Five strategy innovations to redefine the debate surrounding baseline national health coverage in the United States

Jennifer M.

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Five strategy innovations to redefine the debate surrounding baseline national health coverage in the United States

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Abstract

Healthcare is the single most pressing domestic issue in American politics. Over 45 million Americans are uninsured; likely twice that are underinsured. 80% of the uninsured are workers, or live in families with workers. Extensive work has documented the market failure related to health insurance and access to healthcare. A multitude of proposals as to how to change the system exists; the political will and organization to close this gap currently does not exist. As with most services, the government has a role to play in securing access and coverage where the private market is unwilling or unable to provide that product or service to segments of the population. This does not hold, of course, for all products and services; the government should not be in the business of insuring all Americans have access to Playstations. It does hold, however, for goods and services that are considered rights or benefits of living in the United States. The post office is a good example of a service that exists at a reasonable rate and can be accessed by all Americans. This is not because UPS or DHL could not take over the job of reaching all Americans, it is that they simply would not, because there is little money to be made delivering a handful of letters and bills in Gnome, Alaska.

Introduction.
Efforts made towards baseline access to healthcare.
Creation of a social movement.
The opportunity to change the tone surrounding healthcare reform.
Political organizations.
1. The language of the opposition.
2. The first step towards creation of the relevant moral arguments.
3. The second pillar of arguments against universal coverage.
4. The role of policymakers.
5. Examples of successfully moving a political issue into the sphere of moral relevance
Grassroots movements.
1. Focus on the specific demands of the advocating group.
2. Grassroots organizations.
3. Leverage points that policy makers and health care consumers must act upon.
Conclusion.

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[...] Ahead of the United States in this category include countries like Cyprus, Czech Republic, Slovenia, and Malta countries currently have a higher life expectancy than the United States.[xii] The final of critical language to topple will be the notion that a guaranteed baseline healthcare system that cares for all people tilts the American political sphere towards ‘socialism'. This straw man was initially established in the 1920s, when Harry Truman first attempted to pass a comprehensive national healthcare package. Physicians and medicine men jumped onto the fear-mongering bandwagon out of fear that the autonomy of the profession would be squelched. [...]

[...] For Ford, it is the burden of providing healthcare to retirees; for Toyota, it is recognition that placing plants in Canada instead of the United States saves per worker per hour in healthcare costs.[iii] The employer based model for supplying healthcare is incredibly outdated. Such a system was established during a wage freeze in World War II. Because employers could not offer more cash, they began to offer benefits in place of raises to entice workers. Businesses have changed; why has the structure for insurance stayed the same? [...]

[...] A collective voice agitating for baseline healthcare coverage for all will be heard, picked up, championed by the media as a moral cause, and rewarded by a shift in the policy arena. Oberlander, J. The US healthcare system: on a road to nowhere? CMAJ 2002; 167(2):163-168. Pellegrino, ED. The commodification of medical and health care: the moral consequences of a paradigm shift from a professional to a market ethic. Journal of Medicine and Philosophy. 1999;24(3): 243-266. [iii] Erwin, Steve. Toyota to build 100,000 vehicles per year in Woodstock, ONT starting in 2008. [...]

[...] The Service Employees International Union has taken on healthcare as the central concern of its members.[ix] Physicians for a National Health Program have increased their efforts to recruit members to their organization to become politically active.[x] The three top Democratic candidates for President have cited baseline coverage for all Americans as a core aspect of their platform.[xi] The data and the options have been stated clearly. It needs to be supported by well established moral arguments that have been ineffectively applied in this arena. [...]

[...] The second pillar of arguments against universal coverage that can be attacked by advocates of baseline availability is the notion of autonomy and excellence in American healthcare. There is an old prevailing myth in American politics regarding an by your bootstraps' mentality that those who are truly able ought to be able to access care and services, and that those who are truly unable will be cared for by the society. These notions are simply unrealistic, and need to be dispensed with by data recognizing that Medicaid only reaches 40% of the poor and that Medicare is destined to go broke if the retirement age remains at 65 years of age.1 Furthermore, the reality of our system is that the government is already paying half of the healthcare costs in the country through a system that is fragmented and often delivers care of suspect quality. [...]

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