Professional Documents
Culture Documents
UHC Revised Paper
UHC Revised Paper
UHC Revised Paper
The United States is the most industrialized nation in the world. We, as Americans, enjoy more
freedom than other nations. However, there is a tragic darkness that continues to permeate our
society. Over 28.5 million Americans do not have any form of health insurance. If this is the
freest country in the world, then everyone living on this land should have access to free
healthcare. In this essay, we will be discussing Universal Health Care and why it is necessary to
the safety and protection of our most vulnerable citizens. We will examine both sides of this
crucial issue: What are the pros and cons of Universal Health Care? Is it even possible? How
would we go about achieving this? This essay will be arguing in favor of Universal Health Care
Page
Introduction I
Its all well and good for children and acid freaks to believe in Santa Claus XVII-XXVII
A restless idealism on one hand and a sense of impending doom on the other XXVIII- XXXIV
Bibliography XXXVII-XXXVIIII
When the going gets weird: A brief retrospective overview of universal healthcare
When the World Health Organization was founded as a sub body within the United
1948 declaring health a fundamental human right and on the Health for All
agenda set by the Alma Ata declaration in 1978. UHC cuts across (all of) the
health and protection for the worlds poorest. Universal health coverage (UHC)
means that all people and communities can use the promotive, preventive,
quality to be effective, while also ensuring that the use of these services does not
expose the user to financial hardship. This definition of UHC embodies three
services should get them, not only those who can pay for them; The quality of
health services should be good enough to improve the health of those receiving
services; and People should be protected against financial-risk, ensuring that the
cost of using services does not put people at risk of financial harm. (WHO)
Taking this model into account, we can delineate that the goals outlined by W.H.O have
not been met in the United States. The issues surrounding the creation, implementation and
Journal of Economic Issues entitled Universal health care and the economics of responsibility,
In the American health care system the cost of health insurance is underwritten
However, while costs are shared, responsibility is not. The retreat of private firms and
government from assuming a substantial share of the burden of health care costs is
based on the presumption that health care is an individual's responsibility, while the
contributions of government and the private sector are basically optional--a matter
over health care reform will depend on this issue of responsibility. Who should pay for
economics, which treats health care as a consumer good. (1) In this framework, there is
no shared responsibility for health care. There is only individual demand for health care
It is difficult to see how universal health care can be built upon such a philosophy. On the
other hand, institutional economics views health care very differently. As Dennis Chasse
(1991) notes, John R. Commons, John Andrews and other early institutionalists
understood that the social and economic structure of modern capitalism left workers with
little bargaining power. As a result, workers bore an unreasonable share of the costs of
working conditions, and low pay (Chasse 1991, 805). J.M. Clark also recognized that
problems like poverty, unemployment and industrial accidents are systemic in nature and
beyond the reach of individual choice and personal responsibility (Clark 1936). Clark
also stressed that the benefits of good health accrue not only to individuals but to
laborer's health and working capacity which must be borne by someone, whether the
laborer works or not, or else the community suffers a loss through the deterioration of
its working power (Clark 1923, 16, quoted in Stabile 1993, 173). More recently,
institutional economists and others have questioned the applicability of the choice
theoretic framework to health care, since the choice of health care services is, at best, a
joint decision, and is often made by others (Bownds 2003; Keaney 1999; 2002). In short,
in the institutionalist view health care is treated as a social good that is fundamentally a
With this, we see the warrant in arguing for and against universal health care is based on
economic vantages and that, if we are to achieve universal healthcare, it must become a shared
responsibility of the employer, individual and the state. To the employer: it is cost effective to
not pay for an employees health insurance. However, as noted, the workers who bear an
unreasonable amount of burden due to the cost of not having health insurance and factors beyond
their immediate control caused deterioration of working powers, which leads to a loss of
Since the early 90s when universal healthcare was being formulated by the Clinton
the Health Security Act (HSA) (H.R. 3600, 1993), which would have
provided universal health care coverage, or as Clinton (1993) put it, "comprehensive
health benefits that can never be taken away" (p. vi). Clinton's speech received wide
acclaim, and polls showed broad support for health care reform(Skocpol, 1995). A year
later the HSA was dead without having ever come to a voteAlthough the
congressional Democrats had enough votes to enact the HSA, they did not do so.
Liberals believed the HSA did not go far enough, and many supported the McDermott
single-payer bill - American Health Security Act (H.R. 3960, 1994) (McClure, 1994).
Conservatives thought the HSA went too far and supported the Cooper bill - Managed
Competition Act of 1993 (H.R. 3222), which did not provide universal coverageHealth
(McClure, 1994; McKenzie & Bilofsky, 1993; Rasell & Lillie-Blanton, 1994). The
administration had in part designed the HSA to appeal to advocates (Zelman, 1994). The
services and allowed the states to create single-payer systems of their own (NASW,
1993a). Despite this, single-payer backers were ambivalent. Although some viewed the
refused. These demands usually had merit, but many advocates spent more time
criticizing or ignoring the act than supporting it. In California single-payer supporters
focused on the state's single-payer ballot initiative and failed to respond when Sen.
Dianne Feinstein (D-CA) withdrew support for universal coverage. Feinstein's switch
"fatally wounded" Sen. George Mitchell's (D-ME) attempt "to build a majority for a
Due to the malfeasance of our Congress in the 1990s in failing to enact a single-payer
system like the one we have in place currently, our cost of healthcare has skyrocketed,
In 2014, the United States (U.S.) spent more on health care than any other
More on this later. For now, lets focus our attention to the outlying debts incurred by the
healthcare industry for several reasons, which has created the immense stumbling block
preventing the passage of universal healthcare in the United States. We start with our capitalist
system, which permits carnivorous vultures to thrive on the suffering of others through the
aficionado (and infamously opprobrious Pruritus ani) Martin Shkreli made headlines back in
2015 with his 5000% price hike of Daraprim, a lifesaving medicine used to treat rare, deadly
toxoplasmosis infections in AIDS patients (Herper 1.) Controlling drug prices and the cost of
prescription drugs is part of the reason why we dont have UHC: the government does not
completely lacks the transparency good markets need. Drug companies are forced to
focus on expensive drugs for smaller patient populations, because for many common
diseases--diabetes, heart disease, depression--there are now highly effective and
incredibly cheap generic medications available (80% of drugs dispensed in the U.S. are
generic). Moreover, the customers who pay for drugs are not the patients who
consume them but employers and insurance companies--and nobody knows the real
like Express Scripts (annual sales: $100 billion) and CVS Caremark ($140 billion); they
decide which drugs are covered and how much patients pay in copays. Sometimes drug
companies give discounts of as much as 60% to these firms [in order to] get better
placement for their medicines. But this also forces companies to take what price increases
they can, [in order to] make up for those discountsAll drug companies take price
increases in the U.S. on their medicines, often at rates much higher than inflation.
rivals Copaxone from Teva and Rebif from Merck Serono (not the U.S. Merck). But
competition hasn't kept the price down. According to industry analysts, the list price of
Avonex has increased from $16,000 a year in 2005 to $70,000 now, making it just as
expensive as new, more effective MS drugs. This is not the result you'd expect from a
free, transparent market. How does this happen? In a market with only a few drugs and
a few buyers, none of whom are paying out of their own pockets, price competition
can work in reverse. Take the case of Novartis' Gleevec, a lifesaving pill that puts a
deadly cancer called chronic myelogenous leukemia out of business. It was introduced in
2001 at a cost of $24,000 per patient per year. Then, in 2006, Bristol-Myers Squibb
introduced another drug, Sprycel, for patients who had failed on Gleevec. When Novartis
introduced its own successor to Gleevec, it was marketed (at first) to the sick patients
treated with Sprycel. So it priced the drug to compete with Sprycel and raised the
Gleevec price. The result: Gleevec now costs more than $90,000 a year...The biggest
problem is not new expensive drugs but repricing old ones, and not just ones being
purchased by Martin Shkreli [or Valeant,] "You have no new research. You have no
innovation. You have nothing but increased drug prices," says Steve Miller, chief
medical officer at Express Scripts. According to his company's data, the average cost of a
branded drug has increased 127% between 2008 and 2014. (Herper 2)
To support this: an explosive account written by Aaron S. Kesselheim, MD, JD, MPH;
Jerry Avorn, MD; and Ammet Sarpatwari, JD, PhD entitled The High Cost of Prescription
Drugs in the United States: Origins and Prospects for Reform in the Journal of the American
that in all other countries, largely driven by brand-name drug prices that
have been increasing in recent years at rates far beyond the consumer price
index. In 2013, per capita spending on prescription drugs was $858 compared
with an average of $400 for 19 other industrialized nations. In the United States,
health care services. The most important factor that allows manufacturers to set
upon Food and Drug Administration approval and by patents. The availability of
generic drugs after this exclusivity period is the main means of reducing prices in
the United States, but access to them may be delayed by numerous business and
legal strategies. The primary counterweight against excessive pricing during
drug payment plans cover nearly all products. Another key contributor to drug
available at different costs. Although prices are often justified by the high cost of
development costs and prices; rather, prescription drugs are priced in the United
States primarily on the basis of what the market will bearHigh drug prices are
the result of the approach the United States has taken to granting
most realistic short-term strategies to address high prices include enforcing more
To explain this in laymens terms: If the government were to command the prices of
prescription drugs under a universal healthcare system, it would spur the research, development
and eventual implementation of cheaper generic medicine into the market, creating competition
and driving prices down for prescription strength (name brand) medicines. This is basic supply
side economics. This action will then help facilitate drug utilization research that is distressfully
insufficient in the present so better cost-utility/effectiveness and drug efficacy statistics can be
ascertained for R&D (Research and Development.) This is certainly possible within the purview
Medicare/Medicaid) became the de facto authority. Staunch opponents to UHC, such as former
president Ronald Reagan, have gone on record comparing socialized medicine to communist
balderdash; or former governor Sarah Palin claiming that the affordable care act created death
panels which would ration healthcare. Such bullshit reifications are part and parcel of the
erstwhile baby boomer generation playing their highfalutin obstructionist oboes to the tune of
pull yourself by your bootstraps! whilst disgorging nonpartisan pernicious adynata from their
anathematic rostrums.
nonadherence is when patients do not take their medicine as prescribed. Now, you may be
wondering how this affects health care costs and prevents us from having a universal health care
system. Does it really matter if patients dont take their medicine? Yes, yes it does. In a research
paper entitled, Adherence and health care costs, written by Aurel O. Iuga & Maura J. McGuire
In 2010 the costs of health care in the US exceeded $2.7 trillion and
accounted for 17.9% of the gross domestic product. Projections indicate health
care will account for 20% of the US gross domestic product by 2020.14 Twenty
percent to 30% of dollars spent in the US health care system have been identified
year in avoidable direct health care costs The financial pressure is passed
estimated that health-related productivity loss costs are 2.3 times higher than the
most of the existing studies consider only direct health care costs when estimating
costs.36,37 Between $100 and $300 billion of avoidable health care costs have
nonadherence to poor patient outcomes, relatively few high quality studies report
administrative data to evaluate health care costs in populations of patients who are
(NCBI 1)
As aforementioned with prescription drug prices, if we had a universal single-payer
healthcare system in place that had accurate, real time data from drug utilization research,
healthcare costs that could be reinvested into administrative costs. This, in turn, would remove a
burdensome amount of debt from the system without inversely affecting medical practitioners
salaries. To undertake this daunting task will not be easy; but, with the right legislation and
The next complication that poses a challenge to enacting universal healthcare is the
obesity and opioid epidemic plaguing our nation. To begin with obesity, we turn to another
research paper, Direct medical cost of overweight and obesity in the United States: a
quantitative systematic review, written by Adam gilden Tsai, MD, MSCE; David F. Williamson,
$266 and $1723 for overweight and obesity by the number of overweight
and obese persons in the U.S., the $Y2008 aggregate (national) costs of
overweight and obesity were $15.8 billion and $98.1 billion, or 113.9
billion total, equal to 4.8% of health care spending in 2008.65 When pooled
estimates from all 33 studies were used to compute aggregate costs, the
total costs of overweight and obesity were 29.9 billion and $91.0 billion,
studies were used, incremental costs were $531 (overweight) and $1615
(obesity). Thus, total costs among these 29 studies were $38.4 billion
for overweight and $110.5 billion for obesity ($148.9 billion, or 6.2%
These figures were translated from cost estimates commenced by previous studies. Under
a universal healthcare system with tailored access to medicines that can treat exogenous obesity
as a pre-existing condition, this subpopulation would be given more adequate care. Specifically,
short term treatment, accompanied with nutritional and physical education to help these patients
lose weight (and Ritalin in the case of methamphetamine neurotoxicity, should that issue arise.)
This would create a greater demand for physical & nutritional experts, pharmacists and
prescription drug manufacturers, expanding this industry to create more sustainable jobs in
Turning to the opioid epidemic, well focus only on the statistics. Siting The Impact of
the Opioid Crisis on the Healthcare System: A Study of Privately Billed Services by FAIR
Health, Inc.,
Since its inception around the beginning of the 21st century, the current
epidemic of opioid abuse, dependence and overdoses has taken many lives,
prescription opioids alone was estimated to have cost the US economy $53.4
Hansens study attributed 79 percent of the costs to lost productivity ($42 billion),
15 percent to criminal justice costs ($8.2 billion) and only six percent to medical
costs, comprising four percent for drug abuse treatment ($2.2 billion) and
study, healthcare costs, defined more broadly, accounted for 45 percent ($25.0
billion) of the total, while workplace costs accounted for 46 percent ($25.6
billion) and criminal justice costs for only 9 percent ($5.1 billion). Whatever the
precise distribution of the economic impact of the opioid crisis, its healthcare
As we can observe, the monetary metrics involving the opioid epidemics cost on
healthcare ranges from as little as ~$2.3 billion dollars to as high as $25 billion dollars. If
universal healthcare had been in place before the beginning of the opioid epidemic began in
earnest from 1999, wed have had treatment options accessible to patients with opioid
dependency, having them covered under pre-existing conditions and keeping costs down. These
savings wouldve been earmarked to methadone clinics thatre currently underfunded and
understaffed. Patients with opioid dependency and substance abuse disorders wouldve not only
received the necessary physical treatment, but mental health services as well.
Remember our quote from earlier about the cost of healthcare? If you noticed, there was an
$554 billion of these costs; around $60 billion or 10% of the total cost of
methods, abuse, and fraud. Medicare Part D, which provides prescription drug
benefits, has been specifically targeted for fraudulent activity. This activity has
Medicare and Medicaid Services (CMS) have not created a dependable system for
expense authentication (Toothman, Moore and Lee, 2011). In the event a patient
have been known to write prescriptions for the patients spouse or family member
who has not met coverage maximums or altered medical diagnoses (in order to)
nine-to-five hours
It is all well and good for children and acid freaks to still believe in Santa Claus
Now that we have clearly established some numbers here, lets do some math. If,
hypothetically speaking, we could minimalize all the subject areas minus prescription drugs
(since that is a separate issue in and of itself) we can see that wasteful spending costs (using the
upper bound numbers) from medical nonadherence, obesity, opioid dependency treatment and
fraud totals $533.9 billion dollars. This doesnt even begin to put a dent into the $3 trillion-dollar
subsidized under. The Affordable Care Act (Obamacare) has provided a foundation for
covering pre-existing conditions and removes the cap on lifetime limits for those who are
struggling to pay for healthcare by offering tax subsidies to buy insurance through the state
governments,
The Affordable Care Act (ACA) leveraged Medicaid's role in serving the
comprehensive, affordable coverage for over 70 million people and has been
the key driver in the historic and rapid decline in the number of uninsured
2014. The ACA established a new Medicaid coverage pathway for millions of
already provided to children and pregnant women. The law created a continuum
income at or below 138% of the federal poverty level (FPL)--about $27,820 for
a family of three in 2016--with 100% federal financing to the states for the first
three years, gradually decreasing to 90% federal and 10% state funding by 2020.3
This new minimum increased eligibility for parents in many states and provided
new eligibility for other non-disabled adults without dependent children who were
largely excluded from Medicaid prior to the ACA. For those above Medicaid
individuals can purchase insurance and provides federal tax credits for people
with incomes from 100% to 400% FPL ($20,160 to $80,640 for a family of three
DC) have expanded Medicaid eligibility under the ACA. In the 19 states that have
not adopted the Medicaid expansion, 2.6 million uninsured poor adults are
coverage gains have been achieved through Medicaid and the Marketplace in the
three years since the roll-out of the major ACA coverage expansions began.
Medicaid enrollment has grown by 15.4 million since the period before open
enrollment began in October 2013, with gains particularly strong in states that
adopted the Medicaid expansion. An additional 11.1 million people are enrolled in
dropped to historic lows, from 41.1 million in 2013 to 28.5 million in 2015.
Nearly the entire decline in the number of uninsured people occurred among
expansion states had a 15.3 percentage point drop in adult uninsured rates, versus
a 9.0 point drop in non-expansion states. In the 19 states not implementing the
Medicaid expansion, Medicaid eligibility for adults is quite limited: the median
income limit for parents in 2016 is just 44% of poverty, or an annual income of
$8,840 a year for a family of three, and in nearly all states not expanding,
childless adults remain ineligible. As a result, many adults with incomes below
poverty fall into a "coverage gap" of earning too much to qualify for Medicaid but
not enough to qualify for premium tax credits in the Marketplace. Reflecting state
Southern states and African Americans.[12] The expansion has led to improvements
not only in coverage of the low-income population, but also improved access to
insured through Medicaid are significantly more likely to be lower income than
adults who gained Marketplace or other private coverage, reflecting the ACA's
approach to utilizing Medicaid with its broader benefits and stronger financial
protections as the coverage vehicle for the lowest income population. Adults
newly insured through Medicaid are more likely than those who remain uninsured
to have a place to go when they are sick or need advice about their health, have a
regular doctor, and have used medical services or received preventive care.
Medicaid expansion has also been associated with significant increases in the
cholesterol[15] and reduced unmet need for mental health and substance use
designed to address the high uninsured rates among low-income adults, providing
a coverage option for people who had limited access to employer coverage and
limited income to purchase coverage on their own. Medicaid has played a pivotal
role in the historic drop in the uninsured rate with implementation of the ACA
coverage and access to health services with protection from catastrophic and
financially burdensome health care costs. For those who remain uninsured but are
barriers, particularly for the Hispanic population, can further boost coverage.
However, with many states opting not to implement the Medicaid expansion,
millions of uninsured adults remain outside the reach of the ACA and
continue to have limited, if any, option for affordable health coverage: they
are ineligible for publicly-financed coverage in their state, most do not have
access to employer-based coverage through a job, and all have limited income
uninsured reflect the legacy of the system linking Medicaid coverage to only
certain categories of people. People who fall outside these categories--such as
poor. The ACA Medicaid expansion was designed to end categorical eligibility
for Medicaid and offer a coverage option to all poor Americans, but in states
remain.(Roland;Lyons)
To put this into perspective: ACA is part of the continual expansion of Medicare under
Medicaid. When president Lyndon Johnson created Medicare and Medicaid, it was his intention
that these programs be expanded, building upon president Roosevelts vision of an America
where healthcare was a right granted to not only the widows and children of veterans, but every
citizen. In this same breath, president Obama took the initiative and passed ACA to close the
Medicare gap created by the disastrous Medicare Part D, which saw less coverage for medicine
and preventive treatments, causing medical nonadherence for seniors covered under this plan
which they are responsible for 100% of drug costs. Beneficiaries remain in
14%) Medicare Part D beneficiaries reach the coverage gap each year
and receive no financial assistance to help pay for drugs during this
period [13, 14]. Proponents have argued that the coverage gap could help
Critics point to evidence that similar drug caps and increases in cost-
health services use, and adverse outcomes [6, 11, 16-18]. To date, researchers
spending threshold and had no financial assistance to pay for drugs [19-22].
precoverage gap period[20] and were 17% less likely than beneficiaries
Part D plans [23]. Unlike stand-alone plans that only provide drug coverage,
Medicare Advantage plans manage health and drug insurance benefits, and
assistance to help pay drug costs after reaching the threshold were two
times more likely to discontinue a drug but were 40% less likely to switch
who received no financial assistance were 18% more likely to reduce their
priced or generic drugs, entry into the coverage gap resulted in an abrupt
that blunt measures had adverse effects on drug utilization and adherence
[6, 16, 17]
and are also in line with findings
drug discontinuation [19,20,22] and adherence[19-21] but did not observe higher
drug benefit caps, gaps in coverage, and high deductibles [6, 17, 35, 36]. For
medications can be both severe and costly. Our results indicate that
the Part D coverage gap are twice as likely to discontinue and more
the coverage gap's structure are needed. The 2010 US Patient Protection
As ACA continues to expand our Medicare and Medicaid programs, many politicians
during the 2016 U.S. presidential election chimed in with their various health plans. Well focus
in on Senator Bernie Sanders plan. Sanders, a longtime self-described social democrat, served
on the committee that wrote ACA and rolled out a plan during the 2016 presidential election
entitled, Medicare-for-All. This plan for modernized universal healthcare would be billed as a
federally administered single-payer system which would remove all deductibles, co-payments
people. Every other major industrialized nation has done so. It is time for
this country to join them and fulfill the legacy of Franklin D. Roosevelt,
Affordable Care Act was a critically important step towards the goal of
now exists in 31 states. Young adults can stay on their parents health plans
until theyre 26. All Americans can benefit from increased protections
upon the success of the ACA to achieve the goal of universal health
insurance and millions more are underinsured and cannot afford the high
saving money by keeping people healthier. Those who say this goal is
unachievable are selling the American people short. Americans need a
health care system that works for patients and providers. We need to focus
ensure a strong health care workforce in all communities now and in the
all people can get the care they need to maintain and improve their
status.(Sanders 1)
This plan of his entailed spending $1.38 trillion dollars per year and would be generated
through revenues from taxing employers and the wealthiest one percent of Americans,
rates [which] under this plan the marginal income tax rate would be: 37 percent
million; and 52 percent on income above $10 million. Taxing capital gains and
dividends the same as income from work; Limit tax deductions for rich; the
responsible estate tax; and savings from health tax expenditures: Several tax
become obsolete and disappear under a single-payer health care system, saving
$310 billion per year. Most importantly, health care provided by employers is
compensation that is not subject to payroll taxes or income taxes under current
law. This is a significant tax break that would effectively disappear under this plan
because all Americans would receive health care through the new single-payer
With this plan, Sanders projected that we could be saving upwards of $6 trillion dollars in
Last year, the average working family paid $4,955 in premiums and
family of four earning $50,000 would pay just $466 per year to the single-
payer program, amounting to a savings of over $5,800 for that family each
year. Businesses would save over $9,400 a year in health care costs for the
average employee: The average annual cost to the employer for a worker with
a family who makes $50,000 a year would go from $12,591 to just $3,100.
(Sanders 3)
It would seem our path towards universal healthcare doesnt appear to be as farfetched as
the naysayers would have you believe. However, as Bertrand Russell once said,
If a man is offered a fact which goes against his instincts, he will scrutinize it closely,
and unless the evidence is overwhelming, he will refuse to believe it. If, on the other hand, he is
offered something which affords a reason for acting in accordance with his instincts, he will
In the present, a foreboding sense of minacious deportment exudes the wretched minds of
our congressional representatives. House republicans, since the outset of ACA and prior, have
opposed all forms of universal healthcare. House Speaker (and conniving harebrained randian
bootlicker) Paul Ryan has been the biggest vocal opponent of ACA and UHC,
taxes (Ryan 1)
The conflict and contradiction in this statement is that it was Ryan who also said,
America.(Ryan 2)
The vocal opponents to universal healthcare are the Paul Ryans of America, who believe
that larger government creates greater divide and that personal responsibility should fall squarely
on the shoulders of the individual. The prevailing attitude of the neoconservatives is one of
want to go spend hundreds of dollars on, maybe they should invest that in
Another source of contention lies in the fact that implementing UHC would have to be
incremental and, as stated from senator Sanders proposal: everyones taxes would increase. If
the government were to become the sole authority for healthcare, competition would become
scarce and thus drive prices up further, contributing to what we in the business world call brain
drain. This is when the brightest minds, like medical practitioners, leave socialist countries that
have universal healthcare because of the incredible burden leveraged on them by the state. A lot
of this contention, however, is driven by the fact that medicine has become unreasonably
expensive in this country due to the pharmaceutical industries incessant avarice in not allowing
generic medicines into the market, which keeps prices artificially high and will most likely cause
another healthcare bubble like the one seen with Medicare Part D.
The house republicans who oppose UHC favor block granting Medicare and Medicaid to
the states, provided they can attach per capita caps. In an interview by Shefali Luthra of Kaiser
Health News with Edwin Park, VP for health policy at the center for budget and policy priorities
in Washington, D.C.,
Per capita caps have also been endorsed by Ryan. Under those, states also
get a fixed amount of money each year, but that sum is calculated based on how
many people are in the program. Since block grants arent based on individual
enrollment each year, the state wouldnt necessarily get more money to
compensate if, say, more people qualified for Medicaid because of an economic
downturn. In theory, a per capita caps system would increase funding. But if, say,
an expensive new drug entered the market, or a costly new disease emerged, the
Medicaid budgets still wouldnt change to reflect thatThe block grant system is
a radical shift from how Medicaid has worked previously. Republicans say it
could save the government billions of dollars. But other analysts note those
savings could limit access to health care if the funding becomes squeezed. Thanks
to the 2010 health law, which led states to expand Medicaid eligibility, more
people would face the brunt of those cuts. The fiscal impact: The non-partisan
proposals could cut Medicaid spending by as much as a third over the next
decade. The cuts would start small, growing larger over the years. Many
Republicans say that, because states will have greater flexibility, they can
innovate with their Medicaid programs. But opponents note that experimentation
alone wont make up for smaller budgets. The fixed grants could mean states cut
Returning to Ryans argument, the underlying context of his quote regarding universal
healthcare under the command of the government is that it would create a slippery slope to which
our American representative democracy would be transformed into a socialist state. The logic in
this absurdist mentality is reflective of a man who has never worked a real service sector job in
his entire life. A soulless husk of wasted protozoa and four billion years of evolution, Ryan offers
the ultimate contrite bullshit that if healthcare were to become a right, it would then cause other
markets to be subject to government rule, against the free market principles enshrined into our
capitalist society. Remember our Pruritus ani Martin Shkreli earlier? There are many more
Martin Shkrelis in the prescription drug market who price fix at anywhere from 50% to 500% on
the markup of medicine (Herper 3); On one hand, you have the argument that universal
healthcare will lead to a complete government takeover of other markets; in the other hand: our
current system in place that allows for predators to determine who lives or dies based on their
The solution, although simple, is far from easy: Muster enough support to pass a
extremely daring proposition which many politicians would not undergo due to the amount of
called now, it becomes an anything goes style of event. Given that the republicans have a
majority in both the house and senate they could: axe ACA, gay marriage, abortion, gun control,
education and any other social issue that maligns their hyper partisan agenda.
At any length of counterargument that is offered by the republicans and those who
oppose UHC, there is always going to be more pros than cons; and reasonable assertions as to
why we should have UHC instead of the current system in place. In revisiting the quote from
Bertrand Russell: the problem arises in the people. One man, one vote is how our founding
fathers devised our political system. They also were more about solving problems than creating
them. If the people perceive that UHC is more harmful because it has been repeated long enough
to them by opponents of UHC or ACA, then they will be more inclined to believe this illusory
truth as fact. The house republicans whore lulling the people into a superfluous reality are
secretly doing the bidding of special interests who work in the healthcare industry to keep UHC a
pipedream. These cowards have the added protection of making erroneous bullshit claims like,
The Constitution nowhere authorizes the United States to mandate, either
directly or under threat of penalty, that all citizens and legal residents have
Even more intensified bullshit ensued when, during the vote for the American Health
No sir! That is a fascial argument if ever presented with one! This was not a rough-and-
tumble exercise of any sort and you would know this if you knew anything about the founding
fathers, which clearly you do not. In fact, the AHCA is something they would not have wanted.
The founding fathers supported government-run health care, you petulant tempestuous Malaya
mzee!
In 1798, John Adams signed one of the first healthcare bills in the country,
signed An Act for the Relief of Sick and Disabled Seamen. The law
health care insurance Upon passage of the law, ships were no longer
permitted to sail in and out of our ports if the health care tax had not been
collected by the ship owners and paid over to the government - thus the
would then give the sailor a voucher entitling him to admission to the
hospital where he would be treated for whatever ailed him. While a few of
operated, the majority of the treatment was given out at the federal
maritime hospitals that were built and operated by the government in the
nations largest ports. As the nation grew and expanded, the system was
also expanded to cover sailors working the private vessels sailing the
Mississippi and Ohio rivers. The program eventually became the Public
wing [has to] stop pretending they have the blessings of the Founding
iconic hero of the Tea Party also supported the legislation. Sargent
reprints the following email he received from Prof. Rothan on the subject
1792 Report, and it was a Federalist congress that passed the law in 1798.
And mind you: Jefferson and Adams were the biggest rivals in D.C., like what we have
today with democrats and republicans. The only key difference was that if gentlemen had
disagreements with each other back then, they didnt get on one knee and beg for help like Paul
Ryan did with Representative Don Young, THEY SHOT EACH OTHER!
the last seven years since the enactment of ACA has been one giant exercise in futility. Theres
no real lesson these people will learn: theyll remain intransigent because their principle donors
want them to be. They have lost all sense of their oath to protect the people from all enemies,
foreign and domestic, because they have become the enemy. Their loyalty is for-profit, their
Their illusion of superiority, their quintessential delusion that they are of a higher
privilege and can superimpose their will onto the people, is challenged by the impetus of our
founding fathers constitution and the sheer volume of enrollees who continue the groundswell
begun in 2010. There will be metaphorical (and quite possibly literal) blood on their hands
should they repeal ACA and prevent this country from eventually having universal healthcare as
a right.
Myths and legends die hard in America. We love them for the extra dimension they
provide, the illusion of near-infinite possibility to erase the narrow confines of most men's
reality
Wherever you fall on the issue of universal healthcare, it is an inevitable outcome from
years of progressivism starting in the 1930s with FDRs vision for healthcare as a right of the
people, to LBJs great society, Clintons H.S.A. and Obamas ACA. It was immortalized in our
declaration of independence that all men had the right to pursue life, liberty and the pursuit of
happiness. Even if the intention of the founding fathers seems completely anachronistic or too
vague, they meant that everyone who was a citizen of this nation had an inalienable right to
pursue their own path of self-determination, which would invariably include the right to access
healthcare for the continuation of their life. The reifications brought upon by the opponents of
UHC are the weak-willed responses of milksop turncoats who labor to retain power instead of
sharing it with the people. Sycophantic little napoleons attempting to impress their masters
falsified realities for the rest of us who are striving to live out our own American dreams without
fear of being unable to decide if we can afford medical healing. No one, especially the citizens of
freest country on earth that spend as much as we do on healthcare, should have to endure this
tragedy any longer, not when other industrialized nations with universal healthcare spend less
and have greater life expectancy and outcomes. The time is now: 29 million people remain
uninsured to this day. If you want to make a difference in these peoples lives: call your elected
officials, tell them you want ACA expanded into UHC. Universal healthcare is not that far away,
and die.
yesterday.
is pain
The sound
of music floats
down
a dark street.
Bibliography
(WHO) "Universal Health Coverage and Health Financing." World Health Organization. World
Health Organization, n.d. Web.
(Gorin 1) Universal health care coverage in the United States: barriers, prospects, and
implications,Stephen Gorin, Health and Social Work. 22.3 (Aug. 1997): p223. COPYRIGHT
1997 Oxford University Press. http://www.naswpress.org/publications/journals/hsw.html
(Marshall 1 & 2) Bush, Jamie, Leslie Sandridge, Cierra Treadway, Kimberly Vance, and Alberto
Coustasse. "Medicare Fraud, Waste and Abuse." Marshall Digital Scholar. Marshall
University, 22 Mar. 2017. Web. May-June 2017.
(Herper 1, 2 & 3) Herper, Matthew. "Solving Pharma's Shkreli Problem." Forbes. Forbes
Magazine, 04 Feb. 2016. Web. 16 May 2017.
<https://www.forbes.com/sites/matthewherper/2016/01/20/solving-pharmas-shkreli-
problem/#234055236be3>.
(JAMA 1) Kesselheim, Aaron S., Jerry Avorn, and AmmetSarapatwari. "The High Cost of
Prescription Drugs in the United States." JAMA. American Medical Association, 23 Aug.
2016. Web. 16 May 2017. <http://jamanetwork.com/journals/jama/article-abstract/2545691>.
(NCBI 1) Iuga, Aurel O., and Maura J. McGuire. "Adherence and Health Care Costs." Risk
Management and Healthcare Policy. Dove Medical Press, 2014. Web. 16 May 2017.
<https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3934668/>.
(NCBI 2) Tsai, Adam Gilden, David F. Williamson, and Henry A. Glick. "Direct Medical Cost
of Overweight and Obesity in the United States: A Quantitative Systematic Review."
Obesity Reviews : An Official Journal of the International Association for the Study of Obesity.
U.S. National Library of Medicine, Jan. 2011. Web. 16 May 2017.
<https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2891924/>.
(FAIR 1) "The Impact of the Opioid Crisis on the Healthcare System: A Study of Privately Billed
Services." Fair Health, INC., Sept.-Oct. 2016. Web. 16 May 2017
<http://www.fairhealth.org/servlet/servlet.FileDownload?file=01532000001g4i3>.
(Rowland;Lyons) Rowland, Diane, and Barbara Lyons. "Medicaid's Role in Health Reform and
Closing the Coverage Gap." ArticleOne. Journal of Law, Medicine & Ethics, Jan. 2016. Web. 16
May 2017. <http://dx.doi.org.ezproxy.monroecc.edu/10.1177/1073110516684790>.
(Polinski et. All) Polinski, Jennifer M., William H. Shrank, Haiden A. Huskamp, Robert J.
Glynn, Joshua N. Libeerman, and Sebastian Schneeweiss. "Changes in Drug Utilization during a
Gap in Insurance Coverage: An Examination of the Medicare Part D Coverage Gap." Public
Library of Science. Public Library of Science, Aug. 2011. Web. 16 May 2017.
<http://dx.doi.org.ezproxy.monroecc.edu/10.1371/journal.pmed.1001075>.
(Sanders 1, 2 & 3) "Medicare for All: Leaving No One Behind." Bernie Sanders. N.p., n.d. Web.
16 May 2017. <https://berniesanders.com/issues/medicare-for-all/>.
(Ryan 1 & 2) "Paul Ryan." BrainyQuote.com. Xplore Inc, 2017. 16 May 2017.
https://www.brainyquote.com/quotes/quotes/p/paulryan414988.html
(Kaiser) Luthra, Shefali. "GOP's Medicaid Plans." Kaiser Health News. Kaiser Health News, 27
Jan. 2017. Web. 16 May 2017. http://khn.org/news/block-grants-medicaid-faq/
(Maticonis) Mataconis, Doug. "State of Florida v. United States Dept of HHS." Scribd. Scribd,
n.d. Web. 16 May 2017. <https://www.scribd.com/document/39344827/State-of-Florida-v-
United-States-Dept-of-HHS>.
(Ungar 1) Ungar, Rick. "Socialized Medicine - 1798, John Adams." Forbes. Forbes Magazine,
19 July 2012. Web. 16 May 2017.
<https://www.forbes.com/sites/rickungar/2011/01/17/congress-passes-socialized-medicine-and-
mandates-health-insurance-in-1798/2/#4d0be28a5527>.
(Ungar 2) Ungar, Rick. "Thomas Jefferson Also Supported Government Run Health
Care." Forbes. Forbes Magazine, 16 July 2012. Web. 16 May 2017.
<https://www.forbes.com/sites/rickungar/2011/01/21/thomas-jefferson-also-supported-
government-run-health-care/#7b19b14d5324>.