Is universal health care a viable option to solve USA's health care crisis?
Health care in the United States is like an uncured plague, capable of taking millions of lives, yet easily defeated with national intent. The unraveling of employer based health care insurance along with the plight of Medicaid causing an enormous increase in insurance based costs, and a political dismissal of reform at the national level, structurally flaw U.S. health opportunities. The earth's wealthiest nation's health care system is decaying because 15.3% of the gross domestic product, $1,678.9 billion dollars, is spent on health care, with a $5,671 per capita expenditure. This is double that of other industrialized nations. Furthermore history shows expenditures were not always this high. "In 1960 the United States spent only 5.2 percent of GDP on health care. By 2004 that number had risen to 16 percent." (Paul Krugman) Health services do not reach the entire public even though the government spends so much money on health care. People needlessly die on a daily basis because they can not afford health care.
People are living longer, requiring additional treatments through prescriptions and surgery. Millions of people do not have insurance, whether they are illegal immigrants, incapable of purchasing insurance, or even unwilling to purchase insurance. "Premiums for employer-sponsored health plans rose an average of 11.2% in 2004." (USA TODAY) Costs all over the board have gone up, privately and governmentally. "The Long-Term Budget Outlook: In the health care field, unlike in many sectors of the economy, technological advances have generally raised costs rather than lowered them." (Paul Krugman) This unusual trend has thrown off Congress's ability to institute reform, yet as the budget outlook proves, economic growth is stymied by the health care inflation.
The United States ranks among the lowest of countries in people with health care, yet, provide the most beneficial health care in the world. "Current estimates of the number of U.S. citizens that lack health insurance have increased to forty-five million, nine million of whom are children. The uninsured represent 18% of the nonelderly population 5 and the percentage of uninsured adults varies by state, ranging from a low of 7.8% in Minnesota to 31.2% in Texas, 6 with almost one-half of the uninsured residing in only five states. 7 In addition, the vast majority of uninsured working adults are black and Hispanic; only 11% are white." (William P. Gunnar) At least forty five million Americans are uninsured, and this is a burden to the entire population. The government pays for the uninsured, and we all know who pays the government, the people.
Gunnar also points out that "Thirty-three million non-citizen immigrants currently reside in the United States, about nine million of whom are here illegally and are presumed to be uninsured. The number of illegal immigrants is expected to increase by 500,000 per year, with approximately one-half arriving from Mexico. (William P. Gunnar) Immigrants who become injured and are unable to pay for health care force the counties and states to pick up the check. It costs the government millions of dollars.
Public health is the protection and improvement of citizen health by government agencies. Traditionally, states and localities were the primary protectors of pubic health. (States allocate counties to take care of health) Today despite strong federal efforts, states and localities remain the primary providers of public health.
"The story of health care in the United States is familiar, if bewildering: the American government has failed at every attempt to implement a universal health care system, and the country finds itself entering the 21st Century with an exceptionally inefficient, expensive, and inequitable health care system. This result is consistent with America's political and social history, dating to the country's formative years, in which it has repeatedly shunned public welfare programs in favor of private relationships between freely contracting parties. Nonetheless, the failure to act is remarkably pronounced in the field of health care, and the degree to which neither the states nor the federal government has claimed responsibility for the public health is noteworthy, even in the voluntarist American context. The severity of this failure may be the result of an unusual nexus of factors: long-standing libertarian tendencies to reject government welfare; trade unions rejecting government paternalism and vying for rank-and-file control of the American workplace; and a sweeping federal law that preempts state action while offering only the thinnest regulation of, and no mandate for, employer-provided health benefits." (Maureen McOwen)
There are many barriers to health care because of the lack of insurance coverage throughout the nation. "Persons without health insurance are more likely to postpone seeking health care and avoid filling prescriptions because of the cost, have problems paying their medical bills, and nearly a quarter of them will be contacted by a collection agency. Additionally, in 2003 approximately one-third of all uninsured persons who needed health care did not receive it. Persons that delay or fail to receive timely health care are more likely to develop serious illness, become hospitalized for conditions that could have been avoided, and ultimately die. A report by the Institute of Medicine estimated that at least 18,000 U.S. citizens die prematurely each year due to a lack of health care coverage." (William P. Gunnar) These trends provide enough credible information to show how not having health care is detrimental not only to the government, but to the people as well.
The only question that remains then is why has the government struggled throughout history to find a fix on this health care crisis? There a many reasons, including money, cooperation, political agendas, a misunderstanding of the economics of health care, and reactionary political theory preventing reform. The largest problem is the inability of Congress to take a stance on the reform, instead they hand it over to the states. In the long term the country needs a national standard any way, it would be far better to help a majority of states at the same time instead of allowing each state to experiment and persuade its neighbor state to get onto the ship.
States and localities play critical roles in providing and administering health care and welfare policy instead. Due to rising costs, there is a high degree of innovation and variation across states. California has proposed Universal Health care, stating that rates would go down for insurance if everyone had health care. It would be cheaper for states because states would not have to pick up the bill for those needing health care that have no insurance. Unfortunately hospitals and the entire medical industry are against Universal Health care.
Even with all of the evidence suggesting reform is necessary, and even after the Clinton administration attempted change, the following administration has attempted no reform. "The bad news is that Washington currently seems incapable of accepting what the evidence on health care says. In particular, the Bush administration is under the influence of both industry lobbyists, especially those representing the drug companies, and a free-market ideology that is wholly inappropriate to health care issues. As a result, it seems determined to pursue policies that will increase the fragmentation of our system and swell the ranks of the uninsured." (Paul Krugman) The influence the drug industry has on the Bush administration is apparent, and there are probably campaign donations and whatnot, but even if Bush wanted to make changes he probably couldn't because most policies are tied towards the war in the Middle East. It would be hard to win the war on terrorism and win the war on health care too.
California is an innovator when it comes to new state public policies. They were among the first to ban smoking inside of public buildings. Smoking and obesity are the two major health problems in America, and are the most likely to predict education level. 55% of America is obese making the United States the heaviest society in the world. The average American eats out three times a week. No one cares more about its citizens being fat than the government because it costs the government more. As a result California has had a political battle over health care reform leading up to recent legislative reform proposals. Massachusetts, similarly, has come forward with innovation, adopting a plan to obtain nearly universal health care coverage. One of these states may solve the health care crisis for us all in the United States as they increases health care policies, fix public health problems, and provides leadership. Until then the country is left with a fragmentizing pestilence growing up the back of its statute of liberty.
The legislation battle: which policy fits best?
There are four main California proposals and a Massachusetts plan that are worth looking into. They include Senate Bill 840 (Sen. Sheila Kuehl), Assembly Bill 8 (Assembly Speaker Fabian Nunez), the Schwarzenegger Proposal, Senate GOP Proposal, and the Massachusetts plan. They all have similarities when it comes to goals, but they all have differences when it comes to enacting change.
California's senate and house passed "a bill by state Sen. Sheila Kuehl, D-Santa Monica, that would eliminate private medical insurance plans and establish a statewide health insurance system that would provide coverage to all Californians." (Lynda Gledhill) California did this in reply to the health care crisis, most directly because of the fact that there are nearly 7 million uninsured residents in California and the spiraling costs of health care has put pressure on business and consumers. Other California proposals include insuring all children first and then requiring all businesses to insure their employees. This Bill does not take much initiative, the status quo currently uses employer based insurance to get 70% of America insured.
Senate Bill 840 (Sen. Sheila Kuehl):
- Eliminate private health insurance plans and create the California Health Insurance System.
- Provide health care insurance for all Californians.
- Guarantee patients the ability to choose their own doctors and hospitals.
- Pool funds now being spent on health insurance and save money by reducing overhead and using leveraged buying power for things like prescription drugs.
- Require separate legislation to establish financing of the system.
Similarly Bill 8 uses the status quo agenda, without much initiative, targeting employer based insurance. The main difference comes at the poverty level and the aiding of children. There is also the targeting of insurance companies and prevent denying of coverage.
Assembly Bill 8 (Assembly Speaker Fabian Nunez):
- AB 13 would create a state purchasing pool for insurance.
- All employers who have two or more employees and a payroll of over $100,000 payroll would be required to offer insurance.
- Employees would be required to take offered insurance as long as the out-of-pocket expense remains below a minimum level.
- Expansion of existing public insurance plans such as Medi-Cal and Healthy Families would occur.
- New restrictions would be put in place to help prevent insurance companies from denying coverage to people with pre-existing conditions.
- All children who fall below 300% of the federal poverty level would be covered. Eventually, childless adults would also be covered.
In reply to the senators and house representatives Schwarzenegger, governor of California, came forward with his own proposal. His proposal would cost $12 billion to start. The plan spreads the cost amongst employers, individuals, government and insurers and health care providers. The governor also stole strong points from the previous legislations.
Schwarzenegger Proposal:
- The governor's plan would mandate that employers would be required to pay a 4 percent tax if they currently employ 10 or more people. The tax would go into a pool of money that would be used to help provide coverage for employees.
- Californians would have to obtain health insurance through their employer or else buy it individually. The plan would provide for a $5,000-deductible minimum for each person, with a maximum expense of $10,000 per family.
- Low-income Californians would be eligible for payment assistance for health insurance. The number of uninsured low-income persons who could potentially receive such assistance is estimated at 1.2 million.
- All children who live below 300 percent of the federal poverty line would receive insurance under the plan. The state would provide health insurance to all children. Illegal immigrant children would also be included under this part of the plan.
- 630,000 indigent adults not currently eligible for benefits would receive expanded Medi-Cal coverage.
- Doctors and hospitals would be reimbursed by Medi-Cal at a higher rate. However, doctors would be required to pay a 2% provider tax. Hospitals would have to pay a 4% provider tax. This would raise an additional $3.5 billion in money to pay for the plan.
- Insurance companies would no longer be able to reject individuals because of negative medical histories. 85% of their revenue would have to be spent on services.
- Individuals would receive health care discounts for undergoing assessments that determine potential health risks and suggest ways to modify behavior. Those patients would be re-evaluated every two years.
Senate GOP Proposal:
- Senate GOP proposal does not tax or charge employers and health care providers to offer the state's uninsured residents health coverage.
- The proposal calls for a ballot measure in the next statewide election to redirect tobacco tax dollars toward children's health care.
- The plan would attempt to bill the federal government $2.2 billion for mandated health care services to illegal immigrants.
- The plan would offer businesses tax credits to businesses to voluntarily buy coverage for their employees.
- Expands the capacity of low cost or free clinics in caring for the uninsured.
Nongovernmental reports provide alternative ideas as well. "An analysis by the Lewin Group, an independent health care consulting firm, said the plan could be paid for with all of the money now being spent on health care. That would mean combining all state and federal funds, along with business contributions and participant payments and co-payments. The report suggests that funding could come through an 8 percent payroll tax and a 3 percent individual income tax. SB840 allows California to use its purchasing power to negotiate bulk rates for prescription drugs and durable medical equipment, such as wheelchairs, thus realizing an additional $2 billion in savings, Kuehl's office said." (Lynda Gledhill)
There is evidence supporting that a universal health care plan in California would save money. "Claims that the system would cost less have merit, said John Sheils, vice president of the Lewin Group, a Virginia consulting firm that conducted a study last year of how a single-payer system would work in California. The study found that the state would save $343.6 billion in health care costs over 10 years." (USA TODAY) Sheils did admit though that tax revenue declined the system would be hard pressed.
The Massachusetts plan:
Outside of California there is very little comparable hyped legislation. Massachusetts is the other state taking initiative on universal health care, and different from most of California's legislation they didn't just target employers. A year ago the state passed a law that will provide what is nearly universal health care. "The law is projected to provide coverage for about 515,000 of the state's 550,000 uninsured people and leave less than 1 percent of the population uncovered. It goes further than those of any other state." (Pam Belluck) Most of California's plans target small businesses but governor Mitt Romney vetoed a provision that would force small businesses to pay the government up to $300 a year per employee if they didn't provide their employees health care insurance and they had at least 11 employees. Instead Massachusetts targets the individual's pocket, either get health insurance or pay additional income taxes. "(The law) requires residents to obtain health insurance by July 1, 2007. People who can afford insurance and do not buy it will be penalized on their state income taxes." (Pam Belluck)
$1 billion that would have been spent on the state's free-care pool will fund the bill. The free-care pool used to help pay for medical care for patients without insurance, and to subsidize insurance for people who cannot afford it. One of the most important provisions in the Massachusetts bill is that more individuals and businesses are able to buy insurance with pre-tax dollars, saving them money. One of the problems, or benefit, depending on how you look it, is that the system encourages insurance companies to provide "more affordable" plans with fewer benefits or higher deductibles. This isn't necessarily great health care, but it is a step in the right direction. It is also notable that the state will be $160 million short on the $1.56 billion fiscal year by July in 2008.
The advantage of the Massachusetts's plan is that it is a private universal health care system. It meets both the definitions of universal health care and a free system. Health care is affordable for all – or you get a voucher for health care, without removing the privatized insurance industry. The government doesn't force you to pick a particular insurance plan, which would be a single-payer system such as Canada's. By keeping it private people still have to make frugal decisions and not spend what would be the government's money on excessive or unneeded health care.
Transitioning in jobs or unemployment causes a lot of people to be uninsured. This law helps these families and individuals through that transition with coverage that continues through such circumstances. When it comes to the bottom line in the Massachusetts's plan there is one golden apple that stands out, "There are also insurance market reforms. For example, the law will merge the individual and small-group markets in July 2007, a provision that will produce an estimated drop of 24% in non-group premium costs." If this law is successful it will crumble the major argument against universal health care.
The Source of Coverage:
Table one is the 2004 report of none-elderly coverage by population and percentage. The most disturbing fact being the amount of those with no health insurance.
Source of Coverage Table #1
(None Elderly)
Source Millions Percentage
Total population 255.9 100.0
Employment-based coverage 159.1 62.4
Individually Purchased 17.0 6.6
Public 45.5 17.8
Medicare 6.2 2.5
Medicaid 34.2 13.4
Military health care 8.1 3.2
No health insurance 45.5 17.8
The second table is the 2004 report of elderly coverage by population and percentage. When these two tables are compared it becomes apparent that there is nearly universal health care for the elderly population already. Although some new legislations expand Medicaid as does the Schwarzenegger plan with Medi-Cal, these data sets show why most legislation is targeting the poverty, the youth, and illegal immigrants, because the elderly are for the most part already taken care of.
Source of Coverage Table #2
(Elderly)
Source Millions Percentage
Total population 35.2 100.0
Employment-based coverage 12.5 35.5
Individually Purchased 10.0 28.3
Public 33.6 95.4
Medicare 33.5 95.0
Medicaid 3.3 9.4
Military health care 2.5 7.1
No health insurance 0.3 0.8
Countries with universal health care include: Argentina, Australia, Austria, Belgium, Brazil, Canada, Cuba, Denmark, Finland, France, Germany, Greece, Ireland, Israel, Italy, Japan, The Netherlands, New Zealand, Norway, Poland, Portugal, Russia, Saudi Arabia, Seychelles, South Korea Spain, Sri Lanka, Sweden, The Republic of China (Taiwan), and the United Kingdom. Mexico, South Africa, and Thailand, are attempting reform to garner universal health care in their countries shortly. Although California is the size of some countries in the world, it would be better to add the United States to this list and not just a couple states of the union.
Analysis of Universal Health Care:
Reasons for NO coverage
Table #3
66% Cannot afford it
48% Lost job/changed employment
29% Employers do not offer coverage
18% Temporary/part-time jobs
17% Believe it is safe to go without
The private market versus government regulation is a time old question. For the most part economists with American viewpoints have been, "leave it alone, the government will make it worse," attitudes. "There is something vaguely amoral and unacceptable about the atomism of pure market regulation, especially concerning something like health care that is intimately tied to socio-economic conditions. At least one economist has argued that because consumers are not rational and they do not make intellectually consistent decisions to maximize their utility, market intervention is required, and the best model for intervention is universal health care rather than a system based on individual provision of health services." (John Lunstroth) The world viewpoint is often reversed, especially when it comes to national programs that help every individual in the country. Another detrimental argument against the private industry of hospitals is their inability to provide medical treatment during times of surges – such as disasters or terrorist attacks. American hospitals run at 95% capacity for the most profit. Compare this to Israel where entire hospitals can be left nearly dormant until a surge and then easily filled, there is no question that government owned hospitals would provide better for surges.
Universal health care ties both to the social and economic parts of the American society. This is possibly why reform is so difficult to pass. Predictions suggest that the presidential races, along with congressional candidates, will be debating reform of the health care system in the forefront of all other issues for the 2008 elections.
Governors have the biggest role in the reform and development of the future health care system in the mean time. Even if candidate A, B, or C, gets elected claiming health care reform it may take a few more elections before reform is finalized. Arnold Schwarzenegger and Mitt Romney are the dominant figures of 2006-2007. Their state legislators both passed bills into law, but both of them are given a majority of the credit for the reform. Arnold Schwarzenegger stole the thunder from his legislators by making a completely separate reform proposal. Even though California has been debating this issue since the early 90's, their latest law passing was second to Schwarzenegger's ability to persuade all attention on his reform proposal. Due credit to his celebrity status but still, his ability as a governor and a dominant figure is obvious.
Mitt Romney similarly, if only partially, took the thunder from his legislation as governor by vetoing specific provisions of the bill. It is as if he wrote the bill himself and took the credit – even though the only thing he really did was blotch out a provision here and there. It doesn't matter if the legislators turn back around and override the veto, Romney gets much attention.
Mitt Romney and Arnold Schwarzenegger are both dominant Republican figures. Both California and Massachusetts have a democrat majority in the senate. Both governors responded to their state legislators, and both came out on top. As reform progresses in each state the governor will be remembered for the reform, not the legislators.
One good and bad consequence of universal health care is the affects on technologies and diversity. "For instance, both the medical problems presented and the medical technology available would be less diverse within a given group than in the population at large, because the group would be structured to reflect the economic status of its constituents." (James A. Henderson) What this suggests is that the rich won't be hogging all the new technologies that come out, and the poor won't be left without choice. Health care would equalize itself throughout the entire system.
One of the ironies is that some experts claim bureaucratic administration costs will go down with universal health care, which is true, but other experts also claim how necessary bureaucratic administrations are necessary for universal health care reform to be successful. "Bureaucracy is inappropriately absent from a universal health care system." (John Lunstroth)
The problems of Universal Health Care:
"Universal health care, or the provision of health care services to all persons, is a laudable goal but unobtainable within the current paradigm." (William P. Gunnar)
With all of the hopeful legislation these innovating states are taking there must also be a reason to avoid universal health care. Simply put: Access to health insurance is not access to health care. Mandating health insurance is not enough. "The Democratic presidential contenders can't agree on much. But one cause they all support — along with Republicans such as former Massachusetts Gov. Mitt Romney and California's own Gov. Arnold Schwarzenegger — is universal health coverage. And all of them are wrong. What these politicians and many other Americans fail to understand is that there's a big difference between universal coverage and actual access to medical care." (Michael D. Tanner) Tanner points out that simply saying people have health insurance is meaningless and provides the following examples of waiting lists. "Britain's Department of Health reported in 2006 that at any given time, nearly 900,000 Britons are waiting for admission to National Health Service hospitals, and shortages force the cancellation of more than 50,000 operations each year. In Sweden, the wait for heart surgery can be as long as 25 weeks, and the average wait for hip replacement surgery is more than a year. Many of these individuals suffer chronic pain, and judging by the numbers, some will probably die awaiting treatment. In a 2005 ruling of the Canadian Supreme Court, Chief Justice Beverly McLachlin wrote that 'access to a waiting list is not access to healthcare.'"
When Gunnar says that universal health care can not occur within the current paradigm he is referring to two things. First that Congress has yet to take action, forcing states to take initiative. This causes contention on not only the national level but the state and local. Second, the free market of health insurance. Insurance companies will fight to prevent a loss in profit, and universal health care may threaten that status quo.
Supporters of universal health care want the uninsured the opportunity to get health care. Counter arguments suggest there is no relationship between having insurance and better health. "Helen Levy of the University of Michigan's Economic Research Initiative on the Uninsured, and David Meltzer of the University of Chicago, were unable to establish a 'causal relationship' between health insurance and better health. Believe it or not, there is 'no evidence,' Levy and Meltzer wrote, that expanding insurance coverage is a cost-effective way to promote health. Similarly, a study published in the New England Journal of Medicine last year found that, although far too many Americans were not receiving the appropriate standard of care, 'health insurance status was largely unrelated to the quality of care.'" (Michael D. Tanner)
What about the pool?! Don't we need young people to help support the pool? Without young people won't we be left with a pool of old and sick and dying people because everyone else will not have health insurance? Won't the premiums cost more? "That's only true if the law forbids insurers from charging their customers according to the cost of covering them. If companies can charge more to cover people who are likely to need more care — smokers, the elderly, etc. — then it won't make any difference who does or doesn't buy insurance." (Michael D. Tanner)
What about the people who pass along their costs when they receive treatment without health insurance? Tanner does not deny how true this is, but he does call it a manageable problem. "According to Jack Hadley and John Holahan of the left-leaning Urban Institute, uncompensated care for the uninsured amounts to less than 3% of total healthcare spending — a real cost, no doubt, but hardly a crisis." (Michael D. Tanner)
If universal health care is inevitable then what happens to the system? "Unfortunately, the same political sentiments that are threatening the goal of universal access also seem to preclude the expenditure of sufficient public and private funds to finance comprehensive levels of care for those who are granted access. In other words, Congress, when forced to economize on health care, is likely to limit benefits in its struggle to broaden access." (James A. Henderson) The benefits of health care in the current paradigm are lacking and faltering, if the country goes to universal health care Henderson suggests we will lose even more of our benefits. Status quo or reform, both see the loss of benefits.
Tanner concludes that the real danger of universal health care is that the concentration of giving out insurance will miss the real important goal. Instead of legislating universal health care we should be enacting a standard health insurance deduction, expanding health savings accounts and deregulating insurance markets. This could truly expand coverage, improve quality and make health care more affordable. No single plan presented covers every demand opponent's give, but the Massachusetts's law does begin to deregulate insurance markets and that is extremely important.
Conclusion:
The only people in the US that get free health care without question are prison inmates, Universal health care will save the lives of lawful citizens and create jobs. Although the upfront costs and figuring out initial funding is difficult, universal health care is cheaper in the long term. Not only will the government pay less into health care, they will take programs funding into multiple health care related programs and pool them into universal health care. This saves millions of dollars. Ideally a national plan with a single-payer system is our future, but we won't see this in rapid reform. Insurance companies will fight tooth and nail to keep the status quo, they are banking bucks. In the mean time insuring every person is a go-ahead idea.
The predicament of the health care crisis is even worse when we consider that the status quo solution is employer-financed insurance. If the government makes employers pay health insurance for their employees won't employers cut wages to compensate? (Yes they will says economic theory) This is possibly why Mitt Romney vetoed the provision targeting businesses. He may have seen the truth, that businesses can't pay the health care burdens of society completely. Tanner's arguments here probably outweigh anything else, it would be better to standardize health care so that those who do have it can get the health care they need. Legislation forcing businesses to give their employees insurance is applaudable and worthwhile but it is also why legislations like the Senate GOP plan are more attractive for avoiding the targeting of businesses. It is doubtful the federal government will pay for the $2 billion request California is going to bill them for illegal immigrant health care though.
Schwarzenegger's plan probably comes out on top when everything boils down to it. It works with percentages instead of flat fees, expands Medicaid into Medi-Cal, prevents insurance companies from rejecting people with poor health care, and has the best funding solution. The Massachusetts plan works too, because of reallocating state funds. Both Schwarzenegger's and Massachusetts's plans do the most important thing, involve everyone to an extent, individuals, government, health care providers, and employers.
A pre-thought to the entire health care system is the belief in improving health care technologies. It possibly caused the entire health care inflation. The spending on expanding technologies outweighs the decreased spending on more costly former technologies. Instinctively then wouldn't a reform cutting back reform on technological advances save the entire health care system? Even if there was conclusive evidence here the question would not need to be answered because the will to advance technologies has and always will be more important than cutting costs.
"Imagine, for a moment, that some future US administration were to push through a fundamental reform of health care that covered all the uninsured, replaced private insurance with a single-payer system, and took heed of the VA's lessons about the advantages of integrated health care. Would our health care problems be solved?
No. Although real reform would bring great improvement in our situation, continuing technological progress in health care still poses a deep dilemma: How much of what we can do should we do?
The medical profession, understandably, has a bias toward doing whatever will bring medical benefit. If that means performing an expensive surgical procedure on an elderly patient who probably has only a few years to live, so be it." (Paul Krugman)
But a national system of health care would solve the crisis. A state plan is a practical step towards this end goal. The problem and benefit of multiple states choosing different plans is we will find the best plan for each state eventually. This does not mean, however; that each state will get the best plan that they need, and a national standard will not come from the sess pool of choices. It would be better to just start with a national standard.
The reason the Clinton administration failed with their reform is due to the misunderstanding of the health care economics, and there just wasn't a breaking point yet. Clinton rejected a single payer system in 1993 and confused the country with a complex system allowing for the survival of the private industry. The public got confused, and the private industry rejected the plan any way.
The true reform will occur within the next 8-12 years, along with the breaking point. When the breaking point occurs it won't matter who is in office, not the democrats or the republicans, some sort of national health care reform will occur. Regardless of which legislation is best, or if it's good at all, you can expect the next president of the United States to enact federal reform on health care – or every candidate campaigning right now is promising soft air. Well, unless Mitt Romney becomes president (who knows?), he passed reform in his state, why not for the whole nation? One thing we know for sure though, a shift in power from Republicans to Democrats in any particular office is not enough to cause the breaking point. The crisis will explode when percentages of people going uninsured increases and enough people do not gain enough rendered services for their pay-in. If there weren't cure all pills out there the problem might already be solved, but until the breaking point the state governments will creep us in the right direction.
Works Cited:
William P. Gunnar, The Fundamental Law That Shapes the United States Health Care System: Is Universal Health Care Realistic Within the Established Paradigm?, M.D., Loyola University Chicago, Institute for Health Law, Annals of Health Law, Winter, 2006
James A. Henderson, Jr., John A. Siliciano, Symposium: National Health Care reform on trial: Universal health care and the continued reliance on custom in determing medical malpractice, 1994 Cornell Law Review, September, 1994, 79 Cornell L. Rev. 1382
Lynda Gledhill, Assembly approves universal health care Passage of bill seen as election-year test for Schwarzenegger, Chronicle Sacramento Bureau, Tuesday, August 29, 2006
Universal health care push being revived, USA TODAY, Posted 7/10/2005.
John Lunstroth, Voluntary self-regulation of complementary and alternative medicine practitioners, Albany Law Review, 2006, 70 Alb. L. Rev. 209
Pam Belluck, Katie Zezima, Massachusetts Legislation On Insurance Becomes Law, New York Times, Friday, April 6, 2007
Maureen McOwen, Through the Eye of the Needle: How the New York City Health Care Security Act Will Escape ERISA Preemption, Columbia Journal of Law and Social Problems, Fall, 2006, 40 Colum. J.L. & Soc. Probs. 37
Michael D. Tanner and Michael F. Cannon, Universal Healthcare's Dirty Little Secrets, April 6, 2007, http://www.cato.org/pub_display.php?pub_id=8172
Jonathan Barry Forman, Symposium issue: Employer-sponsored health care plans: Featured contributor: Making universal health care work, St. Thomas Law Review, Fall, 2006, 19 St. Thomas L. Rev. 137
Paul Krugman, Robin Wells, The Health Care Crisis and What to Do About It, The New York Review of Books, Volume 53, Number 5 - Marsh 23, 2006.