Health Care and Human Rights

Health Care and Human Rights

Introduction

The American Bar Association defines healthcare as the most fundamental and intersectional human right. The right to health is recognized as an essential human right in Article 25 of the Universal Declaration of Human Rights and Article 12 of the International Covenant on Economic, Social, and Cultural Rights (Gerisch, n.d.). Healthcare should be protected as a public good due to the frailty of human bodies and human lives. Governments everywhere should guarantee universal healthcare to enable the most marginalized and vulnerable population segments to lead lives of dignity.   A comprehensive healthcare system should be available to all people inside a country by making it economically accessible to avoid discrimination. The right to health is not fulfilled in the United States, which only provides a health insurance system instead of a holistic health care system. This essay examines the issue of health care and human rights in the United States in relation to single-payer systems, health insurance companies, cost per individual for a particular treatment, transparency of costs, and current coverage by a national system.

Single-payer systems

Single-payer systems refer to national health care systems that provide health insurance for all citizens and residents in a country. Single-payer systems provide “Medicare for all” through the organization of healthcare financing by a public agency (Elkins, 2018). All residents are provided with a medical cover for all essential services, including prescription medicine costs, vision, dental, reproductive health care, mental health, long-term care, preventive care, hospital, and doctor services (Gerisch, n.d.). The United States does not have a single-payer system. It is the only developed democratic country that lacks a universal healthcare system. In all other rich democratic nations, all individuals are covered by public insurance programs or receive care directly from government-run health insurance programs Elkins, 2018).  Single-payer systems are crucial in securing the right to health care as they keep costs down because there is no need for private health insurance bureaucracy, and the government can negotiate and regulate the price of medical services and drugs.

The Affordable Care Act is considered a key milestone in securing health care access in the United States, but 30 million people are still uninsured as it is not a single-payer system (Elkins, 2018). The lack of a single-payer system means that the United States spends more on healthcare than any other country in the world, but still has poor health outcomes among its population. The push for a single-payer system is a significant plank of politics and elections in the United States. Various Democrats, such as Bernie Sanders, have made a push for the institution of a universal Medicare program to shift the United States to a single-payer system. Support for a single-payer system has grown to 54% of independents and 75% of Democrats (Elkins, 2018). Medicare for all plan focuses on eliminating cost-sharing requirements. It also prohibits the sale of employer-sponsored coverage and duplicative private insurance coverage.

Health insurance companies

Health insurance is complicated and expensive in the United States due to reliance on a direct-fee system. It runs a mixture of two types of government-run programs and private insurance. The public programs known as Medicaid and Medicare are primarily designed for low-income individuals and families, people with disabilities, and the elderly. Everyone else needs to obtain private health insurance plans on their own initiative or through their employer (Gerisch, n.d.). Even with a private health insurance plan in place, healthcare bills are still astronomical in the United States. Most health insurance providers require users to make co-payments at doctors’ visits. The concept of co-payment goes hand in hand with the concept of co-insurance whereby users are expected to pay a certain percentage.  The Affordable Care Act provides subsidies to individuals who are not in a position to pay the high premiums of health insurance plans (Elkins, 2018). The amount of subsidy depends on the income of the individual.

Health insurance plans consist of premiums, deductibles, co-insurance, and co-pay, Premium refers to the monthly cost of the insurance plan; deductible refers to the amount that the user needs to pay out of pocket before the insurance becomes effective; co-insurance refers to the percentage of costs that the user still needs to pay after the insurance becomes active, and co-pay refers to the amount that the user still needs to pay at every doctor visit (Elkins, 2018). Higher premiums usually cover more medical expenses.  Some employers may pay for the full health insurance plan, while others may make a partial payment and require the user to pay for the remaining plan cost (Gerisch, n.d.). Private health insurance is too expensive, and more than a tenth of the population cannot afford coverage.

The problem of health care insurance companies in the US is further aggravated by the reliance of employers on Health Maintenance Organizations (HMOs). HMOs, enroll subscribers through their employers and workplaces (Olsen et al., 2010). They offer prepaid health plans amongst designated providers limiting patient choices to physicians on the HMO’s approved list or physicians employed by the HMO (the University of Minnesota, n.d.). HMOs are popular with employers since they are cheaper than traditional providers if private insurance. Patients often pay a lot of out of picket cists whenever they have to see specialized physicians who are not included in their HMO’s list of approved physicians. Patients also have to change their family or regular physicians if they are not covered in the HMO approvals. HMOs also restrict the types of medical procedures and medical exams that patients may undergo effectively presiding over denial of healthcare (the University of Minnesota, n.d.). HMOs also restrict the choice of prescription drugs to keep medical costs down, harming patients when a medical prescription that is not on their list would be more effective in treating the patient. The failure to access health insurance coverage has adverse impacts on individuals, families, and communities. The failure to have health insurance results in avoidable deaths of approximately 45,000 people ((the University of Minnesota, n.d.) People who lakh insurance are likely to access preventive care services for various illnesses and conditions (Elkins, 2018). Uninsured Americans rarely receive cancer screenings and are likely to be diagnosed with advanced cancer than their insured counterparts.

Cost per individual for a particular treatment (e.g., diabetes)

The United States has the most expensive healthcare system in the world. It spends more money on health per capita than any other developed country. Its spending is 2.3 times higher than that of the United Kingdom, twice as high as that of France, 80% higher than that of Canada, and 50% higher than the other highest-spenders, Norway and Switzerland (the University of Minnesota, n.d.). The high cost could be justified if the quality of healthcare outranked that of its peer nations, but the reality is that the quality of care is more inferior than that of its peer nations. There is, therefore, no justifiable reason why the cost of healthcare in the United States is astronomical, but the outcomes are poor.

Spending on healthcare is unjustifiably high in the United States because of extremely high administrative costs and reliance on the direct fee model of private insurance. Administrative costs are the highest in the world because of the extensive paperwork created by the billing and record-keeping of health insurance (Elkins, 2018). The extensive documentation requires holds of accountants and clerks to process paper works. Administrative and billing costs constitute 14% of the overall cost of healthcare in the United States (Olsen et al., 2010). The expenses are unnecessarily and cumbersome as they can be streamlined through the use of digital technologies.

The fee for service model of private insurance operates on a free market operational basis. Hospitals, physicians, and other healthcare businesses and professionals have the freedom to charge the amount of money they deem fit for their services. The fee for service model differs from the context in other developed nations where the government keeps healthcare prices low through regulations (Gerisch, n.d.). The extensive pricing freedom allows US doctors and hospitals to charge more for their services than their peers in other developed countries. The model in the US allows physicians to charge for every service that they perform, giving them an incentive to perform more medical procedures and diagnostic tests than necessary (Elkins, 2018). Patients tend to pay more for a particular treatment since physicians perform more tests and more diagnostic procedures to earn more.

An examination of the costs of individual treatment for different conditions between the United States and Canada reveals glaring differences. The average bypass surgery costs $59,770 in the US while it costs $22,212 in Canada (the University of Minnesota, n.d.). Natural childbirth costs #8,435 in the UD while it costs $2,667 in Canada (the University of Minnesota, n.d.). A hip replacement procedure costs $34,354 in the US while it costs $10,753 in Canada (the University of Minnesota, n.d.). A routine appendectomy in the US costs $13,123, while it costs $3,810 in Canada (the University of Minnesota, n.d.). Diabetics in the United States are forced to ration the prohibitively expensive insulin, which is much more affordable in Canada, causing people to cross borders. Diabetes management drugs, which cost $12,000 in the US cost a tenth of the price at only $1200 in Canada (the University of Minnesota, n.d.). The costs of diagnostic tests also differ significantly between the two countries. An MRI scan costs $1,009 in the United States, while it only costs $304 in Canada (the University of Minnesota, n.d.). A CT scan of the head costs approximately $464 in the United States, while it only costs $65 in Canada (the University of Minnesota, n.d.). The analysis shows that the costs of individual treatment plans in the United States are unnecessarily high and inaccessible to a majority of the population.

Transparency of Costs

Access to healthcare in the United States is also hindered by the fact that healthcare costs are not transparent. Prices for essential health care services are usually hidden in opaque contractual clauses that are difficult to interpret (Olsen et al., 2010). The lack of transparency in healthcare prices makes it difficult for individuals and employers to assess the value of the health care plan that they are purchasing. Employers spend billions of dollars annually on the healthcare of their employees but have little understanding of the prices negotiated on their behalf.

There is no transparent market-based pricing in the US health care system. Medical service providers do not publish prices before offering the services, making it impossible for patients and employers to compare the available treatment plans (Olsen et al., 2010). Patients typically receive information on medical costs after they have already received the service. The ‘surprise bills’ can be shocking for patients who suddenly find their healthcare insurance depleted while all along, they thought they were adequately covered (Olsen et al., 2010). The lack of transparency makes the cost of healthcare in the United States the highest in the world since doctors and hospitals can charge as much as they want, and private insurance can demand extremely high premiums without accountability to consumers. It also contributes to medical fraud since healthcare providers can bill for services that were never provided (Olsen et al., 2010). There are various campaigns to enhance the transparency of healthcare pricing as it would encourage lowering of the cost of healthcare in the United States.

Who is currently covered by a national system

There are six main healthcare programs in the national system in the United States. They include the Indian Health Service Program covering Alaska natives and American Indians; the Veterans Health Administration Program covering veterans; the Department of Defense TRICARE for life and TRICARE programs covering members of the military, the State Children’s Health Insurance Program covering low-income children, Medicare covering elderly and disabled people, and Medicaid covering people from low-income families (Olsen et al., 2010).  Public insurance only covers approximately 29% of the population.

Medicare and Medicaid are the most popular coverage programs, but they are barely adequate. Many elderly and disabled people covered by Medicare still have to pay thousands of dollars in co-payments, co-insurance, deductibles, and premiums (the University of Minnesota, n.d.).  Medicaid, on the other hand, is supposed to cater to healthcare costs for the poor. Still, most low-income families end up uninsured as they are not considered poor enough to receive Medicaid (the University of Minnesota, n.d.). Eligibility for Medicaid differs from state to state, and a family that is considered poor in one state may not be regarded as poor in another state (Olsen et al., 2010).  Several children from low-income families are still left out by the State Children’s Health Insurance Program. In spite of the existence of public coverage programs, 50 million people, including eight million children in America are without health insurance coverage (the University of Minnesota, n.d.). The numbers of the uninsured are heavily determined by race and ethnicity. The general uninsured population is 16%, but that figure increases to 32% of the Latino population and 22% of the African American population (the University of Minnesota, n.d.). The lack of health insurance coverage among people of color results in poorer health outcomes for their communities.

Conclusion

The analysis in this essay reveals that the healthcare system in the United States prioritizes market-based profits over human lives resulting in a dire state of health care and human rights in the United States. The country has the highest health care expenditure and the most inferior health outcomes among developed countries since it lacks a single-payer system like other developed countries. The lack of a single-payer system makes it impossible for the government to negotiate and regulate the price of health care services and medication. Most people in the US resort to individual or employer-based private health care insurance systems, which are characterized by high premiums, high deductibles, and unclear co-payments. There is no price transparency making it possible for over-pricing and fraud to occur at the detriment of the welfare of patients. The direct fee model in the US healthcare system results in individual treatment costs that are ten times higher than those in other developed countries as the comparison with Canada reveals. National insurance plans such as Medicaid care and Medicare are inadequate as a lot of people are still uninsured. The US health care system needs comprehensive reform to guarantee the right to health and universal healthcare for everyone.

References

Elkins, A. (2018). Moving Towards Medicare for All: Lessons from International Single-Payer     Systems for the United States.

Gerisch, M (n.d.). Health Care as a Human Right. American Bar Association.

Olsen, L., Saunders, R. S., & Yong, P. L. (Eds.). (2010). The healthcare imperative: lowering       costs and improving outcomes: Workshop series summary. National Academies Press.

The University of Minnesota (n.d.). Problems of Health Care in the United States. University of    Minnesota Open Library.