How the US Health Care System Will Look in Ten Years
A quick perusal of current literature and media on the U.S. healthcare system is truly an eye-opening experience. Where one might expect number crunching and cold, rational arguments, what is often apparent instead are agendas: personal agendas, corporate agendas, political agendas. It is quickly becoming impossible to carry on a real discussion of the state of our healthcare system without encountering these various agendas and the prejudices and assumptions that come with them.
The prevalence of such agendas leads to broad assumptions and generalizations about both current and future health care policy that have little basis in reality. Some want you to believe it represents universal government-sponsored health coverage or that it requires every American to buy health insurance (it doesn't). Others want you to believe it is a major, decisive step forward in reforming the health care system (hardly). Others still would have you believe that it is destined to drive the country into bankruptcy, or that it will be THE major factor in balancing the federal budget (wrong on both accounts). Understanding what the current healthy policy both is and is not will help us to grasp what our healthcare system might look like ten years from now.
What Obama's health care plan is really all about, whether we agree on its methods or not, is finding some way to make health care affordable for more people in America. By requiring more people to carry insurance (with the caveat that each state can choose to opt out), the plan hopes to enroll more healthy people in health insurance plans, which helps to keep the premiums lower. Expanding Medicare and Medicaid, while a controversial step, is intended to make sure that hospitals and pharmacies are receiving funding, instead of just treating uninsured patients, which also drives up the cost for everyone else.
Meanwhile, the "long-term" plans to provide government-sponsored health insurance as an alternative to private insurance for those who cannot afford it is an attempt to make sure the middle-class is not squeezed out by rising premiums; it is also a way to introduce competition that represents a suppressive downward force on prices in the rest of the market.
Critics of the plan agree on the problems, but disagree on solutions. Some suggest a voucher system which allows free choice, or encourage further deregulation of the market coupled with Medicare and Medicaid cutbacks. Many criticize the assumption that government need provide solutions to health care at all, noting that our health care became, for a time, the best in the world precisely by relying on the free market to increase the quality of service and care. They point to the inefficiency and poor quality of some government-run health care programs and claim that such programs provide substandard care.
In any case, it seems the problems most often agreed upon are: rising costs for care; rising premiums; an increasing number of uninsured; the expansion of "preexisting conditions" to a level that leaves many unable to become insured; and inconsistency in how hospitals treat policies. To discuss how these problems might or might not be dealt with is to discuss what our health care system will look like ten years from now.
The benefit of continuing down the road of Obama's plan ten years from now could be a system that looks much healthier than today's. One can envision a system in which virtually all of Americans have health care, in which public and private options work together seamlessly to ensure both reasonable coverage and respectable care. In this scenario, the health care plan pays for its expansion of the government's role by the sheer amount of money pouring in from requiring more healthy people to be insured. The influx of cash, the theory goes, also aids the private sector in keeping premiums low. In the end, crisis has been averted, and Americans who can afford private insurance can keep their plans, while those in need will always have a place to turn. Eventually, even private companies may begin offering lower-priced plans in order to draw more customers away from the government, creating a healthy downward pressure on prices.
The downside of this plan, however, could be frightening. It is possible that too many states opt out of the required insurance, meaning that there is no new money to pay for the increases in Medicare and public funding. This could lead to the collapse of Medicare, which would leave million more Americans uninsured. The lack of a public option and healthy policy owners might lead companies to become even more mercenary as a result, leading to even higher premiums and stricter conditions. In short, we would be left with even bigger versions of the problems we currently have, and would be forced to go back to the drawing board in order to totally revamp our system. In order to avoid this happening, states would have to buy into the system.
If we are to continue down the current path, or follow some other vision laid out by future leaders, we must remain committed, unified, and willing to compromise and listen. If the next ten years in this debate are as contentious and full of agendas as the last ten, then we're going nowhere.
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