by Yasha Mathur, College of William & Mary

Introduction

The change of office on January 20, 2009 marked the beginning of a difficult period that continues to face our country till today. Very similar to the early years of the Clinton administration, President Obama has encountered several challenges that are beginning to change the shape of this nation’s political, economic, and social environments. With the United States leading the collapse of the global financial systems to political unrest over nuclear issues in Iran, our nation has been asked to surpass unique circumstances in recent times. Like the economy and foreign relations, another present issue that was revisited by President Clinton is health-care reform. In fact, the “Clinton Health Care Plan of 1993” touched upon various points that are currently on the table but was eventually rejected with much criticism.

Over the last few months, the health care debate has overtaken the United States political agenda. Policymakers, lobbyists, corporate executives, and the American people are all involved in a heated argument between two ideologies and several propositions. However, leaving aside, the left and right wings, the unbiased critique of the current health care system deems it to be inefficient and unsustainable. First of all, the current health care system is too expensive for the United States and its people to continue affording in the near future. In fact, according to a report published by the National Coalition on Health Care, national health care expenditures are expected to reach $4.4 trillion by 2018. This figure is more than double that of 2007. Additionally, the current year’s national health expenditures are projected to near $2.5 trillion, which accounts for approximately 17.6% of the United States GDP. Such extreme spending is certainly not sustainable and is the main cause for the nearly 47 million uninsured Americans. Additionally, with the United States in recovery mode, the economy will be fairly constricted in the near future and developing a system that provides cost-friendly solutions is imperative going forward.

Additionally, with Medicare and Medicaid being forecasted to comprise 50% of all national health care spending in the next three years, there are obvious fiscal concerns over our current system. Another major concern over the current health care system is that while costs are skyrocketing, the overall quality of the system is deteriorating. In fact, in a 2009 survey, the World Health Organization ranked the U.S. health care system 37th in the world for quality. Additionally, according to Rand Corporation, a research institute, 60% of the care delivered in the United States is sub-standard. With the quality-cost argument, it is fairly clear that an overhaul of the current health care system is necessary. Regardless of the Democratic/Republican views, it can be justified that a new system needs to introduce a higher level of competition to keep costs at an affordable level for the general public while maintaining a strong sense of quality.

Democratic and Republican Views

One of the major components of the Democratic health care reform plan includes creating a new insurance marketplace, the “Exchange”, that will allow consumers (individuals and small businesses) to explore prices and insurance plans in hopes of selecting the most appropriate for their particular needs. The efforts of introducing the “Exchange” into the health care arena are based on the understanding that competition in the marketplace increases efficiency, both on the quality and fiscal fronts. Additionally, with issue of costs eclipsing the Democratic plan for reform, several provisions of the plan are related to minimizing excess charges and leaving money in consumers’ pockets. For example, the Democratic plan will cap out-of-pocket expenses when seeking medical care, eliminate extra charges for preventative care (e.g. mammograms, flu shots, and diabetes tests), and provide small businesses tax credits and affordable options for covering employees. Finally, one of the most controversial pieces of the Democratic reform plan is to propose a public option.

The public option is a way for government to have a direct role in the market for health care insurance. By providing an alternative to the private sector, the government option will allow consumers more choices with the hopes of increasing the level of equality and equity in the health care system. While other portions of the Democratic approach to a health care overhaul have raised several concerns, in terms of the strain of cutting costs on the United States government and tax-payers, the public option has been a point of heated debate between the two parties. In fact, the GOP has criticized the public option for being a “socialist” reform and claiming it could potentially stifle the private health insurance market.

In further consideration of the Republican proposal for health care reform, representatives such as Roy Blunt (R-Mo.) claim that “we [Republicans] believe that we can come up with a plan where every person in the uninsured has access to insurance”. Unlike the Democratic plan, which offers a complete overhaul of the current system, the Republican approach is more subtle and pinpoints specific areas. The Republican plan outlines a plan that would allow states, associates and small businesses to pool together to offer health insurance. By giving tax credits to low and modest income Americans, the plan claims to provide universal coverage by scooping much of the 47 million uninsured population. In fact, according to Rep. Dave Camp (R-Mich.), the top Republican on the House tax-writing committee, the tax credits provision would “cover seven million people in America” itself.

Crux of the Matter

The details of both the Democratic and Republican plans effectively carry the message that an overhaul of the health care system is significant for our country’s health. While it is widely accepted that change is important, reaching a bi-partisan solution to the issue has become exceedingly difficult over the past few months. As with most issues that have landed on the political agenda over the past eight years, the right/left wing approaches to health care reform have created further differences between the two parties. With draining fiscal resources and a widening number of uninsured Americans, there is much room for argument and filibuster. However, the crux of the matter is that differences will have to be put aside and the issue must be resolved. It has been made clear by government officials that the 47 million uninsured Americans is not an acceptable statistic and in order to protect the United States from another economic blow, reforming the system today is essential.

The issue of health care is important in the many facets previously discussed, but the underlying importance of finding reform can be addressed in context of young Americans. Young Americans or the so-called “invincibles” are typically the most commonly ignored in discussions about health care reform. In fact, according to the National Institute for Health Care Management, one of the reasons that policymakers tend to overlook those in the 19-29 age group is because they typically report to be in “excellent, very good, or good” health. However, this statistic is hardly indicative of the quality of a nation’s health care system, but rather common to the young, who are relatively healthier than the elderly for obvious reasons. Additionally, according to the Kaiser Family Foundation, about “42 percent of young people are very worried about the price of health care”. With many young people studying or in part-time work, the health insurance market does not adequately provide for their care. Therefore, as most young Americans live through their twenties without the proper type of medical attention, they can potentially develop serious conditions with age. Therefore, an approach to health care reform needs to address many of the concerns discussed previously in a way that keeps in mind that protecting the young is basically an insurance policy against unsustainable costs thereby, promising a healthier population in the future.

The United States has been recently tested with many difficult issues and the country’s political agenda is burdened with a plethora of controversial topics. However, part of the safety and security provided to Americans is the right to medical coverage and therefore a need for reform is inextricably important. The promise for universal health care needs to be kept and the only way for doing so is by controlling exorbitant costs and developing an insurance market that is less overridden by profits and more consumer-conscious. With a hopeful resolution in the coming months, the United States can move closer to tackling a major national issue and regain its title as a model for democracy around the world.