Tuesday, December 15, 2009

Health Care Reform is Needed

This post has an odd formatting, I admit. Originally, it was an essay over Health Care Reform, with the intention that I would attend Senator Lugar's (R-IN) Symposium for Young Leaders. I was successful in my attempt, and have this essay left. I have great respect for Senator Lugar, and am very pleased with the quality of the Symposium. In light of peer review,  I have adapted a few locations, but the original intent is wholly preserved.
            Our Independence Day is July 4, and we recognize 1776 as the year that began our time as an independent nation. What document was agreed upon this day? The Continental Congress, as a “Unanimous Declaration of the thirteen united States of America”, adopted Thomas Jefferson’s Declaration of Independence. In the preamble of this historic document, it was acknowledged that, “all men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty and the pursuit of Happiness. – That to secure these rights, Governments are instituted among Men,” (Declaration of Independence and other great documents of American history, 1775-1864 6-7). Some philosophers, such as Locke, argued that "no one ought to harm another in his life, health, liberty, or possessions," (Locke). An alternative wording of, "life, liberty and property" is in a resolution of the First Continental Congress, the “Declaration of Colonial Rights." Another legal document, (this one from the UN), the “Universal Declaration of Human Rights” states, "Everyone has the right to life, liberty and security of person." One may note two similarities in all of these: Firstly, “Life” is the first of the three, in all cases. Secondly, “Liberty” is the second in all of these. History instructors and true historians (and many who are both) argue that, as the Legislative Branch is detailed in Article One of the Constitution, the power of Congress was meant to be greater than that of the Executive Branch and the Judicial Branch. Life, as it is placed first, is, has, and should always be recognized as the most fundamental of all rights of humans. 
            Quality health care is a right. To simply state that one may live without health care and still be in possession of the right to “Life” is false and inherently illogical. You can no more be without health care and in possession of this right than you can be a prisoner without chance of parole and be in the possession of the right to freely move about the country on your own volition. During the time of the Declaration of Independence, health care was rare, expensive, and dangerous. While it is true that there are experimental drugs today that fit all three categories, the far and away majority of health care options are safe, common, and cheap (comparatively). At the time, a mandating of health care for all would have been perilous for the stability of the nation – “Doctors,” midwifes, and nurses were centred in the major population centres, and were not easily found elsewhere. Not only that, but they often would treat a simple cold with a bleeding or leeches; both of these methods have been found to not only be ineffective, but harmful to the body. People would have rebelled against both the necessity of medical treatment, as well as the methods. As health care was not well regarded, nor was it viewed as a necessity for healthy living, the close vote on the Constitution would have been very different, had there been a health care requirement in the original document. It is the blessing of the Constitution that it is living, and can be amended to modern times.  
            The American health care system needs to be modified greatly to become sustainable. Contrary to what the media portrays the debate to be, the private sector is supportive of this, as it would create millions of new consumers of their product. The first action that must be taken is an Amendment to the Constitution that requires health insurance of some sort for all. All fifty states require automobile insurance, in the case of an accident that causes damage to oneself, or the vehicle. A requirement for health insurance is an obvious next step. According to “The Economist” magazine in October, 46 million people remain uninsured at all; that is as many as Texas, Pennsylvania, and Tennessee combined. Health care costs are between fifteen and seventeen percent of GDP, depending on which study you trust, and this is simply unsustainable. It is projected that Medicaid and Medicare alone will cost more than 20% of GDP in 2050, and that health care costs will be greater than America’s current federal budget. To claim that America can continue to increase health care costs at this rate is folly. If present rates continue (as they are projected to) The Economist projects that we will reach a point where we can no longer support a health care system. 
            Is it in the best interest of the private health care companies to be altruistic and support those who cannot pay for insurance? It is quite the opposite. Although the good will generated would be invaluable, they would still be losing money at a prodigious rate, and that is unsustainable for them. Therefore, a public insurance option is key to health care reform. Hobbes and Locke spoke of social contracts being the foundation of government. A “mutual transferring of right” from individuals to the government was the Hobbesian notion of government (Curtis 337). Where the private sector falls flat – altruistic protection of individuals’ rights – the government thrives. The idea of required self-reliance is one that is at odds with the very basic theory of a government. Mutual reliance on such issues as health care and poverty is the very fundamental of a government. As said before, sometimes the private sector cannot do something, but the public sector can; this is why a public insurance option is essential to the success of health care reform. 
            In 1944, the classic Theory of Games and Economic Behaviour connected ideas as varied as nuclear strategies, political science, and evolutionary thought with economics. Using evolutionary theories of competition and supply and demand, follow this logical path: If there is a fixed supply, but increasing demand, prices rise, as supply is in greater demand. If there is increasing supply, as well as increasing demand, and the rates are approximately equal, prices will remain about equal. If there is increasing supply, as well as increasing demand, and the supply is increasing at a much faster rate than demand, prices will fall because the supply is easily available. If the government has the ability to supply an infinite amount (because it can always be supported with taxes based on need) very cheaply (as it is spread among millions of people) competition will force competitors to expand coverage and lower prices. A public option will reduce premiums and reduce health care costs in relation to expected rates of growth. 
            Preventative is defined by the Oxford English Dictionary as, “That prevents or guards against the occurrence of something; precautionary; acting as a hindrance or obstacle." Preventative care is generally accepted as preventative actions in regards to reactionary health care. The most obvious example of preventative care is found in regular medical examinations, as well as regular special medical examinations (such as mammograms and prostate exams). By mandating that all who accept public health care receive regular examinations, many diseases and disorders that develop (such as cancer or diabetes) can be prevented, or at least treated early in the infirmity. Another action the government can take to promote preventative care seems simple: teach comprehensive sex education. It is believed that more than one million Americans currently live with Aids, and all but 23% reported has been from sexual contact. According to sexologist Victor V. Morales, condoms are more than 95% efficient at preventing pregnancy and disease transmission. Government sexual education policy is very misleading. At a recent United Sexualities (Gay-Straight Alliance/Sex Education) meeting, members compared stories that had been told about sex. According to many government-funded sex education classes (usually between 5th and 8th grade) condoms are notoriously unreliable; one instructor told a member that women got pregnant about 50% of the time when condoms were used (in direct contradiction to Morales’s work); another instructor said that holding hands would lead to sex; in the author’s experience, one instructor explained how sexual activity would lead to damnation from God – all of these were in public schools. This nation is not living in the 1950s, where sex is not discussed. Popular media shouts sex, and explains it in detail; were it not from my parents, I would have learned about sex and safe sex practices entirely from the Norwell Swim Team locker room – this is not the best source of information, I assure you. 
            Another option would be to cap the cost of medical school debt that a person can graduate with. As it is, doctors in the United States are saddled with so much debt, that they are forced to charge more than foreign competitors to compensate for their university training. The Economist that an average medical doctor in the United States takes in almost $200,000 a year, but much of that goes to college and med school loans. In Germany, undergrad, postgrad, and doctorate training is free, and this leads to similar profits, but lower gross salaries. Less goes to paying off loans, and more goes into the wallets of doctors. These are only a few of the options that are available to the government for preventative care. There are literally infinite possible actions that the government may take to promote this. 
            The question remaining question is over cost. Can we afford to take up health care reform? This question is invalid, as all evidence points towards the necessity of health care reform. According to the Organization for Economic Cooperation and Development, in 2008 the United States spent over 50% more of its GDP on health care spending than Switzerland, it’s nearest competitor for the largest percent of GDP in the world. The difference, as explained by the New York Times, is that everybody in Switzerland is covered, insurance-wise. The health insurance industry is wildly successful, and profitable. Everybody has coverage; it is universal. What is more, the coverage is comprehensive, and can cover everything. “Swiss insurance companies offer the mandatory basic plan on a not-for-profit basis, although they are permitted to earn a profit on supplemental plans." To put it simply, universal health care reform is not only affordable, but a must. Over the next eight years, health care costs as a percentage of GDP are expected to rocket to 19.5% of GDP. 
The right to live (so long as one continues to find such life a worthy option) is the most fundamental right of a human, and the right to health care is a cooperative right in a modern world. A public option is necessary for competition and coverage, and should work along side a law requiring health insurance coverage. This plan would lower the cost of health care and insurance premiums, lowering the cost of health care. More preventative education and care requirements will assist this goal. If no action is taken, the United States will have passed beyond a point of no return for reform, and the economic situation will be much less tenable for change. Congress must act now, or else suffer the consequences of lack of reform. 
Works Cited of Sources in Print
Curtis, Michael, ed. Great political theories. 2nd ed. Vol. 1. New York, N.Y: Avon Books, 1981.
Declaration of Independence and other great documents of American history, 1775-1864. Mineola, N.Y: Dover Publications, 2000. Print.
Locke, John. Two Treatises of Government: In the Former, The False Principles and Foundation of Sir Robert Filmer, And His Followers, are Detected and Overthrown. The Latter is an Essay concerning The True Original, Extent, and End of Civil-Government. London: Awnsham Churchill, 1689.