Running Head: HEALTHCARE IS NOT A PART OF YOUR BILL OF RIGHTS

Healthcare Is Not A Part of Your Bill of Rights

Raymonta Green

Kennesaw State University

WellStar School of Nursing

NURS 7797: Health Policy

Dr. Diane Keen

October 8, 2023
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Introduction: Positives of Universal Healthcare

The ongoing debate over healthcare in America revolves around a question that has been

asked for ages: Should we ensure access to health and well-being for everyone regardless of

income? Healthcare advocates imagine a nation built on the principles of life, freedom, and

happiness. They stress that good health is essential for a thriving community and argue that when

people are healthy and free from burdens caused by expenses, they can pursue their goals more

effectively. Bloom et al. (2018) indicate that due to increasing wealth and the understanding that

a well-looked-after population can indicate a country's progress, universal healthcare is

becoming more popular in nations. In today's interconnected world, shouldn't America follow the

lead of nations by considering healthcare as a fundamental right rather than a luxury? However,

as with any issue, some oppose this perspective. Critics express concerns about the implications

of implementing universal healthcare. Zieff et al. (2020) summarize that one common argument

against healthcare is the potential for system inefficiencies, such as extended patient wait times

and limitations on medical entrepreneurship and innovation. This critique is not a one; it was

raised during the discussion surrounding the Health Security Act proposed by the Clinton

administration during his presidency. Critics labeled it as an example of government involvement

in the healthcare system. Will providing healthcare to all strain our resources? What if some

individuals misuse this service access—a privilege many have worked hard for? Transitioning to

such a system poses challenges and complexities. Could encompassing care result in a one-size-

fits-all approach that limits choices or dictates treatment priorities? It is important to remember

that healthcare is one aspect of our country's struggle for justice, personal autonomy, and a

healthier future.
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Economic Impact

Universal healthcare has implications, especially in a large and diverse country like the

United States. The initial costs associated with implementing a healthcare system can be

substantial. The transition requires investments in infrastructure, training, technology, and

regulation. These upfront expenses, funded by the government, often lead to increased taxes or

public debt, which can hinder growth or divert resources from vital industries. Zieff et al. (2020)

identify that critics claim that implementing healthcare in the United States is not feasible from

both financial perspectives. The expenses associated with such a system would vary based on its

framework, advantages, and extent of coverage. Several suggestions propose increasing taxes on

incomes and payrolls for individuals with earnings. However, independent analyses indicate that

these tax plans might only partially fund the strategy.

Additionally, estimates suggest that adopting this approach could cost trillions of dollars

over ten years. Moreover, the shift from a healthcare system may result in job losses for experts

working in private health insurance and medical billing sectors, causing disruptions to the

economy. This can lead to inefficiencies and price increases within the system. Furthermore,

cutting-edge therapies and technology advancements may decrease without the profit-driven

motivation that has traditionally fueled research, development, and innovation in a business-

oriented model. As patient demand continues to rise under healthcare systems, there is a

possibility of facing financial constraints. This could result in care rationing measures being

implemented along with wait times for treatment and lower quality of care.

These challenges can strain a nation's economy due to spending on healthcare services

and indirect effects such as impacts on employment opportunities, innovation levels within the

industry, and overall public satisfaction.

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Healthcare System Abuse

One of the risks associated with implementing healthcare is that it may inadvertently lead

to system misuse, potentially straining resources and compromising the quality of service. When

healthcare is available to everyone for free or at a cost, some individuals may take advantage of

it by seeking medical treatment regularly. This behavior can result in increased healthcare

expenses. Longer waiting times for those who genuinely require treatment. Lyu et al. (2017) state

that waste in the healthcare system is becoming increasingly associated with harm to patients and

increased spending. According to the Institute of Medicine, unnecessary treatments contribute to

a portion of the estimated one trillion dollars in healthcare expenditures in the United States.

Concerns about malpractice and patient requests primarily drive overtreatment. Misusing

antibiotics, use of tests, and unnecessary surgical procedures often cause patient harm.

Moreover, healthcare providers might be tempted to exploit a system by overcharging

their services or engaging in practices to secure more funding from the government. Such

unethical actions can divert funds from those who genuinely need them. Additionally, there may

be incentives within such a system to provide care or opt for treatments that may be less effective

to minimize costs, thus compromising the quality of care. Glynn (2022) outlined that corruption

within the healthcare industry can affect government institutions and direct care providers. The

factors contributing to health sector corruption vary from country to country. As a result,

measures taken to combat corruption in one healthcare system may only sometimes be effective

in another due to differences in incentives, accountability structures, enforcement systems, and

socio-economic and political contexts. Balancing provider behaviors—avoiding overuse and

underuse—is crucial for maintaining an efficient and effective universal healthcare system.
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Transition Challenges

Transitioning from a healthcare system to a government-run universal one comes with

several challenges that can impact the continuity, quality, and accessibility of services. Firstly,

coordinating the organizations involved in healthcare, such as hospitals, clinics, pharmaceutical

companies, and insurance providers, under one entity can be demanding. This may require

revising billing mechanisms, retraining staff, and establishing regulatory bodies for monitoring.

Economic consequences are another aspect to consider. The private health insurance industry

employs several individuals who could face job losses if the government takes over. Healthcare

professionals' income and job satisfaction might also be affected as they adapt to changes in

remuneration arrangements. Crowley et al. (2020) state that shifting to a single-payer healthcare

system could lead to debates and financial challenges as taxes would likely replace premiums,

and insurers' roles could be eliminated. Such a transition would have winners and losers within

the healthcare sector. Patients might face access to doctors and hospitals if insurance companies

and medical facilities create networks. The continuity of care may also be at risk if various types

of coverage, such as marketplace plans, Medicaid, and others, are merged into a public plan.

Moreover, patients might experience disruptions in their care due to provider shifts or the

introduction of treatment approaches. Confusion and misinformation during this transition could

lead to delays or misunderstandings between patients and doctors. Additionally, the existing

healthcare system might face strain due to an influx of patients, which could result in staffing or

facility shortages. Lastly, it is crucial to recognize opposition at intellectual levels. After

spending time working within the healthcare system, several stakeholders may resist change due
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to their deep-rooted beliefs about healthcare services, patient accountability, and the

government's role.

Prioritizing and Rationing Care

While the idea behind healthcare is commendable, it is essential to consider the

unintended consequences that may arise from the challenge of prioritizing and limiting

treatments. Rationing involves allocating healthcare resources based on factors like urgency,

potential benefit, or cost-effectiveness, and then patient preference or need becomes a concern.

One primary worry is that due to resource constraints, patients might face delays in receiving

treatment for conditions deemed "nonurgent," potentially leading to severe health issues in the

future. For example, individuals may experience longer waiting times for surgeries or specific

diagnostic tests, causing stress and inconvenience. Furthermore, ethical dilemmas emerge when

life-saving therapies or medications are limited based on age, overall health status, or perceived

usefulness under rationing circumstances. Rooddehghan et al. (2016) make the main point that

rationing nursing care poses a dilemma as it involves assessing the value and making judgments.

Two categories of nursing services were subject to rationing. The first category encompasses the

needs and demands of patients' routine care and particular status patients. The second category

comprises aspects such as nursing care, patient dissatisfaction, and nurse feelings of guilt. This

approach could inadvertently foster a mindset where a "one size fits all" approach overrides each

patient's requirements, preferences, and medical history. Consequently, patients may be denied

access to medicines or procedures that have the potential to save lives but do not meet the

predetermined criteria of being considered "cost-effective" within the system.

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In a world where individuals are faced with the challenge of making healthcare choices based on

resources rather than solely on medical need, the subjective nature of determining what qualifies

as "essential" or "nonessential" care can result in disparities, possible prejudices, and erode

public confidence, in the healthcare system.

Patient Limitation in Freedom of Choice

Patients often express concerns about their rights to choose their healthcare providers,

specialists, and treatment options when it comes to healthcare. In a government-operated

healthcare system, prioritizing cost-effectiveness and overall population health outcomes

sometimes takes precedence over patient preferences. Consequently, patients might only

sometimes be able to select their preferred doctors or specialists. Instead, healthcare

professionals may be assigned based on proximity, availability, or other bureaucratic criteria.

This can be particularly distressing for patients who have developed relationships with their

long-term physicians. Zolkefli (2017) digests the importance of the ability of patients to make

decisions and communicate them effectively. Having them respected by others is crucial for a

sense of value. Therefore, patient's choices hold significance. This is important because if

patients feel threatened by their condition, their desire to maintain control becomes paramount.

Refraining from disregarding or undervaluing preferences may result in them losing trust and

potentially ignoring advice, jeopardizing their health and the effectiveness of their treatment.

Additionally, paying attention to preferences is essential as it can provide insights into factors,

like fears or unfamiliar beliefs, that healthcare professionals should consider when interacting

with patients. Additionally, specific treatments or medications may be chosen over others based

on effectiveness and cost considerations to reduce healthcare expenses. It is essential to consider

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experimental therapies well; these may not be readily accessible through a universal system until

they have been proven cost-effective or are undergoing further study. Individuals with diseases

and those interested in treatments may find this particularly frustrating.

Lastly, when patients feel that they no longer have control over their healthcare decisions,

they can start perceiving themselves as individuals with specific needs and desires and more like

interchangeable components of a more extensive medical system. The potential loss of autonomy

can affect satisfaction, trust, and, most importantly, adherence to medical advice or treatments.

This, in turn, can impact health outcomes.

Conclusion

The debate surrounding healthcare in America raises a timeless question: Should

healthcare be accessible to all as a right? Should it be limited to those who can afford it?

Advocates argue that universal healthcare is essential for progress, while critics express concerns

about inefficiencies and a potential decline in innovation. The economic implications of

implementing healthcare in a country like the United States add another layer of complexity. The

substantial financial commitments required may necessitate tax increases, strain resources, and

impact sectors such as health insurance, potentially leading to job losses.

Moreover, there is apprehension regarding abuse of the healthcare system through

treatments that could burden resources. Transitioning from healthcare to a universal system

presents challenges that could affect the continuity and quality of care. Additionally, prioritizing

and rationing treatments may lead to waiting times and ethical dilemmas regarding who receives

which care and when. A shift towards healthcare may limit choices and undermine the doctor-

patient relationship and individual autonomy in making healthcare decisions. In summary,

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although achieving healthcare is commendable, it is crucial to consider the numerous challenges

and complexities involved along this path.

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References:

Bloom, D. E., Khoury, A., & Subbaraman, R. (2018). The promise and peril of universal health

care. Science, 361(6404). https://doi.org/10.1126/science.aat9644

Crowley, R., Daniel, H., Cooney, T. G., & Engel, L. S. (2020). Envisioning a better U.S. health

care system for all: coverage and cost of care. Annals of Internal Medicine, 172(2_Supplement),

S7. https://doi.org/10.7326/m19-2415

Glynn, E. (2022). Corruption in the health sector: A problem in need of a systems-thinking

approach. Frontiers in Public Health, p. 10. https://doi.org/10.3389/fpubh.2022.910073

Lyu, H., Xu, T., Brotman, D. J., Mayer-Blackwell, B., Cooper, M. A., Daniel, M., Wick, E. C.,

Saini, V., Brownlee, S., & Makary, M. A. (2017). Overtreatment in the United States. PLOS ONE, 12(9),

e0181970. https://doi.org/10.1371/journal.pone.0181970

Rooddehghan, Z., Yekta, Z. P., & Nasrabadi, A. N. (2016). Ethics of rationing of nursing

care. Nursing Ethics, 25(5), 591–600. https://doi.org/10.1177/0969733016664973

Zieff, G., Kerr, Z. Y., Moore, J. B., & Stoner, L. (2020). Universal healthcare in the United States

of America: A healthy debate. Medicine-Lithuania, 56(11),

580. https://doi.org/10.3390/medicina56110580

Zolkefli, Y. (2017). Evaluating the concept of choice in healthcare. The Malaysian Journal of

Medical Science, 24(6), 92–96. https://doi.org/10.21315/mjms2017.24.6.11