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Matthew Boerger

Prof. Thomas

English 1201

May 3, 2020

The world is currently undergoing one of the greatest pandemics in modern history.

Covid-19 has wreaked havoc among millions of people, and the world has shown its true colors

when it comes to the quality of the health care system. Even before this pandemic, health care

reform has been a prominent topic of debate for over a century. There are those who fight to

implement systems that support those in need, and those who believe doing so is not only

possible but also morally incorrect. It is undeniable that something needs to be done. The

question is: Is reform necessary, and if so, how? Take some time to put yourself in the shoes of a

single mother, who works three jobs. She recently has been diagnosed with breast cancer and has

to decide between receiving treatment or keeping her children fed. This is not an uncommon

situation for someone to be in. But how can situations like that be prevented? Many leading

experts agree. Reform in the health care system must be made, starting with the government.

Leading experts have provided evidence that lack of availability and affordability has deprived

over half of the world form receiving a basic human right in health care, and strides need to be

made to implement new health care systems.

The real issues that a weak health care system presents are terrifying. The World Health

Organization has created a mission, dedicated to informing people about the issues that the world

faces, along with pushing for reform. The WHO reports that “Over 930 million people spend at

least 10% of their household income on health care,” and of those people, “100 million are

driven into poverty each year”(WHO 3). These are not insignificant numbers. People across the
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world lack the funding to have any type of health insurance or to receive any sort of primary

care. Children are unable to receive preventative vaccinations. Some don’t have access to clean

water. Across 57 countries, health systems are experiencing a workforce crisis. This is an issue

that cannot be ignored. A compromise must be made because change doesn’t happen overnight.

Context is necessary to understand the extent of the problem at hand. Professor Karen

Palmer gave some insight as to the roots of this issue, and the potential paths to reform in her

1999 speech to PNHP (Physicians for a National Health Program). Now understandably, some

may discredit her speech as a source due to its age, but with her being a trusted expert in the field

for over 25 years, it can be assumed she is a credible source. In her speech she describes the

origin of modern health care as we know, beginning in Germany in 1883. Other European

countries soon followed suit by adopting some form of universal health coverage by 1912.

(Palmer 2). Knowing this, the idea of providing public primary care is not a new idea. Not one

way is necessarily right or wrong. Different forms of care have been introduced over time. Ideas

like compulsory health care and voluntary health care were introduced in the 1940s. Compulsory

Health care is a system that is in place in countries like Switzerland. The system is an obligatory

tax scheme, in which employers are taxed for employee care, and rates are determined by

individual income. Voluntary health care is privatized and non-government run insurance. This is

similar to what is in the US today, but problems exist with rates and affordability.

The story of the United States’ relationship with health care reform is quite different.

While the ideas were being adopted in late 19th century Europe, the US failed to form any sort of

public health care service. Matters of public well being were left up to private programs. It was

only until Teddy Roosevelt’s progressive administration for health insurance to find federal

support. In spite of Roosevelt’s spoken support, reform was halted by conservatives in the
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government who believed it infringed on capitalistic ideals. For many years the leaders of reform

campaigns were private organizations such as the American Association of Labor Legislation.

For years, groups like the AALL failed to gain any support, being trounced by anti-socialist

sentiments forming (due to WW1), along with opposition from groups in the medical industry.

The push for reform continued to be stopped by large insurance corporations seeking profit along

with conservative lobbying against reform in congress. Palmer states that “in 1945 [Republicans]

spent $15 million on lobbying efforts which at the time was the most expensive lobbying effort

in American history.” (Palmer 12). To this day interest groups impact legislation by using big

buyouts of government officials to vote their way. This is incredibly significant when judging the

issue. Seeing big corporations spend millions of dollars to influence legislation is hypocritical to

one of the largest opposing viewpoints. The idea of a body of people determining what goes on

in an individual’s life is exactly what conservatives have argued against. Whether implementing

new health care reform or large corporations lobbying in congress is more influential on

individual liberties is for others to decide.

But why has providing care for people become such a political topic? One would think

that “health care is a human right of all people, not a privilege for those who can afford it.”

Those words were spoken by Shinzo Abe in the Washington Post. Being the current Prime

Minister of Japan, and a world leader, Abe is outspoken for the cause of health care reform. He is

an example of a politician standing for a humanitarian cause. But when did support all humans

become political. Debates over health reform in United States history can be categorized as

another party based issue. With American politics becoming more and more polarized, it is hard

to see how reform can be implemented. But with continual campaigning and research, a solution

is bound to be discovered.
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In order for major legislation to be passed, undeniable evidence needs to be put forward

about the inefficiency of the current system in place, while also detailing the effectiveness of a

new system. A good place to start is with the research done by expert Christoper Robertson. In a

scholarly article published on April 17 of this year, Robertson summarizes data he collected with

other researches about the problem with health insurance today. The goal of his experiment was

to determine how much of a ‘moral hazard’ exists in the health care system, along with looking

at its cost-effectiveness. By collecting data from over 3000 individual, random samples,

Robertson created a sample that could be trusted as a representative of the population (in this

case the US Health Care System). The study states statistics that are astounding, and clearly

display the issues with the current system. “In 2015, half of all health expenditures fell on just

5% of the population, and that group spent $50,572 on average, which is also roughly the income

for an entire year for a median Americans.” (Robertson 4). When evaluating how severe that

statistic is, one may consider how Americans who have the most health problems are elderly.

The Elderly generally have no income or are working into old age due to insufficient savings. If

such a person, or say a single mom were to live under those conditions, they would either be

bankrupt or be unable to receive treatment. The living conditions people face in modern times

are unacceptable.

Robertson continues the article by outlining the conditions of his experiment to determine

the potential future effects of the current system and then comes to his conclusion. “Healthcare is

far from an ideal market: it is rife with wasteful spending and infected by all sorts of market

failures, including the misaligned incentives of healthcare providers. Our data show what we

know obtains in the real world: healthcare consumers are often willing to consume low-value

care when their physicians recommend it. Yet, our data show that the problem exists regardless
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of whether patients have a traditional insurance policy that occludes the price of care or an

indemnity policy that makes the price salient along with the opportunity costs of consumption.

Thus, our data helps to pinpoint the problem and helps us understand where future policymaking

should focus. For example, our study suggests that it will be more effective to align incentives of

providers with health and thrift, rather than placing more risk on patients” (Robertson 10). To

simplify his formal vernacular, Robertson has determined that the health system in place creates

risk among consumers. The way it works sets people up for bad circumstances, ones which they

may not be able to handle. He points out that the amount of underinsured and uninsured people is

a much more substantial issue than what is known. With his rock-solid evidence and reasoning,

Robertson has statistically found the current health care system to not only be inefficient, costly,

and risky but in desperate need of reform.

Knowing that the system is in desperate need of reform, now a solution is needed. How

can the problem of unaffordability and unavailability of quality health care be solved? Many

schools of thought have been formed. In the US, lawmakers have rarely been able to pass

legislation to implement new programs. Social Security is one of the most socialist based

programs ever put in place but has received multiple amendments. The most recent action taken

by the US was under President Obama’s administration with the Affordable Care Act, which

created what is commonly known as ‘Obamacare’. (Ballotpedia 4). The Affordable Care Act was

established to expand health insurance and to make it affordable to all Americans. The way this

was done was through means of employment, greatly resembling systems like those in Europe.

By actually implementing a Compulsory style program, the US took great steps towards

improving the health care system for all peoples. But under the most recent administration, many

efforts have been made by the government to remove the Affordable Care Act entirely. If reform
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is unable to stick through changes in party control of the government, then what type of reform

will? It is yet to be seen what route will be most effective in swaying the minds of those in

power.

One idea that seems to be universal amongst foreign nations and health care

organizations is the push for Universal Health Care. This idea has found major support among

younger voters and progressives. In the most recent Democratic primary, discussions of

Medicare for all have been popularized by candidates such as Senator Elizabeth Warren and

Senator Bernie Sanders. The actual definition of such a program has been tossed around by each

of the candidates. The general assumption according to a recent NPR interview, is that Medicare

for all is Universal Health Care. This was controversial for many voters, but for some, it is seen

as the next solution (Gross 1). Senator Sanders actually has a bill in Congress that is a radical

change to the system, making a very generous health care program. The belief with this idea is

that no one should have to worry about finances when going to see a physician. These ideas are

not popular with many people, as it is seen as a far too radical change. But, this radical shakeup

may be what is needed to gain grass-roots support to push reform through. In political reality, the

vast majority of voters are middle of the ground, moderate voters. If legislation is to theoretically

be passed a compromise must be made. At this point in time, what that could be is unclear.

Some people, however, may not be willing to compromise at all. As was discussed

earlier, the implementation of health care reform has always been a party divided issue.

Conservatives in power are in no position to budge on their train of thought. With such beliefs

that progressive reforms to healthcare will eliminate the capitalist society that exists or that

individualism will be harmed, anti-reform voters are unlikely to change. An example of such a

voter can be seen in Eric Rozenman’s essay about the topic. Rozenman is a consultant for the
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Jewish Policy Center and conservative value group. In his essay, Rozenman discusses his

contempt with Democrats and the ideas of Health Care For All. His position is that even the

proposition of universal health care is ridiculous. He questions the way such a program would be

funded and goes so far as to say it would bankrupt the government. All of these viewpoints are

well established, and valid points. The reason his argument along with many similar arguments is

that accusations of brain-washing and comparing public servants to dictators is not a counter-

argument to a budget proposal. The author of the article makes a classic mistake when making a

counter-argument. By insulting the opposing viewpoint the author creates an Ad-Hominem

fallacy, detracting from his argument overall. With that and limited statistical data, the counter-

argument made isn’t much of a counter. What is valid is his skepticism about how such a

program would work. A large question about universal health care is how it will be funded.

Multiple proposals have been made in Congress with plans to pay for such a program, as

discussed earlier in the NPR interview. With statistical evidence provided from similar programs

in foreign countries, it is hard to say that such a plan is implausible. But understandably,

compromises must be made.

Palmer made a relevant statement about reform in her speech in regards to health care

reform in Canada. “One Canadian lesson — the movement toward universal health care in

Canada started in 1916 (depending on when you start counting), and took until 1962 for passage

of both hospital and doctor care in a single province. It took another decade for the rest of the

country to catch on. That is about 50 years altogether. It wasn’t like we sat down over afternoon

tea and crumpets and said please pass the health care bill so we can sign it and get on with the

day. We fought, we threatened, the doctors went on strike, refused patients, people held rallies

and signed petitions for and against it, burned effigies of government leaders, hissed, jeered, and
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booed at the doctors or the Premier depending on whose side they were on.” (Palmer 15). In this

advisory statement, Palmer is pointing to the fact that reform will take time and a lot of effort.

That is what it is going to take in order to make these reforms. The questions of what and how

will be resolved. The real question is when?

All in all, it is still unclear what route is best when implementing health care reform. The

problem needs to be addressed. Every day, people around the world are dying to poor conditions.

In the midst of a historical pandemic, the US found itself underprepared, and unable to

accommodate for its population. Who is to say we will be prepared in the future if changes aren’t

made. But the problem does not only exist in America. All around the world people are unable to

afford proper care. They are unable to provide not only for themselves but for their children.

Some people are living in unlivable conditions, open to disease, and everything else the world

has to offer. Only through united change, and moving towards the future, and letting go of the

world previously known. A world shouldn’t exist where a mother should decide between chemo

or food on the table. It is a basic human right to live. For many people around the world, with the

way health systems are now, millions struggle to. With all of the information that is accessible,

the research that has been done, it is obvious that the direction that is being headed in needs to

change. Whether that direction is through a compulsory system, and a voluntary system, a

universal system, or a combination that is yet to be seen is unknown. But change happens with

one person at a time, one day at a time.

Works Cited

"All nations should have universal health care." Washingtonpost.com, 12 Dec. 2019, p. NA.
Gale
In Context: Opposing Viewpoints, https://link-gale-
com.sinclair.ohionet.org/apps/doc/A608480871/OVIC?
u=dayt30401&sid=OVIC&xid=d3d89e10. Accessed 3 May 2020.

Gross, Terry. “In 'Medicare For All,' Health Care Is Seen As A 'Critical Service'.” NPR, National

Public Radio, 12 Dec. 2019, www.npr.org/2019/12/12/787398039/in-medicare-for-all-

Palmer, Karen s. “A Brief History: Universal Health Care Efforts in the US.” PNHP, 2019,
pnhp.org/a-brief-history-universal-health-care-efforts-in-the-us/.

Rasmussen, Scott. “History of Healthcare Policy in the United States.” Ballotpedia, 2019,
ballotpedia.org/History_of_healthcare_policy_in_the_United_States.

Robertson, Christopher T., et al. "Distinguishing moral hazard from access for high-cost
healthcare
under insurance." PLoS ONE, vol. 15, no. 4, 2020, p. e0231768. Gale In Context:
Opposing Viewpoints, https://link-gale-
com.sinclair.ohionet.org/apps/doc/A621127046/OVIC?
u=dayt30401&sid=OVIC&xid=5b25b4f3. Accessed 3 May 2020.

Rozenman, Eric. "'Health Care' for all—Affordability for None." Gale Opposing Viewpoints
Online Collection, Gale, 2020. Gale In Context: Opposing Viewpoints, https://link-gale-
com.sinclair.ohionet.org/apps/doc/FLNHUZ007650530/OVIC?
u=dayt30401&sid=OVIC&xid=e815b93f. Accessed 3 May 2020. Originally published as
"'Health Care' for all—Affordability for None," American Thinker, 16 Feb. 2019.

“Universal Health Coverage.” World Health Organization, World Health Organization, 2020,
www.who.int/health-topics/universal-health-coverage.