WITH LIBERTY AND HEALTHCARE FOR ALL 1

With Liberty and Healthcare for All:

An Advocacy Report Examining the Feasibility of Universal Healthcare in America

Lisa L. Latham

California State University Monterey Bay

CHHS 302, Section 31

Judy Huddleston

May 04, 2015

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Table of Contents

Table of Contents………………………………………………………………..…… 2

Introduction/Critical Problem…………………………………………………….……3

Positionality……………………………………………………………………………3

Rhetorical Timing………………………………………………………………….….4

Stakeholders……………………………………………………………………..……4

Points of Stasis………………………………………………………………….….…5

Causes and Effects………………………………………………………………..…..5

Proposed Solutions……………………………………………………………………7

Conclusions & Recommendations………………………………………………..…..8

References……………………………………………………………………….…..10

Appendices…………………………………………………………………….……12

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Problem Statement Critical Situation

Despite the passing of the Affordable Healthcare Act (ACA), otherwise known as

Obamacare, there is still no universal healthcare coverage in America. Our country is going

broke, spending ourselves into poverty on healthcare and other social programs. I propose

changing our currently passed (but not fully implemented) healthcare system to a single-

payer, true universal healthcare plan. I believe that is what the forefathers envisioned when

they drafted the preamble of the constitution of the United States, and included the phrase,

“to promote the general welfare.”

Positionality

I believe that having free and equitable access to healthcare should be a right for every

American.

I am a nurse and see firsthand the effects of the uninsured utilizing the emergency

department for primary care, or non-emergent problems. I am also an American. I want

healthcare coverage, regardless of my ability to pay out of pocket. My taxes are high. I do

not believe it fair to pay more taxes to pay for those who are uninsured. I see a fix to this

broken system, and want it considered. This new system would provide better preventative

care to patients, better quality of care, and reduce the burdens currently placed on our

healthcare providers.

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Rhetorical Timing

This is one of the most controversial current political topics of our lifetimes, and it is being

debated today! We are on the verge of BIG change, right now! Questions have surfaced

about whether ObamaCare should be reformed. Examine the stance from the Independent

Women’s voice (Figure 1).

We have an opportunity to gather research on current legislation and get involved.

The fiscal spending plan for 2015, as proposed by president Obama, consists of almost 4

trillion dollars. (Figure 2). 40 billion dollars of that money is allocated to foreign aid, and 40

billion dollars is allocated for entitlement programs such as Medicare, Medicaid, ACA. This

is a wealthy country, and we should focus our spending on what needs to be done here in

America first. Since the implementation of ACA, the visits of our local Emergency depart

have not seen a big impact on the volume of patients (now having coverage), but as you can

see as illustration in the graph, the length of time of those visits has drastically increased.

Figure 3). This is theorized as due to patients not having deferred preventative services, and

then presenting with more complicated health situations which require more diagnostics, etc.

Stakeholders

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The stakeholders involved in this proposed policy change are the consumers (patients),

nurses, physicians, hospitals, insurers, employers, pharmaceutical companies, and the

politicians.

Points of Stasis

The biggest point of stasis on this topic, is of course, money. Our government can’t decide

who should pay for the new system, who should be included on what plans, what to do about

people who choose not to participate (regardless of the mandate to do so), and how much

influence government should have over our rights to healthcare. See the graph (Figure 4)

showing the trending health care costs from 2006-2020.

Causes and Effects

In a television documentary, Escape Fire: The Fight to Rescue American Healthcare, Dr.

Steven Nissen says that our healthcare system is badly broken (Lions Gate Entertainment,

2013). He states that we’re spending 16 percent of every dollar on healthcare, and that we

are not getting any healthier than our counter parts that spend half as much. He also says that

we should be talking more about insurance reform, than healthcare reform, as that is a huge

contributor to our crisis…unregulated insurance industry. 50 million Americans were

uninsured prior to the enactment of the ACA. The Dr. Nissen uses the Cleveland clinic as a

model for how healthcare can, and should be delivered. The concept that physicians work

based on salary and not on a fee-for-service basis, improves the quality of care, and reduces

incentives for unnecessary procedures which drive up costs to patients. Newt Gingrich stated

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that the American people are frightened of bureaucratic, centralized medicine. Gingrich

states the reason that President Obama wanted to let young adults stay on their parents’

insurance until they were twenty-six was that he could not find jobs for them.

What is universal health coverage? The World Health Organization (WHO) defines it as

Universal coverage (UC), or universal health coverage (UHC), is defined as ensuring that all

people can use the preventive, curative, rehabilitative and palliative health services they need,

of sufficient quality to be effective, while also ensuring that the use of these services does not

expose the user to financial hardship.

This definition of UC embodies three related objectives:

equity in access to health services - those who need the services should get them, not

only those who can pay for them;

that the quality of health services is good enough to improve the health of those

receiving services; and

financial-risk protection - ensuring that the cost of using care does not put people at

risk of financial hardship.

Universal coverage brings the hope of better health and protection from poverty for hundreds

of millions of people - especially those in the most vulnerable situations.

Universal coverage is firmly based on the WHO constitution of 1948 declaring health a

fundamental human right and on the Health for All agenda set by the Alma-Ata declaration

in 1978. Achieving the health Millennium Development Goals and the next wave of targets

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looking beyond 2015 will depend largely on how countries succeed in moving towards

universal coverage.

Proposed Solution and Community Connection

What can I do to effect change? We should get informed of current law, and upcoming

legislative proposals to appeal Obamacare. We should all become involved in our

professional organization, (Ebner, 2010). When we participate in the process of change, we

get empowered. Until we effect change in policy, be educated and educate those around you

about resources currently available in our communities: free clinics, food banks, etc. As

advocates, and as caring professionals, we need to lead by example. Take the first step!

What is universal health coverage? The World Health Organization (WHO) defines it as

Universal coverage (UC), or universal health coverage (UHC), is defined as ensuring that all

people can use the preventive, curative, rehabilitative and palliative health services they need,

of sufficient quality to be effective, while also ensuring that the use of these services does not

expose the user to financial hardship.

This definition of UC embodies three related objectives:

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Equity in access to health services - those who need the services should get them, not

only those who can pay for them;

That the quality of health services is good enough to improve the health of those

receiving services; and

Financial-risk protection - ensuring that the cost of using care does not put people at

risk of financial hardship.

Universal coverage brings the hope of better health and protection from poverty for hundreds

of millions of people - especially those in the most vulnerable situations.

Universal coverage is firmly based on the WHO constitution of 1948 declaring health a

fundamental human right and on the Health for All agenda set by the Alma-Ata declaration

in 1978. Achieving the health Millennium Development Goals and the next wave of targets

looking beyond 2015 will depend largely on how countries succeed in moving towards

universal coverage.

Conclusion

The fact is, there are many causes for the rise in healthcare costs, and what is currently

approved (and some are attempting to appeal) is not the answer to the crisis. We are one of

the wealthiest countries in the world, yet we are very poor in our ability to provide care. We

give huge amounts of monies away for foreign aid, yet we allow seniors and children to go

without needed medication and food (Figure 5). We need to consider restructuring the

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American budget, altogether. We should eliminate Medical and Medicare which account for

fifty percent of our budget. With the adoption of my proposal, more people would be able to

obtain preventative care, and receive better quality care. We need to take care of our own

family, the American citizens before giving away one dime! Models exist for this effective

type of program, and we should adopt one (Lee, 2012). The Candadians currently have a

universal health care program, but it is too expensive as implemented (Figure 6). I believe

that univerdal healthcare is necessary, and feasible, with reallocation of funds from our

national budget. Remove the 40 billion dollars that is currently given to foreign aid, remove

Medicare and Medicaid, no longer necessary under Ameri-care, and develop a system for

fare, limiting (rationing) of healthcare services with the available monies that we have.

America should be responsible with its money, and provide the basic right the general

welfare as promised by our forefathers!

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References

Buerhaus, P. (2010). Is U.S. health care evolving toward a single-payer system? An interview

with Health Care Economist Paul Feldstein, PhD... Paul Feldstein PhD. Nursing

Economics, 28(3), 198-201.

Ebner, A. (2010). What nurses need to know about health care reform. Nursing Economics,

28(3), 191-194

Guerin, T. T. (2014), Relationships Matter: The Role for Social-Emotional Learning in an

Interprofessional Global Health Education. The Journal of Law, Medicine & Ethics, 42: 38–

44. doi: 10.1111/jlme.12186

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Heineman, M., Froemke, S., Berwick, D. M., Brownlee, S., Jonas, W. B., Nissen, S. E., Weil,

A., Lions Gate Entertainment (Firm), (2013). Escape fire: The fight to rescue American

healthcare. Santa Monica, Calif: Lionsgate.

Lee, J. (2012). Vermont vision gets clearer: Reports, bill reveal path to first-of-its-kind

system. Modern Healthcare, 42(4), 16.

Ovens, H. (2011), ED Overcrowding: The Ontario Approach. Academic Emergency

Medicine, 18: 1242–1245. doi: 10.1111/j.1553-2712.2011.01220.x

Trzeciak, S., & Rivers, E. (2003). Emergency department overcrowding in the United States:

an emerging threat to patient safety and public health. Emergency Medicine Journal, 20(5),

402-405.

Center on budget and policy priorities.

http://www.cbpp.org/research/policy-basics-where-do-our-federal-tax-dollars-go

Health financing for universal Coverage. World Health Organization. DOI:

http://www.who.int/health_financing/universal_coverage_definition/en/

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Appendix i

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Figure 1: Facts about ObamaCare

Appendex ii

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Figure 2: This is a pie chart showing proposed fiscal spending.

Figure 3: A Graphic depiction of Emergency Department Volume and Length of Stay

since the implementation of ObamaCare, January, 2015.

Appendex iii

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Figure 4: A graph showing the trending health care costs from 2006-2020.

Verses

Figure 5: A choice seniors make on how to spend their money

Appendex iv

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Figure 6: This is a chart of the Canadian model of current spending.

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