Whether a government mandated system of universal health care should be implemented in the U.S. remains a hotly debated political topic. Those in favor of universal health care, such as the non-partisan Institute of Medicine of the National Academies of Science, which has called for the U.S. to implement universal health care by 2010, argue that the current rate of uninsurance creates direct and hidden costs shared by all, and that extending coverage to all would lower costs and improve quality. [1] Americans have a lower average life expectancy than those in other industrialized nations with universal health care, such as Australia, the United Kingdom, Canada, and Sweden. [2] Infant mortality rates also remain higher in the U.S., despite declines in recent decades, and are higher than the average of the European Union. [3] [4]
Critics of this argument note that there is very little correlation between life expectancy and infant mortality with the quality of health care, due to such factors as alternate causality and variations in the way countries collect their statistical data. [5] In fact, the U.S. led the world in life expectancy twenty years ago with virtually the same health system. Rather, many analysts attribute the lower life expectancy to a great surge in obesity rates. [6] [7] [8] Opponents of universal health care programs argue that people should be free to opt out of health insurance [9] and that government programs would require higher taxes, increase utilization, and reduce health care quality. They also claim that the absence of a market mechanism may slow innovation in treatment and research, and lead to rationing of care through waiting lists. However, contra arguments are also heard. That waiting is actually not uncommon in the United States, [10] that the American system merely "rations by income and insurance status" and a more rational system would take the view that "health care should be considered a right, not a commodity". [11]
Both sides of the political spectrum have also looked to more philosophical arguments, debating whether people have a fundamental right to have health care provided to them by their government. [12] [13]
Survey research shows that Americans see expanding coverage as a top national priority, and a majority express support for universal health care. [14] There is, however, much more limited support for tax increases to support health care reform. [14] [15] Most Americans report satisfaction with their own personal health care.
Independent fact-check organizations, based on the actual content of the bills currently passing through Congress, have disputed many of the allegations made about America's Affordable Health Choices Act of 2009 (H.R. 3200) [16] and other which claim that the bill would lead to a socialized health care system and government "death panels" that would decide whether a person's life was worth living when no such panels exist in the bill [17]. The bill does not contain provisions for the government nationalization of the health care system, though there are higher taxes for high income individuals and penalties for certain employers not providing health care benefits. Employers with payrolls less than $250,000 p.a. are not assessed for penalties; with annual payrolls of $250,000 the penalty for not providing health care coverage begins at 2% of payroll value, and this rises peaking at 8% for those with payrolls over $400,000. [18] and for individuals who do not have a minimum standard of health care coverage [19]. Private insurance companies will be able to continue to sell new policies but not ones that no longer meet minimum government standards. [20] Neither does the bill permit the extension of subsidies ("affordability credits") to the country's approximately 11 million illegal immigrants. [21] [22] although hospitals and ambulance services are already required by existing legislation to provide care to anyone needing emergency healthcare treatment regardless of citizenship, legal status or ability to pay. [23] Patients needing emergency treatment can be discharged only under their own informed consent or when their condition requires transfer to a hospital better equipped to administer the treatment. [24]
The proposed government insurance plan would be allowed to pay for abortions just as many private insurance policies do, because the Hyde amendment likely does not apply; the public health care plan will be funded by private dollars (insurance premiums) and not from Federally funded taxation. [25] [26] Pro-choice groups claim this definition of "public funds" is too narrow, while pro-life groups claim it is too broad as the amendment only applies to Medicaid. [27] Affordability credits within HR3200 would allow poor people to buy health insurance, but due the Capps amendment, the plan chosen (public or private) would not be allowed to apply them to abortion, but it is unclear whether other funds in the public plan (i.e. premiums) are "public funds" in the same way as tax dollars are. [28] An NBC News/Wall Street Journal polled Americans on what they felt was "likely to happen" as a result of health care reform: [29] "Health care to illegal immigrants - 55%", "Pay for abortions - 50%", "Government takeover - 54%", and "Government decides on health care for the elderly - 45%".
Proponents state this is a result of advertising and political activism trying to create a culture of fear surrounding health care reform by using straw man arguments.[ citation needed] The media has focused on several Town Hall meetings in August that have broken out into noisy and emotional protests on both sides of the argument for reform.[ citation needed]
The following is a listing of universal health care pros and cons as argued by supporters and opponents.
Common arguments forwarded by supporters of universal health care systems include: [30] [31]
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Common arguments forwarded by opponents of universal health care systems include:
|
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Whether a government mandated system of universal health care should be implemented in the U.S. remains a hotly debated political topic. Those in favor of universal health care, such as the non-partisan Institute of Medicine of the National Academies of Science, which has called for the U.S. to implement universal health care by 2010, argue that the current rate of uninsurance creates direct and hidden costs shared by all, and that extending coverage to all would lower costs and improve quality. [1] Americans have a lower average life expectancy than those in other industrialized nations with universal health care, such as Australia, the United Kingdom, Canada, and Sweden. [2] Infant mortality rates also remain higher in the U.S., despite declines in recent decades, and are higher than the average of the European Union. [3] [4]
Critics of this argument note that there is very little correlation between life expectancy and infant mortality with the quality of health care, due to such factors as alternate causality and variations in the way countries collect their statistical data. [5] In fact, the U.S. led the world in life expectancy twenty years ago with virtually the same health system. Rather, many analysts attribute the lower life expectancy to a great surge in obesity rates. [6] [7] [8] Opponents of universal health care programs argue that people should be free to opt out of health insurance [9] and that government programs would require higher taxes, increase utilization, and reduce health care quality. They also claim that the absence of a market mechanism may slow innovation in treatment and research, and lead to rationing of care through waiting lists. However, contra arguments are also heard. That waiting is actually not uncommon in the United States, [10] that the American system merely "rations by income and insurance status" and a more rational system would take the view that "health care should be considered a right, not a commodity". [11]
Both sides of the political spectrum have also looked to more philosophical arguments, debating whether people have a fundamental right to have health care provided to them by their government. [12] [13]
Survey research shows that Americans see expanding coverage as a top national priority, and a majority express support for universal health care. [14] There is, however, much more limited support for tax increases to support health care reform. [14] [15] Most Americans report satisfaction with their own personal health care.
Independent fact-check organizations, based on the actual content of the bills currently passing through Congress, have disputed many of the allegations made about America's Affordable Health Choices Act of 2009 (H.R. 3200) [16] and other which claim that the bill would lead to a socialized health care system and government "death panels" that would decide whether a person's life was worth living when no such panels exist in the bill [17]. The bill does not contain provisions for the government nationalization of the health care system, though there are higher taxes for high income individuals and penalties for certain employers not providing health care benefits. Employers with payrolls less than $250,000 p.a. are not assessed for penalties; with annual payrolls of $250,000 the penalty for not providing health care coverage begins at 2% of payroll value, and this rises peaking at 8% for those with payrolls over $400,000. [18] and for individuals who do not have a minimum standard of health care coverage [19]. Private insurance companies will be able to continue to sell new policies but not ones that no longer meet minimum government standards. [20] Neither does the bill permit the extension of subsidies ("affordability credits") to the country's approximately 11 million illegal immigrants. [21] [22] although hospitals and ambulance services are already required by existing legislation to provide care to anyone needing emergency healthcare treatment regardless of citizenship, legal status or ability to pay. [23] Patients needing emergency treatment can be discharged only under their own informed consent or when their condition requires transfer to a hospital better equipped to administer the treatment. [24]
The proposed government insurance plan would be allowed to pay for abortions just as many private insurance policies do, because the Hyde amendment likely does not apply; the public health care plan will be funded by private dollars (insurance premiums) and not from Federally funded taxation. [25] [26] Pro-choice groups claim this definition of "public funds" is too narrow, while pro-life groups claim it is too broad as the amendment only applies to Medicaid. [27] Affordability credits within HR3200 would allow poor people to buy health insurance, but due the Capps amendment, the plan chosen (public or private) would not be allowed to apply them to abortion, but it is unclear whether other funds in the public plan (i.e. premiums) are "public funds" in the same way as tax dollars are. [28] An NBC News/Wall Street Journal polled Americans on what they felt was "likely to happen" as a result of health care reform: [29] "Health care to illegal immigrants - 55%", "Pay for abortions - 50%", "Government takeover - 54%", and "Government decides on health care for the elderly - 45%".
Proponents state this is a result of advertising and political activism trying to create a culture of fear surrounding health care reform by using straw man arguments.[ citation needed] The media has focused on several Town Hall meetings in August that have broken out into noisy and emotional protests on both sides of the argument for reform.[ citation needed]
The following is a listing of universal health care pros and cons as argued by supporters and opponents.
Common arguments forwarded by supporters of universal health care systems include: [30] [31]
|
Common arguments forwarded by opponents of universal health care systems include:
|
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