Health care, which was a prominent issue this past election, has seemingly been put on the back burner while President Barack Obama attempts to tackle the current economic calamity.
People from all walks of life are worried and unsure of what will happen to their health care. The number of uninsured has risen in the past year by almost four million, bringing the total of people without coverage in this country to 47 million.
Obama has proposed a $150 billion plan to improve the state of healthcare in the U.S. Nancy Nielsen, senior associate dean for Medical Education at the University of Buffalo and president of the American Medical Association (AMA), is concerned about the current state of the health care industry.
One of the biggest concerns for most Americans is job loss because most people receive health coverage through their employers, so if they lose their jobs they lose their plans.
"Another issue is escalating health insurance premiums, with more cost shifting to patients through higher co-pays and deductibles," Nielsen said. "Most non-elderly Americans (61 percent) get their health insurance through their employer, but only 60 percent of employers even offer health insurance now, and that number declines a little each year as premium costs rise."
The idea of universal health care has been widely discussed between political figures and in the media. There are many different forms of universal health care, such as the one-payer system as seen in Canada or the United Kingdom. Another would supply everyone with health insurance, but not by a single provider.
One potential issue with universal health care is that people who already have coverage may not be willing to part with it. However, according to Nielson, no health care transition will be perfect.
"There are two issues of great concern... rising medical costs, and the proper balance between government health insurance and private health insurance," Nielsen said. "No system is perfect, but we should look to see what works well and see whether those things are feasible here. I don't favor a single payer system, and polls show that the majority of Americans don't either."
The issue of providing everyone with coverage requires more than just a quick fix. A major reason why costs have risen so quickly is that the country has access to innovations in diagnosis and treatment, but comes with administrative costs.
The United States is also seen as the lead researcher and developer of pharmaceuticals for the world. This comes at the price to the patients, according to Nielsen.
"There is no easy answer here, and all parts of our society bear some responsibility. But we can and must do better in care coordination, prevention of disease, and treatment of chronic conditions. We need to focus more on prevention and on primary care, as is done in most other countries," Nielsen said.
Many debates about switching health care systems can be affected by outside influences in various entertainment mediums.
"If you haven't studied the health care systems in other countries, you may have your opinion formed from watching Michael Moore's Sicko - that would be a mistake," Nielsen said. "It's better to take a dispassionate, not an advocacy, look at what works and what doesn't in other countries."
Much of the delay in formulating a new plan for our system is due to historical trends. This system has been the backbone of health care since World War II. Looking to the U.K., there are issues with their supposed "perfect system." Nielsen elaborates on this in terms of waiting time to see a specialist.
"In Britain the goal is to reduce the waiting times from time of diagnosis and referral to a specialist to actual seeing of the specialist to 18 weeks. Americans will not tolerate that, nor the long queues experienced in some countries," she said.
The issue of 47 million Americans being uninsured must be moved on quickly, according to Nielsen.
"What other countries have done is insure all their citizens, and we really have to do that. I think we will move in that direction fairly quickly, given the economic downturn and job losses we're experiencing," Nielsen said. "But I think it will be by strengthening the public programs like Medicare, Medicaid and S-CHIP, while still having a strong and vibrant private health care sector."
Nielsen believes that there will be a life ring tossed to the health care system.
"The stresses and tensions are going to make this problem an enormous opportunity, but only if we have thoughtful, respectful discussions and clear goals in mind," Nielsen said. "I believe the time is now. It's long overdue."
