First Draft of Final Paper

Health care costs have been spiraling out of control, and for years the United States government has been trying to acquire a plan to fairly accommodate all people. The current health care system leaves forty-five million people uninsured so a reformed health care system has to be put into practice. Many democrats believe we should implement universal health care, and although there needs to be a change, that would not be the most adequate approach to fix the current problems. Medicaid and Medicare need to be revised to better suit all people, and free riders need to be stopped so that the truly needy can be helped to buy insurance. Health care has to be brought into the twenty-first century and changes need to be made so Americans can have affordable, portable, quality, and private health insurance.
Universal health care, which Canada currently has, is a health care system managed by the government. Some democratic candidates in America want to apply this policy, so everybody is insured and has equal coverage. Under these guidelines everyone has access to hospital and medical services, and they do not have to pay deductibles, and co-payments. Patients have free choice of physician and hospital, and private insurance is not permitted for these services (Feldstein, 377). Although this sounds great people have to remember where the government is getting the money from; it is coming out of the pockets of the citizens. There are several disadvantages that come out of universal health care. The quantity of care increases with this system because the patients have no co-payments, which increases patient waiting time. Patients will demand a higher volume of patient visits. According to Fraser Institute report on the Canadian health care system, “Canadian patients had to wait on average twelve weeks for an MRI, five weeks for a CT scan, and two and a half weeks for an ultrasound (Feldstein, 387)”. Not only is there an increase in waiting time, but also there is less incentive to improve quality, a decrease in salary for the people who work in the medical field, and an increase in taxes (Leavitt). There is already a shortage of nurses and doctors and cutting their pay would only make the shortage greater. Universal health care also taxes the rich unfairly because they would be fully covering people who do not make money. There could be a better answer than Universal Health Care that still covers people, but in a more reasonable and fair way. This is why we need an approach to health care based on a free, somewhat competitive marketplace, organized to make health care affordable to everyone.
First states need to eliminate the insurance regulations that drive costs up and providers out of the market. Right now the United States has the most privatized system, with the most competition—causing the highest health care costs in the world (Krugman). If states were to control the insurance companies more, and limit the number of companies permitted, then prices would go down because competition would decrease.
If costs were to go down then more people could purchase their own health care. Right now only nine percent of people purchase their own health care that are not covered by their jobs (Health Care). If insurance were more affordable then more people would be covered. To make this happen laws would need to be changed at the federal and the state level. More incentives should also be given for companies that do provide health insurance to encourage more jobs to provide care for their employees. America needs a free-market based system that does not give out any more free rides, but tries to allow every citizen in the system.
If Insurance policies decrease in prices that still does not solve every issue. There are still the people who are truly unfortunate such as the youth, the disabled, and the elderly. That is where a revised Medicaid and Medicare program comes in. Medicaid is health care for the poor, and Medicare is health care for the elderly and disabled (Patel and Rushefsky, 51). The SCHIP (State Children’s Health Insurance Program), which is provided by CMS (Centers for Medicare and Medicaid Services), also needs to be improved.
Medicaid is there to increase the access of the poor to health care by providing them with financial assistance to meet their medical needs (Rushefsky, 52). Many hospitals, especially rural, are heavily dependent on Medicare for their long-term financial solvency (Reiter). The states are able to provide coverage people who where not covered under federal law. There are mandatory benefits which states must accommodate for such as physician and hospital services, family planning consultation, care in skilled nursing facilities, diagnostic services, and screening and treatment for various sicknesses and treatment. Optional benefits include prescription drug, dental care, and nursing home care in intermediate-care facilities (Rushefsky, 54). Currently Medicaid varies greatly among the states and does not cover a large portion of those with low incomes (Feldstein, 105). Medicaid should be reformed to include all those with low incomes through an income-related voucher, which includes a standardized set of benefits. As income increases then the voucher should decrease until a certain point so people do not just get all of a sudden cut off. An income-related approach, instead of a system set of assets of a person, which exists today, would be much more efficient (Feldstein, 106). I also think that the national government should take more control over the program so there is not such a drastic difference of benefits from state to state. States should also be given more flexibility to spend their Medicaid dollars in whatever way they find most efficient and effective.
Medicare needs some drastic changes because of impending financial deficits (Feldstein, 79). At the same time a new prescription drug benefit needs to be added because of the outrageous cost of prescription drugs. Right now Medicare covers 34 million aged and 5.5 million disabled recipients, and the number of aged is expected to double during the next few decades (Feldstein, 79). Something must be done to give more to the people who truly need Medicare, and maybe limit what the financially stable will receive. This will save money, allowing things such as prescription drugs to become a benefit. A proposal for reform would be rising the age to 67 than the current 65. With increased life expectancy, people could hold onto their employment-based health insurance longer. Also if part of Medicare’s plan for the elderly was income related that would save a lot of money. A voucher thing should be created for this too like proposed for Medicare. Right now the benefits are the same for all aged regardless of income (Feldstein, 84). I also believe that if Medicare were covered under social security and not two different taxes then that would also save money to help get America out of this deficit.
Another issue that could decrease the cost of health care would be to decrease malpractice insurance of doctors and physicians. If doctors and physicians were not so liable of every little thing then their insurance would not be so high. So when citizens pay for procedures, they are also paying the insurance companies of the practices. People in the medical field have to charge a lot to cover these high insurance prices. There is such a thing as tort reform, which refers to changing or limiting the rules dealing with compensation for the wrongs and harm done by one’s person’s party to another person’s. The excesses of the legal proceedings are an important contributor to "defensive medicine” --the costly use of medical treatments by a doctor for the purpose of avoiding these proceedings (Confronting).
The United States really needs to focus on being a preventive oriented society and not a treatment oriented society. Citizens need to focus on how to prevent all of these cancers and take action. If people keep smoking, drinking heavily, and having unprotected sex then we are going to have the same problems over and over again, spending billions on treating these self-inflicted things.
Health Care is just one of the problems existing in society today, but one of the most important. There are a lot of steps that need to be taken, but if the society and the government work together, the United States health care system can become one of the best in the world. Universal Health Care is not the answer to the problems, there are to many cons that come with it. If insurance prices go down, it’ll allow more people to purchase it. Then the people still not covered can get reformed Medicare and Medicaid. Health Care is such an important issue and the government has to better help its people, and this is the best way to go about doing it.





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Feldstein, Paul J. Health Policy Issues: An Economic Perspective. Chicago: Health Administration Press, 2003.

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Patel, Kant, and Mark E. Rushefsky. Health Care Politics and Policy in America. Armonk: M.E. Sharpe, Inc, 1995.

Reiter, Kristin L. “The Occupational Mix Adjustment to the Medical Hospital Wage Index: Why the Rural Impact Is Less Than Expected.” The Journal of Rural Health 24.2 (2008): 148-154. 12 Aug. 2008 <>.