Health care is a convoluted and uber controversial issue in the United States in this day and age. The debate of whether there should be a welfare program that emulates universal health care in the United States is one of harsh debate because there are many arguments as to how the government should handle health care, and in some cases whether the government should get involved at all. Conservatives believe in a more laissez faire approach in that they think having a more hands off approach to health care, among other things, while liberals believe that a more involved approach is key to providing health care because of the significant portion of Americans that do not have health care. Universal health care is a concept that works on paper and is being executed properly in countries around the world but the United States is simply too big for a universal healthcare program to be economical. A program like Obamacare, however, should be in place to cover those that cannot afford health care because it is a necessity that every citizen has a right to. 

Firstly, universal health care, according to the World Health Organization or WHO, means that the entire population of a country must have access to health care with, “…sufficient quality to be effective, while also ensuring that the use of these services does not expose the user to financial hardship,” (WHO). While this is something every country wants, it is not something every country can successfully implement whether it be because the country’s population is too big or because there is simply not enough capital for a government to provide such health care to every one of its citizens. Universal health care, however, has been implemented in a handful of countries around the world and in some cases it has been very successful. Many developing countries such as China, Sri Lanka, Costa Rica, Cuba and Kerala, a state in India, have all implemented a universal health care program that works, and even though they may not be as successful as one would hope, it is a start to something that would be beneficial to countries around the world if they choose to learn from said countries’ successes and failures that come from the various universal health care programs in these countries. 

In an article form the Harvard Public Health Review, Amartya Sen and Thomas Lamont discuss Thailand and its universal health care program that they believe is, “…exemplary, both in advancing health achievements across the board and in reducing inequalities between classes and regions,” (Sen & Lamont). They go on to discuss Thailand’s departure from a laissez faire health care program, in 2001, and its transition into one that provides healthcare for its citizens. The healthcare program simply placed a limit on how much a patient would have to pay per visit for medical care. This resulted in very significant rise in the life expectancy, from 71 to 74 years, and also lowered the mortality rate from 18.3 to 10.5 deaths per 1000 people. The changes in life expectancy and mortality rate took place over a fourteen year span from 2001 to 2015 which is an excellent example of how a universal health care program can be very successful. 

The universal health care in Canada, however, is a single-payer system that does not work as well as it should. Contrary to United States’ public opinion, Canada’s single payer health care system is not the saving grace some American lawmakers, namely Hillary Clinton, believed it was because of the inherent problems that come with a program funded by a single government organization that simply cannot cope with rising costs of health care without providing subpar care for those that need it. In theory, the single-payer system would provide, “…all medically necessary services, including doctor, hospital, preventive, long-term care, mental health, reproductive health care, dental, vision, prescription drug and medical supply costs,” (PNHP). According to the Physicians for a National Health Program, under this system, “premiums would disappear” and that “patients would no longer face financial barriers to care”, although this is not the case in Canada. David Gratzer, a physician who is a senior fellow at the Manhattan Institute, suggests that, “…to contain rising costs, government-run health-care systems invariably restrict the health care supply,” (Gratzer). Gratzer then goes on to say that Canada’s population was aging and therefore needed more care but because of the restricted health care supply, patients that needed care either suffered a great deal or even died because of the shortage of physicians and hospitals. 

Furthermore, Jason Clemens and Bacchus Barua, who are executives at the Fraser Institute in Canada, assert, in a Washington Post article, that the most apparent failure of the Canadian health care system is that wait times for patients have drastically increased because of the restricted health care supply mentioned in the previous paragraph. Clemens and Barua state that, “In 2013, Canadians, on average, faced a four and a half month wait for medically necessary treatment after referral by a general practitioner,” and also point out that, “[the] wait time is almost twice as long as it was in 1993 when national wait times were first measured,” (Clemens & Barua). 

Both Gratzer and medical institute executives, Clemens and Barua, believe that the single payer system implemented in Canada is flawed because of the aforementioned problems that come with it and that this system is not the solution to America’s health care system, which is, frankly, in complete disarray mainly because of extreme party polarization and the lack of a common goal in Capitol Hill, which should be to provide the best care for Americans while also executing the implementation efficiently but this is not a perfect world and politics will continue to be in disarray as long as party polarization continues to be exacerbated, but this is another problem altogether and will take much more than complaints from a college student to solve.  

Next, the debate over health care in the United States is immensely controversial because of the sharp divide between the Republican and Democratic and how to approach solving the problem that is health care in the United States today. The problem being that there are millions that still live without health care because it is just too expensive for individuals to pay the exorbitant premiums that health insurance companies charge because of a lack of competition in the health insurance market due to the lack of regulatory legislation that would otherwise keep corporations from increasing prices of heath insurance and would therefore make health insurance significantly cheaper simply because there are more providers, and health insurance plans, to choose from. 

This is what conservatives claim the recently unveiled American Health Care Act will execute. According to Chad Pergram of Fox News, the Obamacare replacement legislation would do this by, “…repealing the awful taxes, the mandate penalties and the subsidies in ObamaCare,” (Pergram). This is however, quite frankly, a backwards way to approach fixing the Affordable Care Act because repealing the taxes only reduces the amount of capital that can be put back into the system to help insure more people that would otherwise not have proper health care. Getting rid of mandate penalties would deter employers from wanting to provide health benefits for their employees because it is more economical for the business to not offer health benefits because to many businesses it is just another expense that has to be taken care of whereas with the enforcement of mandate penalties it is less expensive for employers to bite the bullet and provide a variety of health benefits due which is beneficial to employees that otherwise may not be able to afford health care. The repealing of subsides under the American Health Care Act would be giving less money to those under the Affordable Care Act, of which there are millions, by a very significant amount. 

Jessica Wapner writes, in an article for Newsweek, that, “[subsidies people] receive is going to decrease, especially for low-income individuals. In my estimation, the low-income person is the one most severely impacted by this legislation. Right now, the subsidies are income-based. The more you earn, the less of a subsidy you receive. But the AHCA provides adjustments based upon how old you are, not what your income level is,” (Wapner). This means that the American Health Care Act essentially targets elderly people by providing less subsidies to them even though people above sixty five are more likely to need more care. The legislation also cuts taxes for the wealthy and in turn lowers the amount of subsidies given to people with a significantly lower income; it is very much the complete opposite the story of Robin Hood where instead of taking from the rich and giving it to the poor, some conservatives are proposing to take away health care from the poor and giving massive tax breaks to the rich. This is fundamentally and morally wrong and needs to be changed if it is going to have a chance to pass through both the House of Representatives and the Senate. 

The current legislation that is in place to attempt to provide health care to those that do not have it is the Affordable Care Act, otherwise known as Obamacare. Obamacare, according to Daniel Lanford and Jill Quandango who are professors at Florida State University, aims to provide “near universal coverage” by setting harsh regulations on health insurance companies, fining employers that fail to provide health benefits to their employees, placing a mandate on individuals to get health insurance, subsidizing the costs of health care for low income citizens and, most importantly, substantially expands Medicaid, which is the main government funded program that provides the means for low income families and individuals to get health care. The expansion of Medicaid was met with immediate backlash and was ruled unconstitutional and instead was rolled out on a state by state basis, a state could choose the extent of the expansion band many states have since expanded Medicaid significantly and have been able to provide health care to those that make low incomes, it is especially beneficial to minorities. Lanford and Quadango also state that, “it is estimated that because of states opting out of Medicaid, there will be 3.6 million fewer insured and more than $8 billion less in federal payments to states,” (Lanford & Quadango). This is a very significant portion of the population that would otherwise be insured but it is unconstitutional to coerce states into expanding Medicaid so I have no qualms with a state if it refuses to do so. 

Although the Affordable Care Act provides millions with health care and has accomplished a lot over the past seven years, it is not without its flaws. Hagop Kantarjian, an M.D. who has written for the American Cancer Society, lays out many of these accomplishments, some of which being that the ACA has resulted in a decrease in the uninsured rate from 16.3% to 9.1% from 2010 to 2016, it barred health insurance companies from denying coverage based on preexisting conditions, as well as requiring health insurance policies to provide at least the “minimum health care coverage standards and benefits”. 

All of these accomplishments are great for the citizens within the United States but there are many flaws within the health care legislation that were not anticipated before the implementation of it. First of all, 28 million Americans are still uninsured and Kantarjian divides them into three different groups, the first being young Americans who decide to not buy health insurance but if they were to get sick or hurt their chance of survival would be lowered substantially because of subpar care. The second group are individuals and families who do not qualify for Medicaid and also cannot afford health insurance due to an increase in premiums and rates; this could be remedied though, if federal support were increased to 500% above the poverty line from the current 400% level. The third group of people that are not insured are those that are in states that, as I mentioned before, have chosen to not expand Medicaid to the full extent of the provision under the Affordable Care Act; due to this, millions of Americans are without health care and an estimated 20,000 people lose their lives because of this. Kantarjian also points out that, “Access to preferred health care providers and hospitals of choice became more restricted, and out-of-network referrals became significantly more prohibitive financially in relation to out-of-pocket expenses,” (Kantarjian). This was one of the main promises that Barack Obama made but the Affordable Care Act has not lived up to this promise and this is one of the biggest complaints Americans have with the legislation. 

I believe that there is a solution to the problem of health care and Americans need to come together as one and throw away the extreme party polarization that exists today which has only been detrimental to the progress of this country and instead have one common goal, the goal being to provide health care to everyone who needs it, and having a common goal could, and should, be applied to every problem we have but it is not and that is the world we live in today and it will take a lot more than a suggestion for people up on Capitol Hill to start behaving like adults and not pouty 5 year olds arguing over the last cookie. This is besides the point though because the goal of this essay is to offer a solution, as meager as it may be, to improve Obamacare. The AHCA is obviously just a slight roll back of Obamacare and will not do anything to solve America's health care problem because it only exacerbates the underlying problems of Obamacare by taking away subsidies, mandate penalties, and “awful” taxes. Instead, the Affordable Care Act should be beefed up a little bit by reallocating tax payer dollars to help fund Medicaid which could be done without too much difficulty because of the exorbitant amounts of money that go into other government programs such as the military. If Medicaid were expanded in Texas, Florida, and Georgia alone would cover half of the uninsured people in America. Also, expanding Obamacare to families and individuals that have incomes 500% of that of the poverty line. Increasing regulations on corporations that run the health care industry, including drug manufacturing companies which make up 20% of heath care costs. Increasing regulations on these companies would bring health care costs down significantly because of the devilish increases in drug prices in recent years. Implementing all of these little measures, I think, could go a long way in trying to insure those that do not have it. 