Well, instead of easing my way into the blogosphere with a general discussion of my feelings, I felt a more appropriate introduction would be to write something more relevant to current events. While there are numerous issues that I have a keen interest in following, one particular debate that is appropriate (given both the scope and the judicial importance) is the current ideological discussions involving healthcare.
With the Supreme Court soon to rule on the constitutionality of the Patient Protection and Affordable Healthcare Act (or ‘ObamaCare’ depending on your political position), this is an optimal time to discuss the role of healthcare in the United States, the issues that currently face the system, and how the PPAHA helps to address these issues.
Healthcare in the United States is broken. That’s probably an understatement, but that is the best place to start. When the PPAHA was being debated, to think that John Boehner actually said that the United States has the, “best health care system in the world,” is an example of the disconnect that exists between political representatives and how healthcare practices actually play-out in the real world. The health system is struggling, and changes need to be made.
Quite simply, Americans pay more to receive less. To give some statistics, according to the Commonwealth Fund, the average health care spending per capita for the United States is around $8,000. By comparison, the United Kingdom’s number is around $3,000. For another number, health care spending as a percentage of GDP in the United States is 18%. In countries like Germany and France, that number stands at 10%.
The United States is spending drastically more on healthcare than other countries. For example, the average MRI scan and imaging fee is $1,200 in the United States, whereas in Germany that price stands at $839, in France it has an average cost of $436, and in the UK it is $179. In addition to costs related directly to hospital-related costs, the US has exorbitant prices for pharmaceuticals. Looking at brand-name drugs, the average US drug costs three times more than the exact same drug in France. The average US drug costs about twice as much as the same drug in the UK or Germany. To be fair, however, generic drugs are generally cheaper in the US than in other countries.
With the increased spending that the US has compared to other countries, the burden that the costs put on the system would be more acceptable if the outcomes were better. Unfortunately, this is not the case. According to the World Health Organization, the average life expectancy in the US is lower than in Germany, France, and the UK. Worse still, the US has a higher mortality amenable to healthcare rate than the three countries, with one of the worst rates in the developed world. Again, there are some areas that the United States does excel in. Breast cancer survivors generally fair better in the United States than in other countries in the developed world, and many transplant recipients have a higher success rate in the United States. The issue, however, still stands that the US is paying disproportionally more (yet receiving less) than in other similarly developed countries.
The issues facing the healthcare system are different because of the role that healthcare serves in American society. To begin with, everyone will need healthcare, but few wish to think of the time when they will need it. Whereas gas prices immediately impact the wallet of the individual voter, for a large percentage of the population, the costs associated with cancer treatment, pharmaceuticals for the elderly, or MRI scans seem less pressing. This is not entirely the voting population’s fault, as it is human nature to better understand the cost of something that impacts them everyday, as opposed to some cost that may occur in the future. This is not to say that it is any less important, however, and, while the problem is widespread, it is only going to get worse. The two groups that highlight this best are the uninsured and the baby boomers.
According to USA Today, a conservative estimate of the amount of uninsured Americans in this country today would be about 50 million. These individuals and families without healthcare put a strain on the system, which, in turn, raises the taxes on everyone else. Consider the role of emergency rooms in American healthcare. Emergency rooms are just that, places for emergency care. The policy for almost all emergency rooms, however, is that treatment cannot be denied, regardless of ability to pay. If the victim does not have insurance, or ability to pay, the hospital eats the cost, which in turn goes on to shift the financial burden on to the other taxpayers.
Because of the guaranteed healthcare, many patients will go into the emergency room for less-pressing health concerns, knowing that they will receive some level of treatment despite the fact that they cannot pay. Aside from the time and space constraints that this puts on the department, this obviously costs a tremendous amount, as well. Plus, that is a cost that we, as taxpayers, have to pay for the non-profit hospitals receiving assistance from the federal government.
The baby boomers present another challenge to the healthcare system. As more and more baby boomers retire, they strain the already packed hospitals, trying to provide healthcare. To put it simply, baby boomers usually require more healthcare than the rest of the population. Between the different treatments that may be needed and scheduled check-ups, there is going to be a surge in care for the elderly in the next ten to twenty years. Again, the younger generations are going to have to be the ones to pay for a number of the programs that assist the elderly. Considering that, it would be advantageous to have a system in place that has each citizen receive health insurance, in order to lower costs in the future. Mainly this would be through preventative care, and would be especially helpful in addressing the spike that will occur in care for the elderly. Consider prostate cancer, a disease that affects an increasing number of senior citizens. To treat stage 1 or stage 2 of prostate cancer is much cheaper than treating stage 3 or stage 4 (and obviously reaching it in stage 1 or 2 increases the probability that the victim will live). Regular check-ups can be paid for through insurance, and, more importantly, can be regulated through insurance as well. All states have laws relating to what health insurance companies have to provide in their coverage. For example, all states require health insurance companies to provide breast cancer screenings to all recipients of their insurance. Thus, states could regulate health concerns by requiring insurance companies to provide care for items (something all ready in practice). With a focus on preventative care, specifically screenings and tests to catch particular ailments earlier, the overall cost of healthcare in the United States would decrease.
The PPAHA is a very complex piece of legislation, and should be treated as such. There are significantly important measures not discussed that would impact and help the practice of healthcare in the country. For example, the law addresses electronic medical records, preventative care, and insurance coverage for those with pre-existing conditions. Still, most of the debates, from a constitutional sense, revolve around the mandate for health insurance. From a practical standpoint, the evidence suggests that it helps address a problem that will only grow as time goes on. From a constitutional sense, however, there is something to be said for the federal government mandating that everyone have health insurance (or pay a penalty [which would be less than insurance]). The key argument is the specific position that healthcare has in the United States. In many situations, healthcare will be provided to anyone despite the ability to pay, and that cost is then passed onto the taxpayers. Because of that, and the serious problems and strain put on the system, the mandate should be ruled constitutional.
With the state of healthcare, today, the specific problems that exist should be dealt with in order to make the entire system more efficient.
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