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 08, 2015

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Table of Contents

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

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

Positionality……………………………………………………………………….………3

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

Stakeholders…………………………………………………………………….…...……6

Points of Stasis……………………………………………………………………...….…6

Causes and Effects……………………………………………………...………….....…..7

Proposed Solutions………………………………………………………………………10

Conclusions & Recommendations…………………………………………………..…..10

References……………………………………………………………………………. ..13

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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.” —U.S. Constitution, pmbl.

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 raise taxes in order to provide medical services 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).

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Figure 1: Facts about ObamaCare

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).

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

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

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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).

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

since the implementation of ObamaCare, January, 2015.

This is theorized as due to patients having deferred preventative services, and then presenting

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

Stakeholders

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

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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.

Figure 4: A graph 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 the unregulated

insurance industry is a huge contributor to our crisis. An estimated 50 million Americans

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

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model for how healthcare can, and should be delivered. Cleveland’s 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 that “the American people are frightened of bureaucratic, centralized

medicine.” Gingrich also 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.”

The World Health Organization (WHO) defines 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.

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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.

Opponents of healthcare reform have, historically, argued that we should

be wary of imitating foreign healthcare systems because people in other

countries have to wait longer to see the doctor. Cheaper, more universal

care, the argument seems to be, comes with the tradeoff of slower care.

This is not necessarily true, according to new numbers from the

Commonwealth Fund, a nonpartisan organization that studies industrialized

healthcare systems around the world.

The organization surveyed between 1,000 and 5,400 people in 11

industrialized nations. The first thing they found is fairly well-known:

American healthcare is mind-bogglingly expensive, as compared to that of

other Western democracies (Figure 5).

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Figure 5: (Commonwealth Fund)

So much of the uproar over the recent insurance plan cancellation notices

has been prompted by fears that the affected people will no longer be

able to see the doctors they prefer or to get treated as quickly as they'd

like. But compared to the rest of the Western world, that's already the

reality for many Americans. This report is just a sign that some countries

have found a way to not only insure more people, but to get them the

care they need faster.

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

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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!

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 6).

Verses

Figure 6: A choice seniors make on how to spend their money

We need to consider restructuring the American budget, altogether. We should eliminate

Medical and Medicare which account for fifty percent of our budget. With the adoption of

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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 Canadians currently have a universal health care program, but it is too

expensive as implemented (Figure 7).

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Figure 7: This is a chart of the Canadian model of current spending.

I believe that universal 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

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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

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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