Respond to at least two of your colleagues on two different days in one or more of the following ways:
Ask a probing question, substantiated with additional background information, evidence, or research using an in-text citation in APA format.
Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.
Offer and support an alternative perspective using readings from the classroom or from your own research in the Walden Library.
Validate an idea with your own experience and additional research.
Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings.
Expand on your colleagues’ postings by providing additional insights or contrasting perspectives based on readings and evidence.
Jessica Dunne
RE: Discussion – Week 1
Top of Form
NURS 6050C: Policy and Advocacy for Improving Population Health
INITIAL POST
Healthcare as a Human Right
The emotionally charged debate about whether healthcare is a right vs. a privilege is currently raging in the United States, it is discussed on a daily basis. I believe that when we consider human rights, it is important to place emphasis on the human aspect, not merely the American aspect. Americans are a small portion of the human population, and nearly every other industrialized nation considers healthcare to be a human right and, subsequently, guarantees such for its people. The World Health Organization (2017) maintains that healthcare is a human right and should be guaranteed by the government, without bias or discrimination. The international community has recently issued a goal of achieving sustainable universal healthcare by 2030 (World Health Organization [WHO], 2017).
The right to healthcare requires that people have availability, accessibility, acceptability, and quality care. Available and accessible healthcare refers to having facilities and providers within a reasonable proximity, and the means to attain the care an individual requires. Acceptability means that the care provided is ethical, culturally appropriate, and free from discrimination. The quality of care provided must be safe, effective, person-centered, timely, equitable, integrated, and efficient (WHO, 2017). I steadfastly believe that the WHO is correct in its assertion that healthcare is a fundamental and basic human right. The requirements of healthcare as a human right are common sense standards of care. Sadly, our nation is failing to provide this fundamental right to all its people for a variety of reasons. But, the biggest barrier to attaining universal healthcare for Americans is the associated costs.
Economic Considerations
The number of Americans who don’t have access to the human right of healthcare outlined by the WHO is growing. According to Knickman and Kover (2015), shifting demographics in the United States have resulted in an increase of vulnerable populations and greater income inequality. These factors, combined with economic recession of 2008, have forced more Americans to seek social services from the government, further compounding the issues of healthcare disparity and resource scarcity (Knickman & Kover, 2018). The United States being a historically individualistic society coupled with a divisive political climate has prevented the government from being able to effectively manage the healthcare crisis in our country. Fundamental disagreements on the best course of action have unfortunately, contributed to inaction, leaving the American people frustrated.
Considering that healthcare is a human right, we must work together to achieve a universal healthcare system that satisfies most Americans. Levitt (2018) maintains that traditional proponents of universal healthcare largely support a single-payer system, with the associated costs being offset through increased taxes. While this would ultimately lead to coverage for all Americans, some citizens would inevitably pay significantly more than others causing an exacerbation in social and political divisiveness. The benefits of this system are that healthcare related costs would be lowered by decreasing prices for services, reducing administrative costs, and curtailing exorbitant profits earned by private sector companies (Levitt, 2018). However, there are concerns that a single-payer healthcare system financed by increased taxes is not sustainable long term, and would add significantly more money to the ever growing national debt. A single-payer system would also eliminate the free market from the healthcare system.
Simple economics dictates that money can be saved by either earning more revenue or by decreasing costs; single-payer systems do both simultaneously. However, focusing solely on decreasing costs within the healthcare system itself would be much more appealing to consumers, and would more likely garner bi-partisan political support. Hewitt and Longman (2018) make a compelling case for a single-price, not a single-payer healthcare system. The United States has the highest healthcare costs in the industrialized world. For example, an uncomplicated appendectomy costs about $3800.00 in Australia, while the same operation costs $16,000.00 in the United States. “Study after study has found that the biggest reason Americans pay more per person for care than the residents of any other advanced country is simply that the same pill or treatment cost dramatically more in the United States” (Hewitt & Longman, 2018 p. 19).
In our current system, when healthcare costs increase, those costs are passed on to consumers, through employers, by decreasing available benefits, not giving pay raises, or cutting valuable programs like tuition reimbursement. This allows commercial insurance companies to easily inflate the prices of medical services to increase their own profits. Most hospitals are nonprofit organizations, which means they do not pay shareholders. Instead they can use the profits they earn from commercial insurance companies to increase wages of high level employees or fund unnecessary expensive building projects. (Hewitt & Longman, 2018).
The practice of price gouging the vulnerable and ill is morally and ethically reprehensible. Nonetheless, some amount of profit is necessary to maintain healthcare operations. Medicare and Medicaid are government run healthcare programs, which set limits on what medical providers and hospitals can charge based on clinical criteria including disease state, procedures, and services rendered. The idea behind single-price healthcare is to apply these same cost restrictions to private sector commercial insurance companies.
According to the Congressional Budget Office, the price for a one day hospital stay is 89 percent higher when charged to commercial insurance plans and their customers than when a Medicare patient stays in the same bed for the same amount of time (Hewitt & Longman 2018, p. 20).
If Medicare pricing were applied to commercial insurance providers it would decrease the price of healthcare paid by an average family approximately $9000.00, and we could expect to see even greater price reductions in the future (Hewitt & Longman, 2018).
Of course, such a measure would send the healthcare industry into a frenzy. Large urban hospitals will be proclaiming that they won’t be able to keep their doors open, and assert that they are already losing money treating Medicare and Medicaid patients. However, it should be noted that rural medical centers primarily serve Medicare and Medicaid patients, and earn most of their revenue within the governmental reduced rates. These institutions are able to operate more efficiently than their largely private sector driven counterparts; and can therefore serve as a model for success. Single-price healthcare will eliminate the complicated system of various reimbursement rates for different plans, thereby largely reducing administrative costs, and helping to standardize the projectable budgets of healthcare facilities. This strategy would also lend a hand to the free market by ending insurance monopolies and encouraging new, and smaller companies to compete for business (Hewitt & Longman, 2018).
Single-price healthcare will satisfy most Americans because it will not increase taxes, eliminate the free market, or cause consumers to give up their current plans. It will very quickly provide cost savings that are noticeable, and it does not dismantle the Affordable Care Act (ACA). This means that the insurance mandate of the ACA coupled with the newfound affordability of the single-price system would make coverage universal. The single-price system is a collaboration rather than a compromise because, instead of both sides giving something up, both sides will get many of the things that they want. Contrary to what we often hear, universal healthcare is affordable and attainable in the wealthiest nation in the world, if we all work together. And, most importantly, a single-price system would guarantee the fundamental human right of healthcare to every single American.
