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Abstract

The prevailing healthcare system in the United States has drawn many criticisms – from healthcare professionals and citizens alike. The American system fares badly compared to nationalized public health systems of Western Europe. Even in terms of overall costs, the American model is more expensive, which is significantly inflated by bureaucracy costs. All comparative evidence points in one direction – that the country would benefit through an overhaul of the healthcare system. Single payer and universal insurance coverage are the cornerstones of the optimal system. Posing hurdles for this noble objective are vested private interests in the form of private insurance companies, ideologically entrenched politicians and to a lesser extent, healthcare providers.

Why is the article relevant to our course discussions on the U.S. Healthcare system?

The issue of healthcare is a pressing social problem in the United States. All healthcare practitioners, hospitals, policymakers and the citizens all have a stake in the healthcare system. Of all these stakeholders it is the citizens who end up getting a raw deal. In fact, despite being the richest country in the world, the United States has close to 50 million of its citizens uninsured. That is nearly one out of six people in the country cannot even get access to basic healthcare if they fall ill. If any member of this group is unfortunate enough to get a grave malady, his/her chances of survival itself are very low. This situation bespeaks of various vested interests acting upon the healthcare system. There are so many profit-oriented parties at various stages of healthcare delivery that only the well-to-do can never worry about healthcare costs. Considering that documented American population is now nearly 300 million and there are millions who are illegal immigrants, there is much at stake for the continued cohesion of American society. This makes the research paper by Marleise Rashford very relevant for all stakeholders, especially students of health sciences.

The article is relevant to course discussions for other reasons as well. For example, the wide coverage given within the article – which is organized under various subheadings – makes it an overview of the current healthcare situation in America. Students can refer it to get a concise yet precise picture of core problems and factors bearing upon the healthcare system.

What are the major themes of the article and how were the conclusions and findings derived? Do you agree with the conclusions or findings, why or why not?

One of the major themes of the article is finding supporting evidence for universal health coverage in America. As it stands, 50 million Americans have no insurance coverage whatsoever. Even among those who have coverage, depending on the premiums they can afford, they get varied coverage. This means even many insured Americans may not have insurance support for grave or chronic illnesses. This brings into question the moral basis of social policymaking in the country. This lacuna is made more conspicuous by America’s rich history of legislature. A proponent of democracy and plurality for more than two centuries, the current inequities in its healthcare system stands in contradiction to the spirit of its liberal history. Author Rashford evaluates the American health system by contrasting it to nationalized health coverage offered in several European democracies. The strongest argument Rashford makes is this: Why can’t America replicate the successful systems of Britain, Canada and Germany when it has more resources and a bigger population to take care of? It is a persuasive argument and something I quite agree with.

As part of her literature review, Rashford also peruses a comprehensive survey of registered physicians in America. The results of that study show that a majority of the participants favor a nationalized health care arrangement. Although the surveyed were less favorable toward a single payer system, they are mostly in agreement with the European public health care models.

Those who defend the existing healthcare model often cite the heavy burden on the tax-payer that a public system will impose. But this is not such a big burden as is made out to be. For example in advanced industrial societies such as Britain, France and Germany the total expenditure on healthcare as a percentage of the GDP is still smaller than what it is in the USA. The crucial difference though is the number of private business that are involved at various stages of healthcare delivery. In the United States this is markedly higher. Another reason why the nationalized health care models of European democracies are cost-effective is due to the simplified bureaucracy (a benign by-product of a single-payer arrangement).

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