Health Care Programs

We are going to start off with a huge topic, and try to condense it a bit.  This is something that has been, and likely will always be, highly polarized and controversial.  It isn't the health care part that causes the controversy.  I haven't seen any people saying that health care should not be available.  The thing that people cannot agree on is how that health care should be provided, and how things like insurance and the care itself should be handled and charged.

In the United States there are two main programs that the U.S. Government administers: Medicare and Medicaid.  Both programs came into being in their current form when President Lyndon B. Johnson signed the 1965 amendment to the Social Security Act to help further his war on poverty.

Medicare is available for citizens over the age of 65 who have lived in the United States for the previous 5 years and people who are receiving Social Security Disability.  Medicaid is a bit more complicated.  Each state has their own eligibility requirements, but in general, Medicaid is for low income individuals and people who are unable to work.  What constitutes low income differs from state to state.

In the United States, according to the Centers for Medicare and Medicaid Services, there are more than 55 million recipients of Medicare, and 70 million recipients of Medicaid.

In total those two programs cover nearly 33 percent of all Americans.

The questions that are before the public are fairly simple ones.  How much, if any, should the government pay to subsidize health care in the United States?  How much, if at all, should the government control the procedures that are available and the cost thereof?

The meat and potatoes of it all is: how much should the government get involved in the healthcare system.  It is a simple question, but it has very complicated and personal answers.

The extreme left would point to the biggest difference in the health care systems in the United States and the rest of the first world.  Almost every developed nation on earth offers universal healthcare.  In other words, the government collects taxes to pay physicians, dentists, surgeons, optometrists, etc.

Countries in green offer universal healthcare

When an individual goes to receive care they pay very little, if anything at all.  The benefit of this is that no matter the individual’s income they can receive care.  This is the argument for it.  Those who support this system do so under the belief that health care is an unalienable right framed in the Declaration of Independence (the right to life).

There are two main arguments against this extreme option.  The first is that the poor are carried on the backs of the wealthy.  Because the poorest cannot afford to pay the taxes that support the system the rich will, more or less, be footing the bill.

The second argument is that having healthcare universally available without cost will lead to an overburdening of the system.  With everyone going to the doctor whenever they want the medical professionals will not be able to keep up with the work load and the wait times will increase.

The liberals would likely counter these arguments by saying that with the system as it is, the poor already cannot pay the cost of their healthcare and that is passed onto the rich through increased procedure cost.  The second argument would likely be countered by pointing to the system in the United Kingdom.  Not every procedure is covered, this reduces the likelihood that the doctors will have their time filled with less meaningful cases and the giant backlogs that are proposed would not exist.

The extreme right would likely propose a free market solution.  There should be an open market where the providers and insurers decide the cost and availability of procedures and doctor visits.  This would allow for greater competition and lead to the best possible outcome for the consumer.

There is really only one main argument against this: people are greedy.  The companies will not respond to market pressure because the alternative is no care.  Effectively it could end up as an unregulated monopoly.  Companies would be able to decide who they insure and for how much.  People with pre-existing conditions could be refused coverage or the cost could be astronomical.

The conservatives would likely counter this by saying that the people have a hard choice to make, but if they make the choices with care or create an alternative within the market it would force a change.  If the competition charges lower, then all the prices would likely drop or that company would cease to exist.

There is more than the extreme view in this argument.  There are two much more centrist proposals for the healthcare system.  The more moderate liberal suggestion is similar to the Affordable Care Act.  Companies are allowed to administer their day to day operation, but it is regulated by the government.  The government ensures that prices are kept fair and that everyone (in theory) is covered, but the companies are allowed to handle how things are covered and the services that are provided.

The standard conservative argument against this is that the system only works if everyone pays into the system whether they use the healthcare or not.  The only way to ensure this is for the government to force you to buy a service (as the ACA tries to do through a tax for those who are uninsured).  This government intervention is viewed by most conservatives as an overstep and a power grab.

The liberal counter for this is generally that the system did not work as a completely free market.  Skyrocketing cost leads to fewer people insured, which in turn increases the cost of the health care and insurance.

A moderate conservative proposal is generally a combination of the two extremes.  There is a government provided option that is affordable, but does not cover more than the necessities and an option to buy healthcare from the private market.  This would allow everyone who wants insurance to get it and provide an option for even the low income individuals.

The argument that many liberals bring up is that this could lead to a “pay to win” system.  In a nut shell, the people with more money can get better coverage and care, while the poor are left with substandard coverage and options.

The conservatives would likely counter this by saying that the quality and availability of coverage and service would be up to the free market.  They would argue that it is not the government’s job to control what businesses can and cannot do.

There are a plethora of options for how the healthcare system in the United States could be reformed.  Of the near infinite options, none of them are absolutely correct or incorrect.  It is all a matter of opinion.  In general though the conservatives hope for less government intervention and more free market economics, while the liberals believe that the governments job is to ensure equal access to care.