The preference for minimal government oversight and ideas of individualism are responsible for the way American health care system is structured. However, access to health insurance and health care has been a pressing issue in this nation for a long time; rated by the WHO as one of the worst among industrialized countries, the United States’ health care system is too costly and fails to cover everybody. Despite president Obama’s attempt to bring about change, many continue to question the effectiveness of the Patient Protection and Affordable Care Act the concerning both costs and overall coverage. The issues regarding health care reform directly affect the feasibility of the American Dream because adequate health care and insurance are necessary to full citizen participation and it is the government’s responsibility to provide access. I believe that given this nation’s strong anti-statist values it will be difficult to implement a federal health care policy; therefore it is more feasible for states to create health reforms like the one in Massachusetts and ensure universal health care.
In 2007, the US health system presented many problems concerning the amount of people who were both uninsured and underinsured and the fast rise of insurance premiums causing many Americans to report debts and problems due to medical bills (Commonwealth Fund Commission, 232). The cost of American health care is inarguably one of the major setbacks of the system; it is the highest amongst those of other industrialized nations but not necessarily more effective. For instance, a case study in the town of McAllen, Texas, shows how the overuse of medicine and the “fee for service” incentives available to doctors can really drive up the cost of medicine. McAllen is one of the most expensive health care markets in the country where most doctors focus less on preventive care and more on running extra tests, services and procedures out of fear of malpractice, influenced by differences in training, or simply to make a few extra dollars. (Gawande, 340-342). Although the situation in McAllen might be an extreme example, it does not fail to explain how the “culture of money” partly affects the cost of health care system. Unlike systems such as Canada and Japan, the American government plays a minimal role in bargaining down prices or setting price standards, this lack of control allows doctors and medical institutions to often purchase the latest technology, but not the most efficient (Klein, 256). Nevertheless, doctors are not to be labeled as the villains because private insurance companies add to the problem by expending a quarter and a third of their revenues on administrative costs (Weissert and Weissert, 350).
The high number of uninsured Americans (45 million in 2007), is another disconcerting fact regarding the downfalls of the American health care system; it is unfortunate that in an industrialized nation, once considered the most powerful in the world, people are often forced to put their career dreams on hold in order to gain access to employer based insurance. This has a negative impact on the nation’s economic and political development because people who could create the latest technological innovations are “locked” at Wal-marts and the likes. Low income uninsured families like Greg and Loretta, who struggle to keep their children healthy, lose all faith in the American dream and essentially become a burden for the rest of society. Some argue that good health is a personal responsibility, and yes eating a burger everyday will obviously have negative impacts on a person’s health and they should be held accountable for those poor choices. Consequently, some would blame Greg and Loretta for their unfortunate condition, but the question is; how can their children be expected to become productive citizens if they lack basic health care? The American Dream encourages individualism, but individuals cannot perform to the best of their abilities if they lack the necessary tools to do so.
In 2006, the state of Massachusetts passed an “ambitious” health care reform that improved access to care and lowered the rate of uninsured working age adults; in spite of its high costs, this plan exemplifies how reforms at the state level can perhaps be easier to implement and regulate, consequently having successful results. The plan is essentially composed of three parts: expansion of the state’s Medicaid progress (establishing income-related subsidies), creating new private insurance plan open to individuals, and lastly it requires that both individuals and employers participate in the health insurance system or pay a fine. Furthermore, it provides individuals with the alternative to buy from private insurers if they do not have access through an employer (Long, 321). Mixing public and private markets achieves near-universal and gives citizens options.