Overview - Health Care IssuesHealth Care IssuesOpposing .docx

Overview - Health Care Issues
Health Care Issues
Opposing Viewpoints Online Collection, 2015
In recent years, the availability and affordability of health
insurance in the United States has become
the subject of much debate. The United Nations’ Universal
Declaration of Human Rights lists medical
care among the basic human rights to which all people are
entitled. In 2011, however, about 17
percent of Americans had no health insurance at all. For many
people who are insured, the cost of
coverage is a financial hardship. This situation has led some
people to call for the government to
provide health insurance for all citizens. Others, however, are
skeptical of government’s ability to
efficiently manage health insurance and oppose any plans that
involve government. The issue is made
more urgent by rapidly rising health care costs that threaten to
overwhelm the country’s current
system of health insurance, and the national economy in
general. Health care reform has become one
of the most important issues in contemporary American politics.
The Basics of Health Care

In most developed countries, health care systems involve
government control or sponsorship. For
instance, in Great Britain, Scandinavia, and the countries of the
former Soviet Union, the government
controls almost all aspects of health care, including access and
delivery. For the most part, health
services in these countries are free to everyone; the systems are
financed primarily by taxes. Other
countries, such as Germany and France, guarantee health
insurance for almost all their citizens, but
the government plays a smaller role in managing health care.
Both systems are financed at least in
part by taxes on wages.
The US government, by contrast, does not pay for most of its
citizens’ health care. Generally,
Americans receive health care through employer-sponsored
insurance, or they arrange to pay for
insurance on their own. Like all forms of insurance, health
insurance operates by pooling the
resources of a group of people who face similar risks. This
creates a common fund that members can
draw upon when needed. Each person in the group pays a
certain amount, called a premium, every
month. These premiums are used to cover the medical expenses
of group members who become sick
or injured.
Health Insurance in the United States
Today, most Americans receive health insurance through their
place of work. Employers typically pay
for part of the premiums. Most employer-sponsored plans are
administered through payroll
contributions. People who are self-employed and those whose
employers do not provide health

insurance must purchase individual health insurance. Individual
plans are generally more expensive
than group plans. Certain low-income individuals and families
may be eligible for Medicaid, a form of
government-sponsored health insurance. In 1997, the US
government introduced the Children’s
Health Insurance Program (CHIP) to assist the children of
families who do not qualify for Medicaid but
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cannot afford the cost of private insurance. People older than
sixty-five years of age and people with
certain disabilities may be eligible for Medicare, another
federally funded health insurance plan.
There are two basic types of health insurance plans in the
United States: indemnity plans and
managed care. Under an indemnity plan (also called fee-for-
service plan), the insurance company
pays a percentage of the cost of medical services provided
(typically 70 to 80 percent). The insured
person is responsible for the remaining 20 to 30 percent.
Indemnity plans do not limit patients in their
choice of doctors or hospitals. Managed care controls the use of
medical services in an effort to keep
costs low. An example of a managed care plan is a health
maintenance organization (HMO).

Participants in an HMO plan are limited in their choice of
doctors and hospitals. They must receive
medical services at HMO-operated facilities or visit physicians
and hospitals that are affiliated with the
plan. The cost to the participant is usually much lower,
however, limited to a small co-payment for
visits to a doctor or hospital emergency room.
Each type of plan has advantages and drawbacks. Indemnity
plans are more expensive than managed
care plans but they offer great flexibility. Managed care plans
may require individuals to choose
primary care physicians, or doctors who monitor their health
care. Plan participants must consult their
primary care physicians to get a referral to a specialist.
Managed care plans emphasize preventive
care such as office visits and immunizations, but they may limit
coverage for medical tests, surgery,
mental health care, and other support. By contrast, indemnity
plans may not pay for some types of
preventive care, such as checkups and immunizations.
Comparing Systems
Both government-based health care systems and the mixed
public/private system of the United States
offer benefits but also have serious flaws. The former provide
universal coverage, guaranteeing
access to health care regardless of income or employment. Most
government-based plans also
provide better care for pregnant women and newborn babies
than the US system. Supporting these
health care systems, however, requires higher levels of
government spending than the public/private
system.

Furthermore, the goal of providing good care for everyone
cannot always be reached in government-
based systems because of limited money and resources. The
pressure to keep spending under control
leads to tight government restrictions. As a result, patients in
some countries, such as Canada and
Sweden, sometimes have to wait a long time for certain
services.
The health care system in the United States is more flexible
than government-controlled systems
because providing universal health care and containing costs are
not its main goals. In the United
States, patients can obtain virtually any kind of medical service.
When a person becomes ill, however,
treatment will usually depend on the nature of his or her health
insurance. Someone who does not
have insurance or the resources to pay the health care provider
may not be able to get the necessary
treatment.
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The Debate Over Health Care Reform
Many politicians, academics, and citizens have been advocating
the position that the American health
care system is in need of comprehensive reform. Proponents of
this position rely on three major
factors: the high costs of health care, the relatively low quality
of care, and the large number of
persons who are uninsured.
The costs of health care are escalating rapidly. Health care costs
in the United States have more than

doubled in the past decade and accounted for 17.9 percent of the
country’s Gross Domestic Product
in 2010. Health insurance premiums continue to rise faster than
wages. Americans spend more on
health care than any other country in the world. US health care
spending reached $2.6 trillion in 2010.
Employer-sponsored health care plans have increased more than
100 percent in the past decade.
Some health economists have predicted that the United States’
health spending will reach $4 trillion
by 2015.
Statistical measures and indicators suggest that, despite this
high level of health care spending, the
quality of health care available in the United States is low.
According to statistics compiled by the US
Census Bureau and the National Center for Health Statistics, a
baby born in the United States has an
average life expectancy of about 78 years. While the life
expectancy is higher than in previous years,
the United States’ life expectancy continues to lag behind many
other countries in the world, such as
most European nations, Japan, Canada, Australia, Singapore,
Jordan, and Guam.
Finally, many millions of Americans are forced to go without
health insurance entirely. This problem is
exacerbated by the rising costs of care. Rising costs are the
main reason why hundreds of thousands
of companies have stopped offering health coverage for their
workers. Also, due to the sluggish
economy, many people have lost their jobs in recent years. This
means that those who are
unemployed often have no health care. Many who cannot find
new jobs have been forced to take part-
time work, and these jobs typically don’t offer health care

benefits. The number of the uninsured
continues to rise. Gallop polls found that 14.8 percent of
Americans did not have health insurance in
2008. This number increased to 16.4 percent in 2010 and 17.1
percent in 2011.
For people who are underinsured or who lack insurance, getting
health coverage can create a financial
crisis. The high number of uninsured has health and social
implications as well. While laws mandate
that hospital emergency rooms take in all people, including the
poor and uninsured, these people still
often do not get the medical care they need, especially at the
appropriate time. “The uninsured are
less likely to see a doctor … and are less likely to receive
preventative services,” notes Arthur
Kellerman, a medical professor and cochair of an Institute of
Medicine (IOM) panel that has studied
the problem. Thus they often wait until medical problems
become severe before seeking medical care,
creating more costs for the health care system that are passed on
to others.
Proposed
Solution
s
Health care reform has become one of the most important issues
in American politics. It took center

stage for the entire first year of the presidency of Barack Obama
(1961—). Advocates of health care
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reform have proposed several different systems that they
believe would solve these and other
problems. Among the most popular proposed solutions are a
single-payer system, a rationing plan,
and mandates.
A single-payer system is defined as a health care system that
pays for doctors, hospitals, and other
health care providers out of a single fund. Canada utilizes such
a system nationwide, and Medicare is
a domestic example. In Canada, for example, doctors are paid
by a fund with money taken from taxes
collected by the national and provincial governments. The
government collects funds, sets fees for
medical services, and pays health care providers.
Proponents of a single-payer system argue that it would
simplify the United States’ patchwork system
of multiple insurance providers and greatly reduce

administrative costs in health care. Doctors would
benefit by not dealing with multiple insurance forms.
Nonaffluent patients would benefit from more
affordable health insurance. Opponents argue that a single-
payer system is too radical a change from
the American status quo. They also argue that having the
government control medical prices and
costs will inhibit the development of new medicines and
technologies and may compromise the quality
of health care.
The term “rationing” means dividing up scarce resources among
people who want access to them.
Many experts have concluded that offering every type of
medical service to all the people who need or
want it is not possible. They believe it is important to develop
guidelines on what type of care should
be offered and who should be eligible for it. At the small-scale
level, allocation may affect decisions
about individual care. If five people need a heart transplant, but
only one heart is available, a decision
must be made about whom should receive the transplant. On a
larger scale, allocation might involve a
government’s decision about how much money to spend on
expensive drugs and high technology

equipment for the elderly and how much to spend to prevent
childhood diseases.
Advocates of a rationing plan argue that rationing care is the
only way to rein in the growth of health
care costs. They also argue that it is a way to ensure that
everyone receives some basic level of care,
which is key to preventing the widespread health problems
faced by the uninsured. Opponents of
rationing argue that it raises basic issues of fairness. Who
would set the guidelines about what care is
available? Other people think that health care services should be
available to anyone who needs
them. They argue that government and the medical community
have a moral obligation to ensure that
everyone has access to the health care they require. Finally,
many opponents of rationing are
opposed to having the government play a role in private medical
care decisions. In the summer of
2009, opponents of rationing said that government-run care
rationing would result in the creation of
“death panels” in which government bureaucrats would literally
decide who should live or die. This
assertion had no basis in fact, but it was sufficient to frighten
many Americans, especially elderly

Americans, who were already concerned about how proposed
health care reform might affect them
personally.
Another approach, being tried by the state of Massachusetts,
builds on the United States’ system of
private health insurance. Under legislation passed in 2006, all
residents were required to obtain health
care coverage, either by purchase or through their employers. In
addition, people under a certain
income threshold receive subsidies from the state government.
A state agency, the Connector
#
Authority, helps package insurance options and negotiates rates
from insurance companies. Part of
the theory is that by mandating everybody to participate in
buying health insurance, there are more
funds available to provide universal health coverage. The
Massachusetts plan had some initial
success, enabling 150,000 previously uninsured state residents
to obtain affordable coverage. But
some argue that maintaining universal coverage will become

increasingly expensive, especially five or
ten years in the future. Interestingly, while running for the 2008
and 2012 Republican presidential
nominations, Massachusetts Governor Mitt Romney explicitly
promised not to expand the
Massachusetts model to the rest of the nation, arguing against a
“one-size-fits-all” approach, even as
several Democratic candidates were touting Massachusetts as an
inspiration for their own health care
proposals.
Patient Protection and Affordable Care Act of 2010
On March 23, 2010, President Barack Obama passed the Patient
Protection and Affordable Care Act
to reform the US health care system. The act, which is based on
the Massachusetts model set in
motion by 2012 presidential hopeful Romney, is designed to
ensure that most Americans receive
access to affordable and quality health care. A week later,
Congress passed the Health Care and
Education Reconciliation Act of 2010, which amended some of
the provisions from the Patient
Protection and Affordable Care Act. The plan will be rolled out

over a decade and include many
changes to which individuals, employers, and insurance
companies must adhere or face penalties. In
2010 some changes took effect that include provisions such as
requiring insurance companies to
extend dependent coverage up to age 26. They must also
provide insurance for children with pre-
existing conditions—the requirement will extend to adults in
2014—and they cannot deny coverage to
those with severe illnesses such as cancer. Other changes that
are set to take place by 2014 include
the elimination of deductibles and co-payments for preventive
services such as colonoscopies,
mammograms, and cancer screenings. The law has many critics,
however, and faces many hurdles
before it is fully put into place.
Full Text: COPYRIGHT 2015 Gale, Cengage Learning.
Source Citation
"Health Care Issues." Opposing Viewpoints Online Collection.
Detroit: Gale, 2015. Opp
osing Viewpoints in Context. Web. 27 Jan. 2016.

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Here are the instructions:
Applied Final Project
"The Cultural Other"
· Research the history and traditions of a culture that is of
special interest to you. You may research the arts, musical
traditions, literature, significant historical events, and religions
of your chosen culture.
· Armed with this background, create a portfolio of an invented
person from that culture. The result will be a case study.
· Decide on the age, gender, socioeconomic class, family
situation, and community role of the individual, as well as a
personal crisis the individual has involving culture.
· Write up the case study. Include a key historical event that has
some influence on the case.
Suggested format, ideas and examples
Again,this is SUGGESTED, TO HELP YOU TO FORM YOUR
PAPER, NO formal format, since I like classmember to have

the chance to be creative, but here is a suggested format for
those who do better with structure. You can use if you like, or
form your own. The examples are meant to serve as
supplemental material/samples. Remember to check the rubrics!
A good way to look at it is if you were writing the biography of
a person from another culture. Only instead of just fiction, you
would, like a science fiction author, use actual material, facts
and data as well.
So, suppose you are writing up a ‘case study’ or narrative,
about(hypothetically) Ms A from country B. You first research
about country B from reliable sources(library, academic
journals, sites we have used in class, just not web travel sites or
other less academic sources).
Introduction: About county B, and person A, in a few lines. For
the person, report(and keep in mind while writing) age, gender,
socioeconomic class, family situation, and community role of
the individual. For country B, look into arts, musical traditions,
literature, significant historical events, and religions of B..
Para 2 : A’s early life and upbringing as a part of her culture.
1-2 Aspects of culture can go here
Para 3: young adulthood of person, a personal/historic crisis:
say, she falls in love with someone but the norm is arranged
marriage, or the country is invaded, family member becomes
victim of domestic violence, becomes suicidal, etc. How

person is helped (or not) by her society members, professionals,
support groups(UN or WHO starts Women’s group to help etc).
Para 4: How she overcomes these issues as a part of her culture,
perhaps becomes a leader among the women of her tribe,
relationship to culture here again-changing world, changing
values, etc
Para 5: Conclusion on how A is doing now, lessons learned, her
life in perspective, importance of her culture to her wellbeing,
challenges, and how she learns how to thrive(via education, art,
literature, internet, etc).
References
Just as an example, A might be a young girl student whose life
is changed by education, etc. when something like Barefoot
college comes to her village.
http://www.barefootcollege.org/solutions/education-solutions/
Or A could be a grandmother, who lived all her challenging life
in a small village, but whose life changed when she was given a
chance to provide light via solar panels to her community, and
enriching her cuture.
http://www.barefootcollege.org/solutions/solar-solutions/
Or A could be a man who lived in a country where he saw

social and cultural issues at work, and chose to become a
humanitarian hero.
http://www.who.int/mediacentre/commentaries/everyday-
humanitarians/en/
http://www.who.int/mediacentre/events/2015/world-
humanitarian-day/tributes/en/
The above are just examples, you can create your own, just
make sure you check the rubric and provide reliable references.

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