When you ask any American or non-American person, what they think about America’s culture, we often hear something like “America is a Melting Pot.” United States of America has been described as “melting pot” because it resides several cultures, races and religions to fabricate its own modern culture. The imperative characteristics about American culture is the suitable to free will and the ability to make individual choices with limited intervention from the Government; some define it as, “Classical Liberalism” or just “Liberalism.”

In present day America, a proposal for a National Health Insurance is a considerable debate on whether the integrity of an American’s lawful to choose is under threat or whether it is actually preserving Liberalism as defined by President John F. Kennedy, “If by a “Liberal” they mean someone who looks ahead and not behind, someone who welcomes original ideas without rigid reactions, someone who cares about the welfare of the people — their health, their housing, their schools, their jobs, their civil rights, and their civil liberties — someone who believes we can break through the stalemate and suspicions that grip us in our policies abroad, if that is what they mean by a “Liberal,” then I’m proud to say I’m a “Liberal.” ¹

In an article published in Wall Street Journal [WSJ] on April 12, 2009, “The End of Private Health Insurance,” the author gives an insight in to how implementation of National Health Insurance can affect the people in America.² The dispute of the article should appeal to every American, however as this article appears in the WSJ one would pick that in order to interpret and relate to author’s point of view the audience should be familiar with the basic information regarding the existing role of Medicare and private health insurance companies in the health care system.

This article refers to National Health Insurance as “public option,” an insurance program which is essentially financed by the taxpayers and managed by the Government; also this option is open to everyone. The author conveys his position on this debate whether this Insurance policy really is modest and affordable or a threat to taxpayers’ individual choice in an distress to cover the uninsured by highlighting these points below:

1) National Health Insurance will become default coverage for the uninsured Americans.
2) It will compete with the private insurance companies.
3) Overall spending will be controlled over time by paying less for medical services, drugs and technology.
4) The hospitals and clinics will be reimbursed on a fee schedule basis; with the idea of “take-it-or-leave-it.”
5) Allows people who are happy with their current insurance policies to keep it.

So what does all this translate into? What does it mean for the people who are uninsured? What does it mean for the people who are currently insured through private insurance companies? How will this help the hospitals and current deteriorating economic situation? Is this really in the best interest of the American society? Is it fair that America is proceeding towards what’s called Socialized Medicine?

If Congress adopts this “public option,” the taxpayers will be forced to pay more taxes in order to mask the uninsured and there will be relatively low premium rates for enrollment due to access to the national treasury as compared to the private insurance rates. Therefore, private insurance companies will be obligated to offer benefit packages similar to those offered by the public insurance. Depending on the payment levels the congress adopts, the Lewin Group in a recent analysis predicted that a 131 million people will enroll in public option and 119 million people will shift out of or lose private coverage. The Lewin group is a consulting company that provides solutions for the issues related to health care and human services. It serves the public agencies, non profit organizations, industry associations and private companies in Unites States.³

As far as the hospitals and physicians are concerned, they will not be able to deny the amount of reimbursement which is offered to them, which could result into cost shifting by accepting fewer patients at a given time. This in turn could mean that patients will have to wait to see their doctors and wait in queues to have procedures like MRI and Hip replacement for example. This could also mean that hospitals may have to cut down on employees if the patient traffic reduces and if overall income reduces at a given time. It is crucial to warn the public that any plan which provides universal coverage will force the government to curtail the spiraling cost of health care. This will result in limitations in physician choice, beget long delays in diagnosis and treatment and ultimately lead to widespread rationing of health care.⁴

It not only affects acute care settings and primary care physicians, it affects greatly to the profession of Physical Therapy. As patients wait in lines to go through common procedures such as total hip replacements, the degenerative disease progresses and patients characterize deterioration of Quality of Life. Moreover, the post surgical prognosis is worse in patients who get operated on in the later stage of the disease as compared to the patients who get operated early on in the disease process.⁵Besides the surgical interventions, as patients wait to see their distinguished care physicians to get referrals for physical therapy, acute episodes of low back pain for example may already have progressed in to chronic conditions; which not only affects the rehabilitation prognosis but also affects psychological aspects, activity level and over all Quality of Life.

Some scholars debate on whether the National Health Insurance proposal is a step towards Socialized Medicine or if it remains inconclusive from its accessible definition. “Socialized medicine” refers to health system in which the government owns and operates both the financing of health care and its delivery.⁶ The investigation of this definition suggests that classic socialism involves government or collective ownership of the means and distribution of production; hence truly socialized medicine doesn’t exist anywhere in the world.However, it would be valid to argue that America’s health sector is already more than half socialized because government purchases 46% of all medical care. Therefore, technically socialized medicine can be defined not based on how much is spent on the medical care but who decides.⁷

The intent of the National Health Insurance policy may be to practice Liberalism as defined by J.F.K and an act of benevolence by American government, however in an effort to provide coverage to the medically uninsured population the disadvantages in adopting this policy has a substantial triumph over its advantages. Ultimately, it is up to an individual’s discretion whether to support or not to support the public option from the obtainable facts by media and literature.

References

1. Modern Liberalism in the United States. . http://en.wikipedia.org/wiki/Modern_liberalism_in_the_United_States. Accessed May 15, 2009.

Classical liberalism. . http://en.wikipedia.org/wiki/Classical_liberalism. Accessed May 15, 2009.

2. The Raze of Private Health Insurance- When government ‘competes,’ guess who always sins? The Wall Street Journal. April 12 2009.

3. The Lewin Group. . http://www.lewin.com/WhyLewin/AboutUs/. Accessed May 15, 2009.

4. Dr R. Scott Wright. Both Sides: Let the buyer beware of universal health insurance. Post-Bulletin. 2009.

5. Marieke Ostendorf MSc, Erik Buskens MD, PhD, Henk van Stel PhD, Augustus Schrijvers PhD, Louis Marting MD, Wouter Dhert MD, PhD and Abharam Verbout MD, PhD. Waiting for total hip arthroplasty: Avoidable loss in quality time and preventable deterioration. The Journal of Arthroplasty. 2004;19(3):302-309.

6. Uwe E. Reinhardt. What is ‘Socialized Medicine’? : A Taxonomy of Health Care Systems. The New York Times. 2009.

7. Michael F. Cannon. Does Barack Obama Support Socialized Medicine? . The Cato Journal. 2008.