Essay by:
Seth Rosenstein
American University

It is alarming to most Americans that a significant portion of the population has no access to health care besides emergency care. When comparing the amount of citizens with health care insurance in the United States to the number of citizens with health care insurance in other highly industrialized nations, the numbers suggest that the United States has become a below average country in that regard. The healthcare reform package being pushed by President Barack Obama and the democratic-controlled Congress champion the fact that 96% of Americans would be covered by health care insurance. However, little attention is paid by lawmakers to the overwhelming cost of this health care reform package and the need to control health care costs in general for both federal programs like Medicare, Medicaid and S-CHIP, as well as for the private sector.

When assessing the American health care system, many people believe that our system is the best system in the world. It is true that many major advances in the health care field in modern times have originated in the United States. It is also true that many Americans find themselves uninsured and without access to preventative and catastrophic care. In addition to an absolute lack of access, many Americans have health care insurance that is not comprehensive and does not include all forms of health care. According to the National Coalition on Healthcare nearly 47 million Americans, or 20% of the population under the age of 65 did not have health care insurance in 2008. While many people are offered health insurance in their workplace, they are unable to afford their portion of the premium. With an annual increase of inflation at 2.5% and the health insurance premiums for small workplaces increasing on average 12% percent annually, employers are indirectly discouraged from providing their employees access to health care insurance.

A number of ways to reform health care in the United States have been proposed by politicians from both sides of the aisle. The “America's Affordable Health Choices Act of 2009” was passed in the House of Representatives on November 7, 2009 by a 220-215 margin. This bill was introduced by the Congressional Democratic leadership and was passed with the support of only one Republican member. Prior to the legislation’s passage, the Congressional Budget Office (CBO) provided its non-partisan analysis of the bill. Without taking into consideration and modifications or amendments to the bill after July 14, 2009, the CBO found that enacting the bill would “result in a net increase in the federal budget deficit of $239 billion over the 2010–2019 period.” The CBO also found that the projected 10-year cost of the bill’s insurance coverage provisions would be approximately $1,052 billion. Considering that America’s national debt currently stands around $12,000,000,000,000 and that America’s foreign debt and budget deficits are soaring, any American does not need a degree in economics to understand that such spending is detrimental to our economy and long-term financial standing.

It is difficult to imagine a bipartisan solution to health care passing either chamber of Congress in the current political climate. Conservative politicians are pushing for a bill that has significantly less government intervention and that seeks to create market-based solutions for the problems that plague health care today. It is my belief that a centrist and bipartisan plan would solve a number of the problems faced by Americans while keeping the federal budget and deficits under control. First, I propose that Medicare be extended to any Americans wishing to join the program. Individuals wishing to participate in Medicare would pay an insurance premium set by the federal government. In the case of Americans who are unable to afford such an insurance premium, these people would pay a premium based on their annual income. Second, those Americans not wishing to join Medicare would be given the option to purchase their own privately-purchased insurance or the option to buy into a group policy coordinated by the Department of Health and Human Services. The group policy would provide citizens with greater bargaining power and lower premiums. Third, the government would establish a national system of electronic medical records. A similar system is currently in place in the Veterans Administration health care system. According to public-policy researcher Dr. Richard Hillestad, if 90 percent of hospitals and doctors' offices participated, approximately $80 billion would be saved annually.

My fourth proposal is to require private insurance companies by law to not discriminate against people with pre-existing conditions. Companies will not be able to avoid covering such people. This would eliminate the problem of many people losing their health insurance when changing jobs due to conditions that would have previously kept them from getting insurance with another insurance company. Fifth, I would create legislation that allows for the importation of pharmaceutical drugs from other nations with strict regulatory oversight. This would reduce costs and create significant competition among both domestic and international pharmaceutical countries. My sixth point is to allow and encourage the purchasing of private health care insurance across state lines. This would increase competition and lower the price of insurance premiums. In addition to buying across state lines, insurance plans should be portable. Rather than having people change insurance plans when changing jobs or moving across state lines, Americans would "own" their policies. This would give insurers an incentive to make more investments in prevention and in managing chronic conditions.

In a time of economic trouble and an extremely large federal budget deficit, it is my belief that the United States cannot afford the health care reform that has been proposed by President Obama and the Democratic Congressional leadership. As some of my proposals are based on concepts created by the Republican-backed health care reform package and have not yet been evaluated by the Congressional Research Service, it is difficult to place an approximate figure on the amount of money that could be saved by implementing my proposed reforms. While a dollar amount cannot be placed on my proposals at this time, I have created a plan that would allow for significant health care reform, yet allows for significant reduction of the federal deficit instead of increasing it.




Re: A Centrist Approach to Healthcare Reform

This essay was very easy to follow and I think it cleared up a lot of things for me. I knew we had problems but I do agree that most of us have not really thought a lot about it. We (as Americans) do think that we have the best of everything but I do not think we always do! Great essay!


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