Ideological Perspectives

1
The American Health Care Dilemma
Ideological Perspectives
Ideological Perspectives
2
Health Care in the United States is Expensive.

The U.S. spends twice as much as other developed
countries on health care.

3
The United States does not provide universal
health care.

• The U.S. is the only affluent country that does
  not offer universal
• health care.
• The U.S. spends 100 billion per year on health
  services for the uninsured.

4
A large portion of health care in the U.S. is
provided by tax subsidized, employer based health
insurance.
174 million Americans receive health care
benefits through their own, their spouses, or
their parents employer.
5
Employment based health insurance coverage is
dropping.
The percentage of people with employment based
health insurance has dropped from 70 in 1987
to 61 in 2004.
6
Premiums under employer based health insurance
are high.
Between 2000 and 2003, the median family income
fell 3. Health insurance premiums rose 10.9 in
2001, 12.9 in 2002, 13.9 in 2003, and 11.2 in
2004.
7
Many Americans purchase health care on their own
or qualify for government programs such as
Medicaid or Medicare.

• 27 million Americans purchase individual health
  
• insurance.
• 40 million elderly and disabled are enrolled in
  
• Medicare.
• 38 million poor are enrolled in Medicaid.

8
Health care costs are paid mainly through health
insurance or government, contributing to medical
inflation.

• Doctors are paid for individual services so they
  
• are financially rewarded for performing
• unnecessary treatments.
• Patients are not adequately informed
• of the cost of treatment.
• Patients and doctors have no need to control
  costs.

9
Medical inflation is also fed by the
administrative costs of the health insurance
system.

• 47 of medical field
• staff is clerical.
• Since 1970, the supply of
• physicians has gone up 60
• while the number of medical
• administrators has gone
• up 500.

10
The Classical Liberal Perspective

• Markets will bring perfect information to
  consumers and sellers
• Health care should be operated as a free market,
  with no government intervention
• Our current system causes a moral hazard

11
You Get What You Pay ForBut Not in this Case
12
Classical Liberal Solution

• The universal tax credit policy would give
  Americans the freedom to choose their own health
  insurance, whether fee-for-service plans, HMOs,
  or MSAs. Individuals would also be free to
  purchase their health insurance individually
  through their employers or through professional
  associations, churches, or labor unions
  (Blevins).

13
The Future of Health Savings Accounts
www.celent.com
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(No Transcript)
15
The Keynesian Liberal Perspective

• Health care in the U.S.
• is a distorted market.
• Market distortions make health
• care in the U.S. highly inefficient.
• Health care is a second best market.

16
The Keynesian Liberal Solution

• Single Payer Plan
• The single payer plan provides universal
• coverage.
• Health care facilities remain
• in private hands.
• The government acts as the single payer,
• collecting taxes and distributing money to
• fund health care facilities.

17
Who Should Have Health-Care?
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the first "language" of American culture is
individualism. This language centers on values
such as freedom, self-determination,
self-discipline, personal responsibility, and
limited government. The language is easy to use
since "it taps into values reinforced by dominant
societal myths endlessly repeated in the popular
culture." In contrast, there is a second language
of community rooted in egalitarianism,
humanitarianism, human interconnectedness, and
social responsibility
19
A Structuralist Solution
Primary health care, including public health
and prevention, must be the cornerstone of the
health service system. All financial barriers
to primary health care access must be
eliminated. A comprehensive, integrated, health
status information system, incorporating both the
public and private sectors, must be developed.
20
Resources For Further Study
www.cato.org www.economist.com www.primarycareso
ciety.org One Nation, Uninsured by Jill
Quandagno Physicians Working Group/www.kaisernet
work.org The American Prospect/www.prospect.org