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St. Thomas Law Review

First Page

1013

Document Type

Article

Abstract

The United States is the sole remaining Western democracy to continue to allow a large "percentage of its population to go entirely without health insurance coverage." The world is left to ponder why and how the most affluent nation on the planet can continue with a health care system which is unable to contain costs and leaves over forty million citizens with no health insurance and millions more with inadequate coverage. The failure of the nation's health care delivery system continues to plague the United States in the twenty first century as one of the nation's most important unresolved social problems? Economic feasibility is often cited as the largest obstacle to enacting meaningful reform. What about the nation's massive budget deficit? What about skyrocketing Medicare and Medicaid costs? How can we even imagine paying for something as monstrous as universal health care? "The argument that 'we simply can't afford it' states the problem backwards. What we are affording, but do not want, is the system we now have.'" The United States currently leads the world in health care spending. National health expenditures were 1.3 trillion dollars in 1998, representing 13.5 % of the Gross Domestic Product. Although U.S. per capita health care spending was between sixty nine percent and 174 % higher than that of other developed countries in 1992, the United States ranked eighteenth for life expectancy among females and twenty three for males. Americans spend more money on health care than anyone else. Americans spent an average of $4,095 per person on health care in 1997, substantially more than in other industrialized countries, such as Switzerland ($2,611), Japan ($1,760) or Great Britain ($1,391), countries having lower infant mortality rates and higher life expectancies than the United States. On a worldwide scale, in 1992, "the United States rank[ed] twelfth... in life expectancy, twenty-first in the number of deaths of children under age five, twentysecond in infant mortality, and twenty-fourth in the... [number] of babies born with adequate birth weight." Not only do we spend the most, but our health care expenditures continue to rise at astronomical rates. While inflation consistently remains at three to four percent, health care costs increase at a rate of five times that." Therefore, the question is not whether we can afford reform since our current spending levels on health care would be more than enough to finance a reformed universal system, nor should there be a question of whether we need reform. The current health care delivery system's skyrocketing costs if left unattended will cause economic disaster. Instead, the inquiry should turn to how we can contain costs and reduce spending while at the same time providing health insurance to everyone else. This article will be broken down into three segments. Part I will consider why we must reform the health care delivery system in America. This segment will discuss the moral obligations involved with health care, whether access to health care is a fundamental right and the dire financial and economic consequences which will continue to balloon if the present health care delivery system is not reformed. Part II will discuss the obstacles most often cited in opposition to universal health care and health care reform. Impediments such as supposed economic inability, fear of government involvement, opposing political interests being too powerful to overcome, and the fear that universal health care will result in substandard health care will be addressed. Part Ill will discuss what types of reform are economically and politically feasible, what we can learn from other western democracies that provide universal health care, and finally a health care plan that can work in today's political and economic climate.

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