To those outside of the United States, the current healthcare reform debate may be a perplexing or bizarre spectacle. To those who live in the United States, it is more than a fascination. The debate over healthcare reform is centered on the question of a citizen’s right to healthcare. While some conservatives claim that healthcare is not a right guaranteed by the state for every citizen, debt incurred due to medical bills is the leading cause of bankruptcy in the United States, raising other questions than entitlement.

While the mixed system of the United States is the most expensive in the world, spending a greater GDP per capita than any other nation, ironically remaining below the OECD median, it is the only wealthy industrial nation that does not insure all of its citizens.

Those in favor of universal healthcare reform cite the immense number of uninsured Americans generating indirect costs, which are then shared by everyone – coverage extended to all could lower costs and improve quality by the elimination of “middle men” and “profit seekers”. As approximately 60% of medical costs is already publicly financed, putting a federal system in place of individual spending could cut costs on the whole.
Opponents, conversely, tend to emphasize that people should be free to opt out of health insurance. They claim that government healthcare could eliminate market competition, or increase spending, as people may take advantage of free healthcare. One cannot help but notice that fear of alleged public inefficiency, rights to privacy and state power are what often drive conservative discussion.

President Barack Obama’s 2008 reform proposed to decrease premiums by 2,500USD for an average family, require health insurance for children, grant coverage regardless of health status and permit a private option, thus amounting to an estimated 60 billion dollars annually. While the original package was a publicly funded proposal, it was later changed to an insurance cooperative, due to congressional unrest and angry local town hall meetings, which even escalated to brandishing of firearms, arguments about constitutionality, and comparisons of Obama with National Socialism.

Americans do in fact generally support expansion of universal healthcare coverage as a top priority. Support for tax increases is more limited. While a large number of Americans report satisfaction with their healthcare, a growing 15.3% of the American population (45.7 million people) remains uninsured, often due to income limitations, as access to insurance occurs chiefly with employers. Estimates indicate that one fifth of the uninsured is able to afford insurance, one quarter is eligible for aid and more than the remaining half need assistance. But, there also is a population of five million Americans who are considered “uninsurable” because of “previously existing medical conditions”. Because of these “conditions”, no company will to extend coverage to them due to their costliness. A state of affairs such as this fairly screams of problems. Apart from the political debate of whether it is a governmental or “individual responsibility”, it is clear that rights and responsibilities have no sense for people who cannot use them – the chronically ill, dead or dying. “Freedoms” are not simply the presence of a “choice” between several “options”, but the reality and possibility of “choices” must be somehow guaranteed, if they are to be real. It is a terrible irony, that in fear of all embracing government coverage permitting no options, many Americans in fact subject themselves to the tyranny of the medical institution being arranged as though it ought to remain a business. |