Access to health care services has been a problem in the U.S. for a long time. The American health care system is stated to have been the most costly in the world in 2000, whereas occupying only the 37th position in performance and 72nd in the overall degree of health in a study by the World Health Organization which scrutinized 191 countries (as cited in Rak & Coffin, 2013). The combined high cost of health care services and the lack of insurance coverage have serious negative consequences for the overall health of the American nation.
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In 2010, the Patient Protection and Affordable Care Act (ACA) was introduced, in particular, to address the problem of the low insurance coverage; it fully came into effect in 2014 (Rak & Coffin, 2013). However, a large proportion of the U.S residents remains not covered by medical insurance. Therefore, it is paramount to provide universal health care insurance if the U.S. population is to have a better health level, and, consequently, a higher quality of life.
In 2010, there were almost 50 million uninsured U.S. residents, which amounts to more than 15% of the population of the USA (Rak & Coffin, 2013). According to a more detailed account, among adults aged 19-64, nearly 20% were uninsured in 2010 (Blumenthal, Abrams, & Nuzum, 2015). ACA was supposed to address this problem, allowing for a significantly larger degree of insurance coverage for the American population; it is emphasized that ACA “advocates that ‘healthcare is a right, not a privilege’” (Rak & Coffin, 2013, p. 317).
And yet, even despite the ACA, a large part of the inhabitants of the U.S. (16% of adults aged 19-64) remain uninsured as of 2014 (Blumenthal et al., 2015). This results in most dire aftermath for the health of the American people, for, being combined with the extremely high prices on health care services, it leaves the most vulnerable populations practically no chance to obtain any health care at all, significantly decreasing their quality of life, preventing them from finding adequate employment, and further exacerbating their highly adverse situation both in the short and the long term.
Noteworthy, providing general insurance coverage allows for better prevention and more effective treatment of disease, for example, by allowing patients to visit doctors and detect an adverse health condition at an early stage. For instance, it has been discovered that near-universal insurance coverage results in earlier detection of breast cancer among the population (Sabik & Bradley, 2015). Therefore, it is important to introduce further legal acts that would allow for providing medical care to the whole population of the U.S.
On the other hand, there are a number of opponents of universal health insurance coverage who claim that the government should not provide insurance for all Americans. Basing their arguments on the fact that, having obtained medical insurance, people are more likely to visit physicians (Card, Dobkin, & Maestas, 2008), they state that such a provision would result in excessive health care expenditures and significant tax burdens for the middle class.
As for ACA, which is aimed at supplying a larger part of the population with medical care, it is claimed that ACA has so far been implemented inefficaciously, resulting in serious financial problems (Moffit, 2016). Some authors also complain that universal health coverage is redistributive, is usually favored by leftist parties, and “is very difficult to take away once it has been provided” (as cited in Atkinson & Giovanis, 2015, s631), which is why it should not be introduced.
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Potential Solutions to the Issue
To solve the problem of insurance coverage, it is possible to introduce further amendments into ACA or adopt new legal acts that would allow for extended insurance coverage for the population. For instance, it is stated that the current version of ACA contains a number of loopholes that allow health insurance companies to deny paying for treatment in cases where trial treatments were provided for the patient (Jain, Steensma, Stewart, & Kantarjian, 2016).
Another solution might be the complete reformation of the American health care system, one in which the state pays directly to hospitals and physicians, avoiding additional expenditures pertaining to the use of services of the insurance companies; it is clear, however, that a way of doing this must be carefully designed and discussed.
Of course, there still exists a problem of financing the universal medical care, because the American health care system, as it was stressed, remains one of the most expensive ones in the world (Rak & Coffin, 2013). Berwick and Hackbarth (2012) offer a way to reduce the expensiveness of the health care sector by lowering the amount of “waste” in the American health care system; in particular, it is stated that the utilization of the best health care protocols, the use of effective coordination in the sphere, addressing the problem of overtreatment (such as excessive antibiotics use), lowering the degree of administrative complexity, and dealing with pricing failures, as well as with fraud and abuse, can decrease the number of finances needed for health care by estimated 20% percent or more.
However, the opponents of general health insurance coverage argue that health insurance for everyone ought not to be introduced. They state that the market processes should be able to regulate the problems once they are left without governmental control. It is argued that ACA has been ineffective, incompatible with individual and religious freedom, resulting in heavy taxation, and should be canceled (Moffit, 2016).
Arguments for the Position
Despite the claims of the opponents, it is apparent that universal health insurance should be implemented. As it was shown, prior to the introduction of ACA, there were a large number of individuals who could not obtain medical care. The market mechanisms failed to provide these people with medical attention, resulting in adverse consequences for the U.S. population (Rak & Coffin, 2013; Blumenthal et al., 2015). On the other hand, universal health insurance has been shown to allow for better prevention and earlier detection of disease (Sabik & Bradley, 2015). Even ACA, despite all its flaws pointed out by numerous critics, allowed for wider insurance coverage (Blumenthal et al., 2015).
Therefore, it is important for the government to be active and attempt to allow all people to access health care, rather than hope that the situation will be solved on its own via the market mechanisms. As it was stressed, it is possible to do so by creating amendments to the existing legislation, to introduce legal acts allowing the government to directly pay the hospitals, and to address the “waste expenditures” in the health care system; clearly, numerous other methods may be offered.
Therefore, it can be concluded that the provision of universal medical care should be carried out because it allows for better prevention and earlier detection of disease, permits vulnerable populations to gain access to medical care, and can increase the quality of life of many Americans. Of course, in order to be effective, the way of implementation of universal health care should be designed carefully. To come closer to this goal, it is possible to address the currently existing problems, for instance, by allowing the government to directly pay the hospitals, or by lowering the “waste expenditures” of the health care system, diverting costs to broader insurance coverage.
Atkinson, G., & Giovanis, T. (2015). Impact of the Patient Protection and Affordable Care Act: Overview. American Journal of Public Health, 105(s5), s631-s632.
Berwick, D. M., & Hackbarth, A. D. (2012). Eliminating waste in US health care. JAMA: Journal of the American Medical Association, 307(14), 1513-1516. Web.
Blumenthal, D., Abrams, M., & Nuzum, R. (2015). The Affordable Care Act at 5 years. The New England Journal of Medicine, 372(25), 2451-2458.
Card, D., Dobkin, C., & Maestas, N. (2008). The impact of nearly universal insurance coverage on health care utilization: Evidence from Medicare. The American Economic Review, 98(5), 2242-2258.
Jain, N., Steensma, D., Stewart, D. J., & Kantarjian, H. (2016). Insurance denial of coverage for patients enrolled in cancer clinical trials is still a problem in the Affordable Care Act Era. Journal of Oncology Practice, 12(4), 283-285. Web.
Moffit, R. E. (2016). Year six of the Affordable Care Act: Obamacare’s mounting problems. Web.
Rak, S., & Coffin, J. (2013). Affordable Care Act. Medical Practice Management, 28(5), 317-319.
Sabik L. M., & Bradley C. J. (2015). The impact of near-universal insurance coverage on breast and cervical cancer screening: Evidence from Massachusetts. Health Economics, 25(4), 391-407. Web.
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