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SUPPORT FOR UNIVERSAL HEALTHCARE

33 million people in the United States (10.4% of the US population) did not have health insurance in 2014 according to the US Census Bureau. The United States, Greece, and Poland are the only countries of the 34 members of the Organization for Economic Co-operation and Development (OECD) that do not have universal health care.

No one in the richest nation on earth should go without health care. A right to health care would stop medical bankruptcies, improve public health, reduce overall health care spending, help small businesses, and that health care should be an essential government service.

In 2012 US health care spending totaled $2.8 trillion dollars and accounted for 17.2% of the US Gross Domestic Product (GDP). The average annual cost of health care for the typical US family of four was over $20,000, and health care costs that year rose at double the rate of inflation. According to a 2012 study from Consumer Reports, paying for health care is the top financial problem for US households. About 62% of all individual bankruptcies are related to medical expenses according to the most recent study available from 2009. According to a 2011 report, of the 34 member states of the OECD, the United States ranks #1 in per capita health care expenditures at $8,508 per person, which is 2.5 times more than the OECD average of $3,339 per person.

US health care spending is financed by a mixture of households (28%), the federal government (26%), businesses (21%), state and local governments (18%), and other private sources (7%). Health care is the largest private-sector industry in the United States accounting for about 13% of the total US workforce.

The United States is one of the world’s only developed nations that does not guarantee universal health coverage for its citizens. In 2005 the United States and the other member states of the World Health Organization signed the World Health Assembly Resolution 58.33, which stated that nations should "transition to universal coverage of their citizens... with a view to sharing risk among the population and avoiding catastrophic health-care expenditure and impoverishment of individuals as a result of seeking care."

Compared to the 34 nations of the OECD, the United States had the third highest rate of infant mortality (behind Turkey and Mexico), 2.4 practicing physicians per 1,000 people (lower than the OECD average of 3.1), and an average life expectancy of 78.7 (lower than the OECD average of 80.1 years).

In the United States, fewer than 10% of patients wait more than two months to see a specialist versus 41% in Canada, 34% in Norway, and 28% in France. The US 5-year survival rate for all cancers is 64.6%, over 10% higher than the 5-year cancer survival rate in Europe (51.6%). A 2009 study found that the United States had better cancer screening rates than 10 European countries including France, Germany, Sweden, and Switzerland. The United States is estimated to have the highest prostate and breast cancer survival rates in the world.

The World Health Organization ranked the US health care system at #37 out of 191 countries in its 2000 report, between Costa Rica and Slovenia. In 2014, the Commonwealth Fund ranked the United States last in overall health care behind (in order) United Kingdom, Switzerland, Sweden, Australia, Germany, Netherlands, New Zealand, Norway, France, and Canada.

Throughout the 18th and 19th century the US federal government did not finance or otherwise provide health care to the public. However, in the early 20th century, a debate over the right to health care began to emerge. In 1915 the American Association for Labor Legislation drafted a series of bills to provide state medical benefits to low-income workers. In 1920 the New York State Commissioner of Health, Hermann Biggs, began promoting public health services at the county level, and Charles-Edward Amory Winslow, the Chair of the Department of Public Health at Yale University, wrote: "I look to see our health departments in the coming years… enable every citizen to realize his birthright of health and longevity."

Government-funded health insurance was considered by President Roosevelt’s Committee on Economic Security, but it was never included as part of the 1935 Social Security Act, in part due to opposition from the American Medical Association. In 1938, health care reform to provide universal coverage was proposed by President Franklin D. Roosevelt as an extension of social security, and US Surgeon General Thomas Parran argued that "equal opportunity for health is a basic American right." In Feb. 1939, Senator Robert Wagner (D-NY) introduced the National Health Care Act of 1939 which would have implemented a national health care system, however, the bill did not gain the necessary support in Congress and died in committee.

In 1945, in another attempt at universal healthcare, Harry S. Truman sent a message to the United States Congress asking for a new national health insurance program to be run by the federal government. The voluntary program would have allowed individuals to pay monthly fees in return for coverage of all medical expenses. The program was introduced in Congress as the Social Security Expansion Bill. The bill never passed, in part, due to the American Medical Association.

By the early 1960s, debate grew over the King-Anderson bill, a precursor to Medicare, that would have extended Social Security to cover the medical bills of Americans over the age of 65. Despite some public opposition, Medicare (the Social Security Act Amendments of 1965) was eventually passed by the House (307-116) and the Senate (77-6), and was signed into law by President Lyndon B. Johnson on July 30, 1965.

In 1971, President Richard Nixon laid out a National Health Strategy to reform the health insurance system and move towards universal healthcare. In a 1972 message to Congress, President Nixon continued to advocate for universal healthcare, arguing that "reform of our health care system - so that every citizen will be able to get quality health care at reasonable cost regardless of income and regardless of area of residence - remains an item of highest priority on my unfinished agenda for America in the 1970s." A competing plan by Senator Ted Kennedy, the Health Security Act, sought to implement a universal single-payer federal health insurance plan to be financed through taxes. Despite their efforts, by the end of the Nixon presidency, no health care legislation had reached the President’s desk.

President Clinton brought the issue of national health care back to the forefront in 1993. On Sep. 22, 1993, he delivered a speech to Congress stating that the "most urgent priority" of the nation was to provide "every American health security, health care that can never be taken away, health care that is always there." Three months later the Health Security Act was introduced to move the United States towards the goal of universal coverage by requiring all individuals to obtain health insurance and instituting an employer mandate to provide insurance. During this same time period, other legislators introduced a competing act to create a federally run "single-payer" national health insurance plan. As in the 1970s, none of the plans gained enough support to pass Congress, much less make it to the President’s desk.

During a presidential candidate debate on Oct. 7, 2008, then-US Senator Barack Obama stated that health care should be a "right for every American." In a June 15, 2009, speech delivered to the American Medical Association (AMA), President Obama urged Congress to craft legislation that would ensure coverage for all Americans. After intense debate, lawmakers passed the Patient Protection and Affordable Care Act (PPACA), which President Obama signed into law on Mar. 23, 2010. According to a 2013 White House estimate, 27 million previously uninsured people gained coverage under Obamacare. A separate 2013 study found that despite the expansion in health insurance coverage under Obamacare, 29.8 to 31 million people would still remain without health care coverage by 2016.

The PPACA did not institute a universal right to health care, and some members of Congress, including Senator Bernie Sanders (I-VT) and Representative Jim McDermott (D-WA), and organizations, including Physicians for a National Health Program (PNHP) and the American Nurses Association, continue to advocate for the implementation of a "single-payer" health care system in the United States that would guarantee the right to health care for all Americans under a federally run health insurance plan.

According to a study in the American Journal of Public Health, Canada, a country that provides a universal right to health care, spends half as much per capita on health care as the United States.

Karen E. Lasser, David Himmelstein, and Steffie Wollhandler, "Access to Care, Health Status, and Health Disparities in the United States and Canada: Results of a Cross-National Population-Based Study," American Journal of Public Health, July 2006

 

In 2010 the United Kingdom, another country with a right to health care, managed to provide health care to all citizens while spending just 41.5% of what the United States did per capita.

Organisation for Economic Co-Operation and Development (OECD), "OECD Health Data 2013," June 27, 2013

 

According to a 2009 study from Harvard researchers, "lack of health insurance is associated with as many as 44,789 deaths per year," which translates into a 40% increased risk of death among the uninsured.

Andrew P. Wilper, Steffie Woolhandler, Karen E. Lasser, and Danny McCormick, et al., "Health Insurance and Mortality in US Adults," American Journal of Public Health, Dec. 2009

 

Another study found that more than 13,000 deaths occur each year just in the 55-64 year old age group due to lack of health insurance coverage.

J. Michael McWilliams, Alan M. Zaslavsky, Ellen Meara and John Z. Ayanian, "Health Insurance Coverage and Mortality among the Near-Elderly,"Health Affairs, July 2004

 

A 2011 Commonweath Fund study found that due to a lack of timely and effective health care, the United States ranked at the bottom of a list of 16 rich nations in terms of preventable mortality.

Kimberly J. Morgan, "America’s Misguided Approach to Social Welfare," foreignaffaris.com, Jan-Feb. 2013

 

On Dec. 10, 1948 the United States and 47 other nations signed the United Nations Universal Declaration of Human Rights. The document stated that "everyone has the right to a standard of living adequate for the health and well-being of oneself and one’s family, including... medical care."

United Nations, "The Universal Declaration of Human Rights," un.org (accessed Jan. 27, 2014)

 

In 2005 the United States and the other member states of the World Health Organization signed World Health Assembly resolution 58.33, which stated that everyone should have access to health care services and should not suffer financial hardship when obtaining these services.

World Health Organization (WHO), "The World Health Report 2013: Research for Universal Health Coverage," who.int, 2013

 

The United States and Mexico are the only countries of the 34 members of the Organization for Economic Co-operation and Development (OECD) that do not have universal health care.

Organisation for Economic Co-operation and Development (OECD), "Health at a Glance 2013: OECD Indicators," oecd.org, 2013

 

As of 2013 over half of the world’s countries had a right to health care in their national constitutions.

Mark Wheeler, "A Constitutional Right to Health Care: UCLA-Led Study Shows That Many Countries Have It, But Not the US," newsroom.ucla.edu, July 18, 2013

 

According to a 2012 study from Consumer Reports, paying for health care is the top financial problem for US households.

Consumer Reports, "Sluggish Economy Forces Americans to Cut Corners to Pay for Medications," consumerreports.org, Sep. 2012

 

According to a peer-reviewed study in Health Affairs, between 2003 and 2013, the cost of family health insurance premiums has increased 80% in the United States.

Gary Claxton, Matthew Rae, and Nirmita Panchal, et al., "Health Benefits in 2013: Moderate Premium Increases in Employer-Sponsored Plans," Health Affairs, Sep. 2013

 

According to the Kaiser Family Foundation, 26% of Americans report that they or a family member had trouble paying for medical bills in 2012, and 58% reported that they delayed or did not seek medical care due to cost.

Henry J. Kaiser Family Foundation, "Health Security Watch," kff.org, June 2012

 

According to an Institute of Medicine report, the US economy loses $65-$130 billion annually as a result of diminished worker productivity, due to poor health and premature deaths, among the uninsured.

Board on Health Care Services (HCS) and Institute of Medicine (IOM), "Hidden Costs, Value Lost: Uninsurance in America," nap.edu, 2003

 

According to a 2012 study in The Lancet that looked at data from over 100 countries, "evidence suggests that broader health coverage generally leads to better access to necessary care and improved population health, particularly for poor people."

Rodrigo Moreno-Serra and Peter C Smith, "Does Progress Towards Universal Health Coverage Improve Population Health," The Lancet, Sep. 7, 2012

 

In the United States, people are 33% less likely to have a regular doctor, 25% more likely to have unmet health needs, and over 50% more likely to not obtain needed medicines compared to their Canadian counterparts who have a universal right to healthcare.

Karen E. Lasser, MD, MPH, David U. Himmelstein, MD, and Steffie Woolhandler, MD, MPH, "Access to Care, Health Status, and Health Disparities in the United States and Canada: Results of a Cross-National Population-Based Survey," American Journal of Public Health, July 2006

 

The United States spent $8,508 per person on health care in 2011, over 2.5 times the average spent by member countries of the OECD ($3,322 per person).

Organisation for Economic Co-Operation and Development (OECD), "OECD Health Data 2013," June 27, 2013

 

If the United States implemented a universal right to health care, businesses would no longer have to pay for employee health insurance policies. As of 2011, 59.5% of Americans were receiving health insurance through their employer.

Robert Wood Johnson Foundation, "Number of Americans Obtaining Health Insurance through an Employeer Declines Steadily Since 2000," rwjf.org, Apr. 11, 2013

 

According to the Business Coalition for Single-Payer Healthcare, a right to healthcare under a single-payer-system could reduce employer labor costs by 10-12%.

Business Coalition for Single-Payer Healthcare, "Business Benefits of a Single-Payer Medicare-For-All System," healthcare-now.org (accessed June 4, 2014)

 

Many people are afraid to start their own businesses for fear of losing the health insurance provided at their existing jobs. The Kauffman-RAND Institute for Entrepreneurship Public Policy estimated that a 33% increase in new US businesses may result from the increased access to health insurance through the Obamacare health insurance exchanges.

Emily Maltby and Angus Loten, "Will Health-Care Law Beget Entrepreneurs?," wsj.com, May 8, 2013

 

About 62% of all US bankruptcies were related to medical expenses in 2007, and 78% of these bankruptcies were filed by people who already had medical insurance.

1. David U. Himmelstein, MD, Deborah Thorne, PhD, Elizabeth Warren, JD, and Steffie Woolhandler, MD, MPH, "Medical Bankruptcy in the United States, 2007: Results of a National Study," American Journal of Medicine, Aug. 2009. 2. Joy Wilke, "Majority in US Say Healthcare Not Gov’t Responsibility," gallup.com, Nov. 18, 2013

 

The World Health Organization ranked the US health care system at #37 out of 191 countries in its 2000 report, between Costa Rica and Slovenia.

World Health Organization, "World Health Organization Assesses the World’s Health Systems," who.int, June 21, 2000


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