Introduction
Medicare and Medicaid are healthcare programs that were established in the 1960s in the United States of America making medical services affordable for defined categories of the population including the elderly and the poor. The financing of Medicare in the United States has come a long way and has undergone many changes due to certain alterations in the healthcare statuses and reforms in this field.
As indicated in the study by Martin and Weaver (2005), the Medicare program was introduced in 1965 and was aimed at providing cheaper healthcare services to older people. In 1988, the US Congress passed a bill that paved the way for coverage of catastrophic illness; this law reshaped the public policy as it now reverted from paying the coverage from general tax revenues to charging taxable income on the benefits received by the elderly people to support the coverage.
The changes leading to the adoption of universal care have had one major problem among others – the incremental approach. The healthcare legislation that was previously regarded as a solution to the problems in this sector has been disjointed as the decisions tended to shift the problems to other areas and to express them in a dissimilar manner.
The policies, costs, and procedures related to the healthcare reforms raised the only question concerning the appropriateness of such healthcare programs and universal healthcare for contrasted to the special type of healthcare services provided to Americans.
The expected changes in the healthcare system including insurance pertained to the insurance coverage obtained by every citizen of the United States by early 2014 as reported by the federal government. The tax penalty was suggested as a measure to force every person to obtain coverage to ensure that all citizens are provided with affordable healthcare. Employment was one of the ways to obtain healthcare coverage through the employer’s scheme by the law provisions.
However, individuals whose employers have not taken care of their coverage were expected to obtain coverage independently of the employer and the organization. Other options for obtaining the coverage include a regulated insurance program that permits individuals to use an exchange system or any other authorized healthcare coverage program (Bierce & Kennerson, 2010).
Pros of Universal Healthcare in the US
Reduction in operational costs
Reduction in operating costs can be considered one of the advantages of universal healthcare for Americans. As reported by Battista and McCabe (1999), the US spends over 40% extra per capita on its healthcare as compared to other industrialized countries which have universal healthcare systems.
Studies that have been carried out by the Congressional Budget Office, as well as the General Accounting Office, have established that universal healthcare could help cut down the spending by huge amounts of approximately $100-$200 billion annually despite the increasing costs of healthcare (Battista & McCabe, 1999).
This would be possible due to lower administrative costs because currently, the US pays out about 50-100% excess on administration as compared to universal healthcare systems (Battista & McCabe, 1999). So, if the government can reduce the administrative costs, then it would have the capacity to offer universal healthcare and, at the same time, increase benefits and save money. Universal healthcare would help cover the millions of people who currently have no insurance coverage.
Improve healthcare and reduce excess bureaucracies
Healthcare workers including nurses and nurse practitioners endure long shifts for low salaries through excessive costs are issued for the healthcare system. Doctors also complain of exhaustion as the number of patients increases which in turn increases the number of working hours.
The time healthcare providers spend with each patient is limited by the amount of paperwork that has been mandated by the insurance companies. The bureaucratic issue can be solved using a universal healthcare system that would reduce the work with documentation related to insurance coverage as the coverage would be the same for every person.
Increase in healthcare options
Universal healthcare would provide Americans with the opportunity to choose their healthcare providers, unlike the present managed care system where people are compelled to go to healthcare providers on the insurer’s list to acquire medical benefits. Universal healthcare would also eliminate management of care which over the years has permitted insurers preapproval for services thereby denying the healthcare providers and the patient the opportunity to make healthcare decisions.
Improve the quality of healthcare
In some cases, the quality of healthcare services provided to patients has been compromised since the motivating factor in some of these corporations is mainly to gain more money through increasing the costs of healthcare provision while offering low-quality care. This phenomenon has negatively affected the quality of healthcare and, in addition to that, access problems have also gone up..
Besides, private for-profit corporations are generally not very efficient when it comes to the delivery of healthcare as they use up to about 20-30% on their administration as well as on profits. The public sector which is the most efficient in this dispute spends about 3% of the money set aside for Medicare on administration (Battista & McCabe, 1999).
Distributed costs
The current situation with healthcare services in the United States suggests laws that mandate the emergency rooms to attend to patients even if they are not covered. These costs have to be paid by insurance companies as well as consumers under the universal healthcare system. Such people who normally acquire medical care without any cover would automatically pay it through taxes. The distributed cost is expected to reduce the personal expenses of people who are already paying for insurance (Philip, 2009).
Cons of Universal Healthcare in the US
Universal healthcare program is uneconomical
As reported by Feld (2011), economists including the CBO director have projected that the healthcare insurance coverage will overwhelm the state as well as the federal deficits forcing employees to go into private insurance using their own after-tax money or Medicaid.
The healthcare reform act cannot restore the healthcare system as it is impossible to save money or even to reduce the deficit using the reform act. Most Americans realize that the government cannot subsidize healthcare coverage for millions of Americans and, at the same time, reduce the deficit.
According to Feld (2011), in just over the next ten years, the mandatory universal healthcare program will have cost the government over $2.6 trillion. This is mostly expected to come from the small businesses which have created over 70% of jobs in America. The mandatory universal healthcare would force companies to increase the price tags of their products meaning that this will be passed down to consumers who are also the taxpayers.
Reduction in quality healthcare
To strengthen the program, Obamacare has come up with the idea of Accountable Care Organizations (ACOs) which the government is in the process of implementing (Feld, 2011). For ACOs to be effective and operational, the government has to incorporate all physicians otherwise physicians’ productivity will be greatly reduced.
What the program is bound to generate, is more rules that will only increase paperwork while decreasing patient care. ACOs are expected to raise the government’s control over patients’ lives as they aim to protect the cost from exploding instead of reducing the cost. Patients are not likely either to control the drug and Medicare cost if the program is made free to all Americans.
Increase in national deficits
The Healthcare reform act exempts many groups with over two million workers; over 733 companies and unions have been exempted, implying that the bill was not intended to cover all Americans (Celente, 2011). Exemptions will not be given to the small businesses which have created millions of jobs for Americans.
At the same time, the owners of the small businesses will be forced to buy the workers an annual insurance policy of $20,000 or drop insurance benefits for their employees and pay a fine of just $2,000 (Celente, 2011). Most likely, they will choose to be fined meaning that the over 27 million workers employed in the small businesses will have to buy private insurance with after-tax money. As suggested by Celente (2011), the national deficit is likely to increase provided that the reform comes into force.
Rationing and the associated problems
Universal healthcare insurance as it is currently in the Obamacare being mandatory for all is likely to cause rationing. The government-controlled system will create rationing, especially, when the medical procedures or even the medicines one is allowed to have would be considered inappropriate or unnecessary.
Those who would want to get away from government restrictions have no choice if the proposed universal healthcare is implemented; in this respect, some people will not be able to take advantage of the healthcare options not covered by the program including reconstructive surgery and other sectors that do not save lives but are aimed at fixing the defects caused by traumas, inborn defects, and others.
People would not be able to opt out of the program even if they want to avoid death from preventable diseases (Warner, 2009). Besides, even the drug companies may as well decide to limit access to newer drugs as they are not allowed to charge high prices.
Conclusion
Universal healthcare is an excellent program; however, it should be aimed at reflecting the needs of all Americans and the economic realities of the state rather than saving money and limiting the opportunities. There is a high possibility of rationing that is guaranteed if such a program is implemented leading to a reduction in the opportunities available for ordinary Americans that cannot afford insurance coverage obtained from private organizations.
The government subsidy on healthcare to all Americans cannot be easily sustained by the government and, therefore, would increase the national deficit which is imposed on taxpayers. The worst part of the mandatory scheme is that hardworking citizens will have to pay for those individuals who damage their lives by smoking cigarettes and abusing drugs and alcohol. Consequently, a mandatory universal healthcare system would not meet the needs of Americans but would impose higher taxes on taxpayers and prevent them from choosing numerous options currently available.
Reference List
Bierce, S., & Kenerson, P.C. (2010). A new twist on labor arbitrage: The impact of Obamacare to promote offshore outsourcing. Web.
Battista, J. R., & McCabe, J. (1999). The case for universal healthcare in the United States. Web.
Celente, G. (2011). 733 companies, unions and other groups with 2,189,636 workers now exempt from Obamacare. Web.
Feld, S. (2001). Repairing the healthcare system: Entitlements do not save money. Web.
Martin, P. P., & Weaver, D. A. (2005). Social security: A program and policy history. Social Security Bulletin, 66(1). Washington, DC: University Press of Kentucky.
Philip T. W. (2009). The pros and cons of universal health care in the United States. Web.
Stirewalt, C. (2011). Dems test the waters on Obamacare overhaul. Web.
Warner, T. H. (2009). Rationing will come. Web.