There has been an active debate about health care reform among many Americans in the United States. Some the recent concerns and questions involving a right to health care are access, fairness, efficiency, cost, choice, value, and quality.
Health Care” Right or Privilege”
Health care in the United States is provided by many separate legal entities. Health care facilities are largely owned and operated by the private sector. Health insurance is now primarily provided by the government in the public sector, with 60-65% of healthcare provision and spending coming from programs such as Medicare, Medicaid, TRICARE, the Children’s Health Insurance Program, and the Veterans Health Administration (“Health care in the United States.,” 2011). In the United States, ownership of the health care system is mainly in private hands, though federal, state, county, and city governments also own certain facilities. The non-profit hospitals share of total hospital capacity has remained relatively stable (about 70%) for decades. There are also privately owned for-profit hospitals as well as government hospitals in some locations, mainly owned by county and city governments. There is no nationwide system of government-owned medical facilities open to the general public but there are local government-owned medical facilities open to the general public.
The federal Department of Defense operates field hospitals as well as permanent hospitals (the Military Health System), to provide military-funded care to active military personnel. The federal Veterans Health Administration operates VA hospitals open only to veterans, though veterans who seek medical care for conditions they did not receive while serving in the military are charged for services(“Health care in the United States.,” 2011). Hospitals provide some outpatient care in their emergency rooms and specialty clinics, but primarily exist to provide inpatient care. Hospital emergency departments and urgent care centers are sources of sporadic problem-focused care.
Surgery centers are examples of specialty clinics. Hospice services for the terminally ill who are expected to live six months or less are most commonly subsidized by charities and government. Prenatal, family planning, and “dysplasia” clinics are government-funded obstetric and gynecologic specialty clinics respectively, and are usually staffed by nurse practitioners (“Health care in the United States.,” 2011). Over 45 million Americans are uninsured or underinsured. Those living in poverty exhibit the worst health status. Employment, education, income, and race are important factors in a person’s ability to acquire healthcare access. Having established that there are people lacking healthcare access due to multi-factorial etiologies, the question arises as to whether the intervention necessary to assist them in obtaining such access should be considered a privilege, or a right(“Health care in the United States.,” 2011).
An active debate about health care reform in the United States concerns questions of a right to health care, access, fairness, efficiency, cost, choice, value, and quality. Some have argued that the system does not deliver equivalent value for the money spent. The USA pays twice as much yet lags behind other wealthy nations in such measures as infant mortality and life expectancy, though the relation between these statistics to the system itself is debated. Currently, the USA has a higher infant mortality rate than most of the world’s industrialized nations and life expectancy is ranked 42nd in the world. (“Health care in the United States.,” 2011) The Patient Protection and Affordable Care Act (PPACA) is a United States federal statute signed into law by President Barack Obama on March 23, 2010. The law (along with the Health Care and Education Reconciliation Act of 2010) is the principal health care reform legislative action of the 111th United States Congress (“Patient Protection and Affordable Care Act,” 2011).
A majority of the states, and numerous organizations and individual persons, have filed actions in federal court challenging the constitutionality of PPACA. As of September 2011, federal appellate courts are almost evenly divided on the constitutional issues raised in this litigation; at the district court level, three judges upheld the constitutionality of PPACA and three declared it unconstitutional, in part. PPACA includes numerous provisions to take effect over several years beginning in 2010(“Patient Protection and Affordable Care Act,” 2011). Perhaps the biggest disappointment of our legislative and executive branches of government in the creation of “Obama Care” is that they lacked vision and a concrete understanding of the bigger picture when crafting and ‘pushing’ this new agenda. With a broad brush assessment, we can see that the architects of “Obama Care” failed in addressing the following two areas: Bridging Safety loopholes that needlessly lead to over 100,000 medical-related deaths and hundreds of thousands more in injuries in American medical institutions each year.
Propagating the misperception that a one-tiered, national health system plan, with greater centralized control, can work somehow ‘better’. One of the provisions I disagree with is the shared responsibility requirement, commonly called an individual mandate, it requires that nearly all persons not covered by Medicaid, Medicare, or other insurance programs purchase and comply with an approved insurance policy or pay a penalty. The only people exempt from the mandate are individuals of recognized religious sects or those individuals able to obtain a waiver from the Internal Revenue Service in cases of financial hardship(“Patient Protection and Affordable Care Act,” 2011) . The Act’s provisions are intended to be funded by a variety of taxes and offsets. Major sources of new revenue include a much-broadened Medicare tax on incomes over $200,000 and $250,000, for individual and joint filers respectively, an annual fee on insurance providers, and a 40% tax on “Cadillac” insurance policies.
There are also taxes on pharmaceuticals, high-cost diagnostic equipment, and a federal sales tax on indoor tanning services. Total new tax revenue from the Act will amount to $409.2 billion over the next 10 years. $78 billion will be realized before the end of fiscal 2014(“Patient Protection and Affordable Care Act,” 2011). I have two problems with what many Americans now refer to as “Obama Care”, one I am no fan of paying higher taxes. Any economist will tell you that raising taxes does not stimulate economic growth and without economic growth people will continue to spend less, businesses will not hire new employees or expand, and the unemployment rate will continue to rise. Also an increased unemployment rate means more people in need of government assistance, along with more Americans unable to afford health care. So in short our government is going to raise taxes to give all Americans health care which will in effect cause more Americans to become unemployed and lose there health care and become subject to a penalty.
Sounds like the democratic version of utopia is nothing more than a double edge sword doomed for failure. The concept of utopia is an unrealistic dream; for each person’s vision of utopia is different. The other problem I have with Obama’s centralized health care plan is that we are letting government dictate what we as American have to purchase or be subject to a fine if we do not comply. Our constitution states each person has the right to pursue happiness, it does not say the government should or could guarantee it, just that you have to right to pursue it.
Some people suggest making healthcare mandatory is the same as having to purchase automobile insurance, the only problem with this type of thinking is that you do not have to drive or own a car. If you choose not to, no one fines you for it. I view health care as a right in respect that I have the right to purchase health care or to choose not too. I believe all Americans have the right to choice and should not be fined or penalized if they choose to exercise that right. Too many people today view our government as a separate entity and believe that it owes them something. We as Americans are in fact the government, for we are a government of the people for the people.
Health care in the United States. (2011). In . Retrieved October 24, 2011, from http://en.wikipedia.org/w/index.php?title=Health_care_in_the_United_States&oldid=456210485 Patient Protection and Affordable Care Act. (2011). In . Retrieved October 24, 2011, from http://en.wikipedia.org/w/index.php?title=Patient_Protection_and_Affordable_Care_Act&oldid=456759152
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