By: Selina Chao
Jill Quadagno set out to understand that the United States has no National Health Insurance is due to multiple effects from private sectors, and it’s not merely due to the government’s inability. Most Western industrialized countries, except the USA, guarantee health coverage and essential health –care services to their citizens. Without National Health Insurance, poor people and people with illness will suffered not just physically, but also financially. The author set out three main purposes in this article. First, he wants to point out the variety of hardships and problems faced by people who live without health insurance in the USA. Second, he want to show how the inefficient health care system came to be after decades and the possible reasons that lead to the failure of the advocacy of the National Health Insurance in the USA. At least, he wants to use the political histories to provide some repeated evidences of the applied pressures made by physicians and private insurance companies on the USA health care system.
In the USA, poor people and people with illness can hardly survived in the society with the pressures and discrimination applied by the private health insurance companies and the tremendous amount of medical money charged by health care system. Private insurance companies are market-based and want to make as much profit as possible from the health care system. Private insurance companies discriminate against people that have high risks occupations or chronic diseases. They try to lessen their expense by refusing to pay for the health problems patients are most likely to have. For example, patients with an abnormal pap smear have to pay 3000 dollars per year, but if her illness develops into cervical cancer, then her health insurance will not cover any of the cost. It seem not surprised to me at all for such difficult circumstance, as I already read about a lot of similar circumstances experienced by patients in the previous articles, I feel really sad and sympathy for all the patients met such cruel circumstances. For me, I think that people who have multiple illness and cancer have to spent lots of money to buy insurance, and then they have to pay the treatments for their cancer out of pocket. How can individuals with part time jobs or disabilities pay for all those expensive medical bills? For example, people might only have a small illness, but due to a lack of coverage by health insurance company are not willing to cover it, people may avoid treatment, and their diseases will develop into more serious conditions that would require even greater expenses. People who don’t have insurance will meet the same fate. First, they will be less likely to visit doctors compared to people who purchased insurance. Second, they will less likely to have family doctors, and they will have less opportunity to receive preventive health services. For those who are uninsured and have children, their children will be uninsured too. Children without insurances will be less likely to receive regular care or receive basic immunizations and are more likely to be hospitalized for an illness.
Antistatist values, weak labor, racial politics, the effect of American political institutions, and the legacies of past policy decisions might be the reasons lead to an effect on the failure of the advocacy of the National Health Insurance. The author points out many different types of factors that might lead to the failure of the advocacy of National Health Insurance. First, he thinks that health policy experts might hold antistatist values. From 1910s till now, there have been multiple presidents who tried to advocate some modification on health insurance plan and try to make it more available to all the citizens, but there are always some organizations such as AMA or AALL campaign that undermine the support for those modification. Those organizations will create a variety of different excuses to explain why they have to decried the modification. For example, many have argued that Truman’s national health insurance plan might lead to creation of health bureaucracy and might end up to takeover by communists. However, the author think antistatist values is not the major causal force, because Medicare was successful established. The author believes that weak labor movement might be unable to mobilize the working class. Weak labor force are usually due to the restrain made by the owner. For example, the largest trade unions like AFL didn’t allow their worker to form labor party, for AFL was afraid that the formation of labor party might lead to pursue of higher wages and better working conditions. The companies will want to restrict the influence of the workers by so the workers have no direct way to influence policy decisions. However, when AFL and CIO formed a single union, the workers mobilized for the Disability Insurance and then for Medicare, this show that the success to support the health modification don’t really have to form political party. Thus, the author think that weak labor force can’t be accounted to the major cause leading to no national health insurance. Third, the author think racial politics of the South might lead to some pressure in the health care system. As is well known, southern states have more health care facilities with racial barriers that separate white and colored patients from the past, even though the enactment of Medicare force southern health-care facilities to integrate, but the racial dynamics has not disappeared completely. According to the author, Black or minorities groups might have harder access to job-based benefit, so it will lead to a secondary effect of employment. Many facilities worry about the health care benefits received by minorities group and will resist modification to the health care system. Fourth, the author think state structure and policy legacies have some effect of the health care system. For example, Medicare will benefit senior citizens and will subsequently be primed to oppose any benefit cuts or tax increases. But how can Medicare overcome the opposition from the hospital industry? Thus, institutional theorists cannot predict the direction of policy decisions, due to a variety of groups that have different ideas in mind and can hardly integrate into an actual policy decision. Although all the explanations, above made by the author, try to explain the reasons that there is no health insurance in the USA, and have some effects on the opposing of the health care modification, none of them are the major effect on the failure of the advocacy of the National Health Care.
Physicians and private insurers are primary impediment to the creation of national health insurance. From multiple pieces of evidence in the article, whenever there are presidents that try to promote the health care systems, there will always have some organization trying hard to undermine the modification. The major opposition force came from physicians and private insurance companies. For physicians, they are important key in supporting the elected official in the government, and thus, they have the ability to convert their preferences into the negative votes on the health care modification. The physicians in the USA are also market-based much like the private insurers. The private insurers may prevent the modification of the health care system, so they can increase profit by charge higher premiums for those people that are likely to be ill and not cover anything when people has cancer. However, even though physicians and private insurers have the ability to oppose the National Health insurance, there is still some bright hope that might modify the current USA health care system. For example, the successful establishment of the Medicare makes reformers feel more optimistic about the prospects for National Health Insurance. Although I know that it will be hard to changed the current health care system, because the opposition cycle will repeat, but we still have to try to reform it. Or else it will not just affect the poor people and people with ills, but also their children and their offspring. This kind of misery endless cycles will keep repeating and eventually hurt the USA as a whole, because every citizen in the USA matters. Although the US is generally considered the greatest country in the world, other countries such as Germany, Canada, and the United Kingdom have better health care system compared to the USA. If the USA still ignoring those health care system problems and continue to focus on profit not health outcomes of people, the country will be weakened. If USA didn’t organize a good Health Care System, then how can it remain the most leading country in the world?
Citation
Quadagno, Jill. “Why the United States Has No National Health Insurance and What Can Be Done about It.” Oxford University Press EBooks, 9 Oct. 2006, pp. 201–214, https://doi.org/10.1093/acprof:oso/9780195160390.003.0009. Accessed 4 Sept. 2023.
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