even in Michigan the idea maintains a level of popularity—the Big Three all endorsed Canada’s system of universal healthcare, and a poll of Michigan small businesses found that 63% supported the creation of it, even if that meant increases in taxes. Another term for universal healthcare is socialized medicine, which has been in place in many industrialized nations (such as the United Kingdom and Australia) for years (Harrison, 2006). This idea is not without its pros and cons, of course. A positive attribute, as one might reasonably conclude, is that all citizens, regardless of socioeconomic status, will have access to healthcare. Another plus was mentioned in the proposal quoted by Sirota would save roughly $200 billion a year in administrative expenses, which almost matches a report during the same year that if American costs were limited to Canadian levels, we would save more than $280 billion a year; and economist Paul Krugman stated, “The great advantage of universal, government-provided health insurance is lower costs.” However, the downsides to socialized medicine require attention. The laws of supply and demand can apply here. If health care is free, demand will rise, and in all countries that use socialized medicine, just that does, in fact, happen, notes Harrison. This can be very damaging; the high demand for unnecessary care (such as going to the doctor for a common cold that could just as easily been cared for without his or her care) “creates shortages, ending in long lines and waiting lists at the doctor’s offices,” says Harrison. This, in turn, leads to a poorer quality of healthcare, and Harrison goes on to state the evidence suggesting this lies in countries most similar to America politically and socially: the United Kingdom, Canada and Australia. As Harrison points out, “An instructive statistic from their experience with socialized medicine is the percent of patients who have to wait more than four months for surgery. 36% of the British have to wait, as do 23% of Australians and 27% of Canadians. 5% of Americans wait that long.” So once again, we as Americans facing this crisis head-on are left wondering: what exactly are we to do, then? Should we risk sacrificing quality for quantity? Would that risk truly pay off enough to where the benefits would be considered worth it? Those are very tough questions for a very tough quandary.
So what, then, is left for us to do about this? Unfortunately, there is no black-and-white, cut-and-dry sort of answer. And it appears there may not be one for awhile. The crisis looms on until all sides—the government, the healthcare industry, and citizens—can cooperate and work towards an appropriate solution. Whatever the right choice may be, we as individuals must be as proactive as possible in fighting this issue. Whether that be in the form of taking better care of ourselves, setting money aside for the express purpose of funding healthcare, or writing to our governmental officials, we must do something now, before we are all completely stifled by the ever-growing cloud of healthcare uncertainty.
Fast facts on the U.S. health care crisis: From infant mortality to preventive care—the stats on American health care. (2006, October 13). Retrieved December 7, 2006, from http://www.abcnews.go.com/WNT/PrescriptionForChange/story?id=2563381
Harrison, M. (2006). Avoiding Dr. Leviathan: Five points to solve America’s health care crisis. Retrieved December 7, 2006, from http://www.prometheusinstitute.net/opinion/mh7706.htm
Joyce, A. (2006). Shifting risk, responsibility. (2006, November 26). Retrieved December 7, 2006, from http://www.americansforhealthcare.org/media/news/news.cfm?nid=1675
Kosmetatos, S. and Terlep, S. (2006). Workers pay more of health tab: Companies shift burden, hiking deductibles, adding surcharges for smokers and limiting plans. (2006, November 21). Retrieved December 7, 2006, from http://www.detnews.com/apps/pbcs.dll/section?Category=LIFESTYLE03&template=HEALT...
Sirota, D. (2006). How corporate America perpetuates the health care crisis. (2006, May 22). Retrieved December 7, 2006, from http://www.alternet.org/story/36341