Access to affordable health care for Americans

Access to affordable health care for Americans has been mentioned, discussed and debated in every presidential campaign since the Nixon era. The debate still rages on between various governmental bodies and advocates for public health care.

Central to the debate, at least the poster child for the debate, is the proposed expansion of publicly funded health care for children. It seems simple enough that children should be able to go to the doctor when they are sick. But the controversy about the expansion of health care for children stems from the question of at what family income level is it appropriate to provide health care at taxpayer expense?

And also the broader question, is it appropriate to provide government funded taxpayer supported health care to others, not just certain qualifying children, but to all U.S. citizens as a matter of public policy?

The State Children’s Health Insurance Program (SCHIP) began in 1997 to address the problem of children without health insurance. Designed as a state/federal partnership the basis of its intent was to provide health insurance for children in families that did not qualify for Medicaid but also could not afford private health insurance. SCHIP was initially designed to provide health insurance coverage to targeted low income children.

A low income child is defined as a child who is part of a family with income below 200% of the Federal Poverty Level or whose family has an income 50% higher than the state’s Medicaid eligibility income level. There are similar programs to SCHIP in most states which extend health care insurance coverage free or at no cost to adult relatives of qualifying children.

Politicians and the media decry government funded health insurance as a move towards socialism. The benefits of government funded health insurance, also called single payer or universal coverage health insurance, over private health insurance is also part of the debate. Many Americans have a bias against “socialized medicine” believing that the quality of medical care would deteriorate if we were to have socialized medicine in the United States.

Detractors of socialized medicine seem to routinely forget that, socialized medicine is alive and well in the United States, it is just that not everyone is covered by it. Both the Medicare and the Medicaid programs neatly fit within the definition of socialized medicine.

Health insurance coverage paid for through tax dollars for the benefit of individuals who do not have to pay for their medical services out of pocket. For some services, such as a doctor’s visit there may be a very small co-pay, like two dollars, most services are free of charge to the covered individual.

Is it true that single payer health insurance, universal coverage, delivers a lower quality of health care than private health insurance?  Apparently not true. Jonathon Cohn wrote in a 2007 article for “The Republic” that the arguments against universal health coverage fall apart quickly once the issues are closely examined.

Cohn states that patients in Massachusetts and California are waiting much longer for routine services than patients in France and Germany. Also if the European style of health coverage is so bad, why is it that new mothers in France are kept in the hospital for four days following delivery and sent home in less than two in the United States?

Yet another argument asserted to discredit universal health care insurance is that patients no longer have access to the newest medical technology once the services are meted out by the government. Japan, another country with universal health care insurance, has, by far, more MRI machines per capita than exist in the United States. The U.S. also regularly scores poorly on international comparisons relating to health care around the world. (Cohn, 2008).

The issue of universal health care insurance in the U.S. has long been a political hot potato. After Bill Clinton was elected President, Hillary Clinton, as first lady attempted to put together a universal health care coverage plan.

It failed. Barack Obama as state senator from Illinois worked to pass expanded health coverage in that state. On the campaign trail for President, 2008, Obama, first supported a universal health care coverage agenda, but later diluted that goal.

A 2007 report by two health policy analysts puts the need for some kind of  plan for Americans to access affordable health care in perspective. In Pennsylvania of 2,240,000 individuals; more than 20% of individuals too young for Medicare will spend 10% of their gross incomes on health care in 2008.

And, of those 2,240,000, 601,000 are in families that will spend more that 25% of their gross income on health care in 2008. The vast majority of all of these individuals, over 80%, have health insurance. (Bailey & McCarthy, 2007).

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