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The importance of social research cannot be underestimated as new figures reveal ever more striking figures about the need for universal health care.
The United States has been facing difficulties in its effort to provide health care for all citizens for the past several decades and the problem is expected to become worse in the context of the the global economic crisis. In the midst of the current economic turmoil and in light of decades-long debates, it is becoming clear that the capitalist system is not aligned with the provision of healthcare for all citizens. As it stands, healthcare in America is far more about market competition and rewards rather than promoting equal coverage for all. In short, despite the way capitalism has been touted as the panacea to the world’s ills, it is quickly becoming more associated with inequality now more than ever before as the divides between rich and poor grow more drastic in line with ever-increasing healthcare costs.
Many view America as the place where any dream and ambition could be achieved, which is in part due to the perception that our capitalist system with its healthy market economy promotes well-being and wealth for all. These sentiments seemed especially true after the end of the Cold War, as United States of America improved their positions in the world as the superpower and many became more convinced that confident that capitalism is the best economic system in existence.
We were the first to send men to the moon, we developed the most advance weapon, we have the most millionaires in the world, we were able to win the Cold War and prove the inferiority of the communist model. It seemed that that there was no limit to what America was capable of. However, despite all of the visible signs of progress and advancement, at the same time these great accomplishments were being achieved, America had 47 million people with no access to health care. Oberlander (2008). This same discussion by Oberlander, an associate professor of social medicine and health policy and administration at University of North Carolina, states that “In the face of escalating costs, uneven quality of care, and the growth of the uninsured population, there is broad agreement that the U.S. health care system requires reform (p.781).” Clearly there are large gaps in American development priorities as it seems that the most money is granted to agencies that can promote the image of dominance across several realms while at the same time allowing an issue of vital national importance dwindle.
The debate over healthcare has always been a prominent one during political campaigns, although the issue has been receiving more attention lately as general healthcare cost continue to climb in parallel to lessened ability for many to pay due to job losses and other consequences of the financial downturn. For example, during the presidential campaigns of 2008, Democrats and Republicans offered deeply-felt different views and approaches toward health care reform but little in the way of how they could reach their lofty goals. Still, the issue of healthcare figured prominently in how voters were aligned for the election. For instance, Oberlander (2008) in his interpretation of data from the Kaiser Family Foundation, found that Republican voters are more inclined to support a new health plan that is limited and would cover only some uninsured groups but involve less spending. In short, Republicans wanted a continuation of the same system, although one that was cheaper—a rather difficult deliverable, no matter what kind of political might is behind it. On the other hand, Democratic voters generally supported a major effort to provide insurance for all or nearly all of the uninsured, which is a much more progressive plan but one that would undoubtedly involve a substantial increase in spending. As it stands, the 2008 Democratic presidential candidate is suggesting proposals that “build on existing private and public group insurance with shared responsibility for financing coverage” (Fuchs, 2008, p. 1749) in order to cover the majority of people. Fuchs, who is an economics professor at Stanford University goes on to suggest that “The high cost of care, the large number of uninsured people, and the rapid increase in expenditures year after year have convinced many that our system is a mess…The present impasse must give way to recognition that major change will not be an option much longer, it will be necessary” (p. 1749).
History
There have been many attempts, historically speaking, to implement universal health care policies in the United States, with Medicare being one of the most broad-based and aggressive, especially in the context of more recent movements that lack the necessary bi-partisan and unilateral cohesion necessary to succeed. Medicare is the most influential health program to provide health access to vulnerable part of population and continues to thrive, despite its inability to keep up with the demands of ever-growing costs.
To truly understand what is required for healthcare reform to happen, at least in terms of the critical political function, it is crucial to look back at the creation and implementation of Medicare. After several years in process, President Harry S. Truman officially endorsed national health insurance in 1945, but decided not to move forward with this idea by the end of his administration. It was not until 1961 when President John F. Kennedy recommended that Congress should provide health insurance for the elderly through social security system that greater calls to fully realize Medicare took shape and began to be realized in policy action. Finally, after so many years moving across deks in Washington in many forms, in 1965, President Lyndon B. Johnson signed Medicare and Medicaid into law to provide health care to elderly and poor segment of population. In 1972, individuals with long term disabilities and end-stage renal disease became eligible to Medicare. Hospice benefits were added on a temporary basis in 1982, and became permanent in 1986. The law on outpatient service and home health agencies took effect in 2000. In 2006, Medicare Part D, which provided the all-important outpatient prescription drug benefit became available.
Using Medicare as a case study for the actions that are required for true healthcare reform reveals that it is guaranteed to be a long process that will most likely stretch across presidential terms and different majorities in Congress that have varied aims and goals for such reform. Indeed, it should be noted that Medicare achieved something beneficial and have had been trying to improve more. However, complaints from many unhappy and sick people still exist, and the process of improvement is getting slower and slower. Medicare part A, B, and D covers the basic traditional Medicare benefits, provides partial coverage of prescription drugs and does not cover eyeglasses and hearing aids. Medicaid coverage varies from state to state. Medigap insurance does cover some benefits not covered by Medicare, but the premiums could be high for some people. Medicare advantage plan also covers extra benefits which are not included in Medicare, but choice of providers is restricted. The need for health care reform is continuously increasing. The 1993 proposal by Clinton’s administration could have been a major breakthrough. According to Bukhardt and Nathaniel (2008), it was supposed to provide universal health care access through managed competition, mandated coverage at places of employment, with employers to pay large percentage of premiums, subsidize small business, and federal authorities would be responsible for people who are not covered by employer-based plans”. (p. 391) However, this proposal was defeated.