Introduction

Health Care Reform in the United States has received a lot of attention both in the past and the present. It must be noted that the United States is one of the few countries among the G8 nations that does not provide a national health system. This could probably be the reason why a lot of proposals have been made in relation to this.

Literature review

The main issue receiving attention in health care reform is the fact that the government should be more involved in the provision of health services within the country. It can also complement this through provision of health insurance for every American Citizen. Besides this, the government can roll back on tax cuts for individuals earning high amounts. Besides this, there has been talk of increasing health insurance access to people who fall within the low income brackets. (Democrats, 2008)

There are various suggestions that have been made about how health care within the US can be reformed. This can be dome through increased budgetary allocations. Others have suggested that there should be introduction of free market reforms. They believe that if health care is operated like any other market in the economy; where there is consideration of all the necessary market forces then it will be well on its way to proper recovery. Advocates for increased government spending in health care also adhere to the belief that there ought to be universal coverage. These advocates plan on increasing the governments’ role in health care through provision of tax credits. This will be done for poor families that may not have the finances to purchase insurance coverage on their own. Besides this, there is also a problem with the provision of health services itself. Therefore advocates for these heath care reforms believe that the government should give small businesses tax credits such that they can have the ability to provide health insurance coverage to their workers. This would mean that more people are liable to health insurance coverage.

Besides this, they also believe that insurers should deny coverage to certain individuals who may be having pre-existing conditions. This is especially applicable to situations where a worker changes from one job to another. The burden of managing this type of health care reform will be placed in the hands of some of the employers who are expected to play their part in contributing to these reforms. Supporters of more government involvement in health care also believe that there should be more tax cuts for Americans getting more than a quarter of a million dollars every month. These advocates believe that other countries in the first world provide universal health care and so can the US. This has been true for many countries even regardless of the fact that they allocate fewer finances to health care than the US does. (Green Party, 2008)

On the other hand, advocates for free market solutions within the field of health care claim that the health care system in the United States has been crippled by numerous bureaucracies. They believe that the health care administration is too complex and the government spends too much catering for the needs of the players in the industry. Consequently, there is a need to make sure that these past mistakes are not repeated again. Advocates for these reforms believe that health care should not involve government mandates any more.

It should be noted that the main advocates for free market reforms are the Republican candidates while their opponents; the democrats believe in universal health coverage. Other issues in health care highlighted by the Republican candidates include provision of incentives in insurance markets that will allow better treatment of chronic diseases. Adherents to these reforms also believe that there should be expansion of savings accounts created for health purposes. These account programs should also be made more efficient and customer friendly for users. They also believe that the system of medical liability should be changed for the better. On top of this, there should be promotion of better lifestyles. This will go a long way in ensuring that medical cases are minimized in the country.

There are also certain segments that have received a lot of attention by the republicans in health care reform. They believe that there should be increased use of Information Technology during provision of medical services such that less people are subjected to medical errors as it has been in the past. This will also improve that rate of service delivery as less time will be wasted on their reform programs. They also believe that the Federal Drug Authority’s drug approval process should be made more efficient.

Advocates for free market reforms (republicans) believe that the reform can be achieved through a number of ways that include; tax deductions for the self employed. They also believe that health care consumers should be given the option of choosing the major insurance costs. Consumers should also be given the option of maintaining their current insurance or receive coverage at an affordable rate even when they are out of town. (Butler, 2003, p 6-7)

A critique

In light of the two different view points about national health care reform, one cannot help but see some of the benefits that will come from the republican candidates’ proposal. Therefore, it is my firm belief that they are on the right track towards improving the health care system within the United States. This is because for the past thirty years, the United States has been heading towards more government participation in the health care system. All this has done yet the country’s health provision has drastically deteriorated. The disadvantages of universal health provision and its methods of implementation will be too much to bear for many citizens within the country. Free market reforms are the only way that will ensure recovery in the health industry and these are the reasons why.

Controversies in the reform

National health care reforms come in various shapes and sizes but provision of a government funded, or in other words universal health care, is one of the most dangerous reforms that can face the US health care system. This is because all the costs would trickle down to the American tax payer. Even self employed citizens are not excluded from this type of reform. Corporate income taxes will be affected because they are a considerable source of funding for the reform.

Even after taking up all that revenue, there would still be minimal health care that can be bought; that is, there will be shortage of services. There is considerable evidence of this in other countries that have implemented increased government involvement in health care. The first is in New Zealand. It was reported that are about fifty thousand patients who are still waiting for surgery in that country. The situation is further emphasized by other countries such as Sweden where are some of the patients have to wait for a period of one year just to get heart x-rays. Doctors from such countries have highlighted that it is more dangerous for such patients to be kept on the lists rather than being operated on! The US should learn that further government involvement in the health care system will only add insult to injury as it has been seen in those countries. (Schildt, 2007)

If the government offers universal health care coverage, it might have to exercise some sort of rationing in the provision of health care. Other countries offering this system of coverage have had to choose between different patients in need of similar services. For example, if two patients approach a health service provider and both of them are in need of a kidney dialysis, then that provider will have to give the service to the younger patient. If it happens that one of the patients is in his fifties, then he may not be liable for treatment.

Provision of universal health care as a reform places a lot of attention on coping with the increased numbers; this makes all other issues in the heath care system less important. For example, it will impede the introduction of technological reforms in service delivery. In Canada, where there is provision of universal coverage for all patients, technological advancements in their health care systems are quite minimal. The United States is one of the frontrunners in the application of the technology during medical practice. However, when that health reform is introduced, then the Unite States will no longer be respected for their technologies. (Robbins, A. and Robbins G. , 2006, p44)

It should be noted that most of the countries that have such systems are quite different from the United States. This is in relation to their economic standpoint. Advocates for the introduction of universal health care claim that other countries spend less on health care and are still able to remain comfortable but this argument does not hold water. Such proponents have not weighed the economic differences between the Unite States and those other countries they refer to. The issues that they should have considered include ;

inflation rates
currency rates
population growth
size of the elderly population
cases of teenage pregnancy
violent crimes
poverty rates

As it can be seen, the US will need to invest in other areas of the economy to get things going. The country happens to have a large population of elders; it has very high violence and crime rates. These are all issues that will require medical attention and will also need to be accommodated in the health reform’s implementation. Consequently, this proposal may not be the best way forward given the circumstances that the country is operating in. (Goodman, 2002, p 23)

Advocates for provision of universal health care have suggested that employers should bridge the gap for incurring these extra expenses. However, there are a number of alarming issues that could occur. Simple economic rules require that more investment should be made when returns increase. However, when employers are required to award their workers more compensation even when those employees have not increased productivity within the company, then there will be a gap which will prompt employers to act in any one of the following ways.

First of all, employers could decide to reduce cash payments made to their employees. However, because the issue of cash payments sparks off a lot of emotions then employees may not choose that avenue. Alternatively, employers can decide to lay off some of their staff members such that they can reduce some of the amounts they lost after the health reforms. On the other hand, employers may decide to avoid recruiting more employees. This implies that there will be soaring cases of unemployment in the country all because the simple rules of economics were not followed. Most of people who may be affected by these cases of unemployment will be workers falling under the low income section. Yet universal health care was uniquely tailored for such people. Essentially, the country would have to sacrifice jobs for health care. It goes without say that this beats common sense. Economists and researchers- such as the National Federation of Independent Business- have indicated that the United States would have to deal with the following if it implemented universal health care;

Business /enterprise / individual / stakeholder

Loss associated with the reform

23% of small businesses

lay offs

22% of small businesses

Close completely

Lost jobs

64,000-3. 5 million

businesses

30 billion dollars in taxes

US Gross national product

Reduces by 27 billion dollars

Budget deficit

46. 5 billion dollars

Tax payers

36 million dollars in taxes

(Butler and Haislmaie, 2006, p34)

It should be noted that there will be immense levels of unfairness if such a policy is introduced because most of the individuals who remain uninsured are usually young people. These are healthy individuals who have just decided that they will invest some of their money into other areas other than health insurance. Consequently, by introducing universal health care systems, low income earners will loose their jobs for people who could afford their own health care in the first place! With this in mind, only free markets would be the best and most viable option.

A real time example of the severity of such a system can be seen below: Most employers maybe paying about eight thousand dollars in terms of health care benefits. This may constitute about twenty three percent of what an employee is earning. But if the country implements the national health care reform; where the employer is expected to pay more payroll tax, he will definitely be tempted to pay the tax through this employee’s insurance. There are certain companies within the US that provide very comprehensive and expensive health benefits to their staff members. When this health reform will be introduced, it will come in the way of such comprehensive options. Companies who offer good health coverage currently can mostly be found in the automobile sector. Some of them are

Chrysler
AT &T

Indeed, if the government decides to introduce this health care reform, then they would be reducing the burden that such huge and profitable companies are carrying. Yet these same companies have the capability of handling that burden. (Shlaes, 1998) Essentially, what the government will be doing is that it will give them permission to transfer their health costs onto other parties that will have to strain themselves in order to handle it. Shown below is a portion of some of the individuals who are not taxed at present. The government will disrupt this arrangement through the national health reform.

Health Insurance by Tax Status

Status

Insured (%)

Uninsured (%)

100% Tax-Free Employer Provided Coverage

97. 2

2. 8

25% Tax-Deduction Self-Employed Coverage

71. 4

26. 6

0% Tax-Deduction for Individuals Purchasing Insurance on Their Own

32. 5

67. 5

Source; Employee Benefits Research Institute (2004): Employees without Health Insurance; Washington: a report for Employee Benefits Research Institute, p15

Another option that employers can use to ensure that they remain competitive in their field of specialty is to charge more for their goods. Eventually, the burden is placed on the poor consumer.

Discussion

Overly, what is being said in the above mentioned health care reform system is that there are certain problems that can and will arise during the implementation process. First of all, it will be letting the more affluent members of society of the hook. This is because employers will be expected to chip in the funding of such a reform. Consequently, such employers will be prompted to deal with this deficit through eradication of their less valuable employees who happen to be low income earners. As a result, what the government is doing is that it will be giving a tax break to certain companies and transferring it to other disadvantaged members of society. It should be noted that majority of the people who will be funded in the scheme are most likely going to be the young and healthy. This is because they knowingly choose not to engage in the purchase of their own health care. (Schildt, 2007)

Recommendations

The heath care system in the United States needs to move towards more free market solutions rather than more inclusion of the government. Although some people might argue that health care is not a tangible item that can be bought and sold at will. They claim that when a patient is in dire need of health care systems, they will not go around choosing which healthcare system is the most appropriate. Such patients will definitely choose the nearest health care service regardless of other market forces like price.

However, one must not underestimate the fact that emergency cases only take up about fifteen percent of all cases that come into hospitals. Essentially, what this means is that people have the ability to choose health care services just the way they do for other goods like cars or television sets. A study done in the State of Illinois revealed that patients in need of cataract surgery would have to pay anywhere between one thousand to six thousand dollars. Similarly, patients in need of hernia surgery would have to pay anywhere between six hundred to four thousand five hundred thousand dollars. This implies that numerous hospitals are competing on the basis of price and other factors. Consequently, patients should be given the mandate to purchase their own health care given the diverse alternatives out there. (Goodman, 2004, p17)

Consumers should be informed about the types of purchases that they can make with regard to their health choices. They should know that not all the people who pay less for their health care denied themselves essential services. Instead, such people simply decided that there are certain optional services that they can do without. On top of this, patients who save on medication are the ones who do cost selection.

Free market reforms through tax equity will go a long way in streamlining the US healthcare system. This is because it will allow equal treatment of patients who happen to be insured by their employers or those who insured themselves personally to be equal. Eventually, more health care consumers will be encouraged to participate in the health care system and there will be more competition in the industry. This will improve the level of service provision through incorporation of better technology.

Conclusion

The United States has continuously been increasing government involvement in healthcare reform. Consequently, the level of health provision has been undermined. What the government needs to do is to allow free markets. Free markets would mean fewer costs for the government, businesses and eventually the common man. It would increase their access to health care and would improve quality of service provision.

Reference:

Democrats (2008): health care reform proposals from the democratic candidates; retrieved from http://www. gohealthinsurance. com/politics/democrats. htm accessed on 29th March 2008

Green Party (2008): Clinton and Democrats are obstacles to real health are reforms; retrieved from http://www. gp. org/index. shtm accessed on 29th march 2008

Robbins, A. and Robbins G. (2006): What a Canadian-Style Health Care System Would Cost U. S. Employers and Employees; Dallas: National Center for Policy Analysis, p 44

Goodman, J. (2002): National Health Care in Great Britain; Dallas: Fisher Institute, p 23

Goodman, J. (2004): National Health Insurance and Rural Health Care; Chicago: American Farm Bureau Research Foundation, p. 17

Schildt, A. (2007): In Sweden, Equality Is Tinged with Inefficiency, Washington Post, August 16, 2007.

Shlaes, A. (1998): Market Tests Britain’s Health System, Wall Street Journal, January 27, 1998

Butler S. and Haislmaier B. (2006): A National Health System for America; Washington: Heritage Foundation, p 34

Butler, S. (2003): Using Tax Credits to Create an Affordable National Health System; Washington: Heritage Foundation, July 20, 2003, pp. 6-7

Employee Benefits Research Institute (2004): Employees without Health Insurance; Washington: a report for Employee Benefits Research Institute, p15