Wednesday, August 19, 2009

A Helath Care (Plan) DIlemma :: Part II

Published on Thursday, April 16, 2009

Over 50 million people in United States do not have health insurance; this isnot a good score for the "most powerful" country in the world. There is aconflict among private insurers, health providers and the general publicvis-à-vis the idea of establishing a federal universal health care system inUnited States. Last month, during a health care forum, President Barack Obamaproposed to offer a Medicare-like insurance plan to anyone, at any age, livingin United States. Such a program would aim to cover the uninsured, givecustomers more choices and create some competition in the private healthindustry. President Obama's proposal will insinuate a reduction of prices fromdoctors and hospitals than private insurers are able to negotiate (Abelson,2009).

Medicare is a self-financing system, in which workers and their employers are"required" to contribute to employees' retirement pensions during employeesworking years and then they will establish moral claims. This has been theinherent weakness of Medicare, for, historically, any benefit increase and/orimprovement has resulted into an increase of Medicare payroll taxes. A federalMedicare-like insurance is likely to follow the same trend, particularly whenover 8% of the country's workforce is unemployed and over 50 million people arestill not covered by any form of private or public health insurance plan.

Although the idea of a national health insurance seems ethically reasonable, butmany doubt that the government will be able to play the duo-niche of reducinghealth cost and insuring the non-insured in parallel without increasing taxes onall employed Americans. In 1965, the enactment of Medicare was politicallyobtainable (Jonathon, 2006) because of its target groups and the successfulsocial security model it was based on. In this state of distressed economy,employment' security becomes more uncertain because of capital displacement,bankruptcy, the cost of wars (Iraq, Afghanistan) , etc.; therefore, trust fundshortfalls are (and will be) inevitable.

The Obama's idea of a health plan for all may be unlikely to insure allAmericans. Without eliminating or restructuring Medicaid and many other healthsub-programs throughout the country, those who are not able to contribute to thetax-pool (over 24 million unemployed and a good portion of the 40 millionMedicaid beneficiaries) might be left out or those who are actually employedwill have to carry the load. But the real issue is the fear of health careproviders and insurers of a government's mainmise over the health care industryand the threat of not providing health care services to those who are (or willbe) covered by the government plan. Historically, there has been a conflictbetween health care advocate/interest groups and supporters of a public plan.The American Medical Association (AMA) has been concerned about physicians'ability to make money when (or if) the government uses its pricing power toregulate the cost of health services__ although recently AMA has been openlysupporting President Obama's health reform proposal. Other health organizationsfear that the government will force them out of business by establishing anunfair competitive system. However, those who support the plan believe thatlowering health service cost will "impose a greater disciple on insurers byforcing them to keep costs in check and make their policies affordable"(Abelson, 2009). Because of persistent trends in the health care system and thedecline of quality-of-life in United STates, the public has favored extendinginsurance coverage since 1993 (Skocpol, 2004).

Nevertheless, the Obama's idea of a health plan for all has not been welcomed bymany organized groups, local citizens, private health care providers and amajority of Republicans; recent/current Town Hall meetings throughout the nationare vivid examples.


•Reed Abelson. The New York Times: A Health Plan for all and the concerns itraises. March 25, 2009. p. C1

•Engel Jonathon. Poor People's medicine: Medicaid and American Charity CareSince 1965. Durham, NC Duke University Press, 2006

•Theda Skocpol , Patricia Seliger Keenan. Policy Challenges in Modern HealthCare: Cross Pressures: The Contemporary Politics of Health Reform. NewBrunswick, N.J. Rutgers University Press, 6th ed. 2004.By: Macceau Medozile

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