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The debate over American healthcare has spanned decades, but it has not been in a greater spotlight than it is now. Social media and news outlets have gone through great lengths to spread information to its readers and viewers to allow the people to make more informed decisions. Problem is, no one can agree if healthcare should be a right of every citizen or simply a privilege for those who can afford it.
What is being said?
This has been an ongoing debate for decades. Usually strained on partisan values: Democrats want to raise taxes to provide healthcare for everyone and Republicans want to cut taxes and allow every person to pay for it themselves. I will leave the politics to you. The focus here is on ideology. Should healthcare be provided to everyone or should the people have the option to purchase healthcare on their own?
Recently, the President released a budget proposal for 2020 that called for trimming of Medicare that ranges from $500 billion to $845 billion dollars over the next 10 years. This is all according to the Committee for a Responsible Federal Budget.
President Trump may be playing into the hand of his rivaled Democrats as the increasingly popular term, “Medicare for All,” becomes a campaign slogan. Medicare for All means different things to different candidates who will have to clarify what they mean exactly.
This sparked a more macro-view type of question.
Should healthcare be a right for every American?
For the sake of argument, let’s say yes it should be an American right. What would it mean? Simply, it would mean that the government is in control of our healthcare. Truth be told. This side of the argument is more philosophical than financial. The idea is that the last thing on every American’s mind is to think whether or not you can afford treatment. You shouldn’t have to decide whether to get the lifesaving treatment for your child or pay your rent/mortgage.
Edward M. Kennedy, LLB, late US Senator (D-MA), stated in his July 18, 2009 article, “‘The Cause of My Life,’” published in Newsweek magazine:
“Quality care shouldn’t depend on your financial resources, or the type of job you have, or the medical condition you face… This is the cause of my life. It is a key reason that I defied my illness last summer to speak at the Democratic convention in Denver… to make sure, as I said, ‘that we will break the old gridlock and guarantee that every American… will have decent, quality health care as a fundamental right and not just a privilege.' It goes to the heart of my belief in a just society…”
It’s obvious that if you believe healthcare should be a right, it is more philosophical than logical. Hear me out. Just because an idea is not based on logic does not make it wrong. Democracy itself was not based on logic. It was founded as an idea. Something no one has thought of at the time and looked at as a philosophical fantasy. But should the wealthiest of nations be the only country in the world that does not provide healthcare to its citizens as a fundamental right?
Should healthcare be a privilege?
In contrast, let’s say it is not a right, every American should pay for the healthcare they wish to receive. With most Americans, if you have a full-time job, then your employer will have health insurance options available for you. If you don’t want it, then you can look elsewhere and get your own.
On its surface, it sounds great and fair. But there’s a catch. What do you do when you develop an illness and your provider no longer wants to cover you? What happens when you cannot get insurance because of a pre-existing condition? This is where your “feelings” kick in and you no longer listen to the financial experts tell you how it makes sense. There are medical costs that insurance companies won’t want to take on the risk of covering. Cystic Fibrosis averages about $250,000 to treat. Hepatitis averages about $80,000 to treat. Cancer—you can’t really average this out because the price varies, but a “guess-timate” is around $100,000.
Healthcare Around the World
It is common knowledge that most of Europe, Asia, and Canada provide healthcare to its citizens as a right and it is not even debated. Conservative parties in each of those countries push harder for providing that right than most liberals. Why is it so different for the United States? There are three different forms of universal healthcare found around the world: Public, Private, and Mixed (Public and Private).
The United Kingdom and Canada have what is known as Public Insurance. It is a single payer system that is funded through citizen taxes. Its providers are directly contracted with the government and do not make up their own hours. All care is provided, so long as it is between the hours of 8 AM to 5 PM. (I am speaking in generalities in terms of the times, but it is structured this way.) If you get hurt overnight, you may have to wait until the next morning to receive adequate care. Also, with set hours for doctors to work, the lines are that much longer since everyone must receive care within a given time.
The Netherlands have private insurance. Government sets the policy and regulates private insurers. This means that the care provided is also run by the private sector. Everyone is required to have healthcare provided by these private insurers. Patients also must buy supplementary insurance for glasses and dental. This is also very similar to the ACA, also known as “Obamacare.”
Mixed Public-Private Insurance
France has what is known as Mixed Insurance. This combines both private and public insurance. Government taxes support for both private and public insurance. In this case, the Government manages three major non-profit funds who pay providers. All citizens must be covered.
Notice how there is no exact cost of treatment. Simply put, no one gets charged the same amount. You can be at one hospital, get an x-ray done, and pay one amount, then go down the street to another hospital and pay a completely different amount for the same procedure. Who is controlling these procedural costs? How can we be assured that lifesaving treatments are not being priced fairly?
You can’t. We can go into a whole other topic about why hospitals prices differ from one to the other for their treatment and procedural costs, but I can give two hints as to why. Insurance and law. Simply put, insurance companies have their own contracts with hospitals and the law says hospitals do not have to disclose the justifications for why they price the services they have.
The pain in everyone’s side in the healthcare world is drug cost. It cost a fortune and years of testing and paperwork for a drug to get approved by the FDA. Most insurance companies and health providers want to negotiate drug prices. (Medicare is not allowed to, for some reason.) On average, the US pays 100 percent more than most countries on expensive drugs. Pharmaceutical Manufacturers argue the cost of research and development, marketing, etc. to justify why the drugs cost so much.
These are just a few issues with allowing the market to dictate whether you can receive healthcare. If healthcare is a privilege, then when healthcare begins to cost too much for insurers, how do you get healthcare insurance? If it is a right, when healthcare costs too much, would the government still be able to cover the cost?
As of right now, Americans have the choice of their healthcare provider. It is being treated as a privilege and so long as you have a full time job you are assured healthcare coverage. The debate over whether it is a right for the richest country in the world continues. We just need to know how to accomplish this. There are more questions than answers.