Health Care Reform:  A Good Investment?

Many people think that health care is a basic human right:  the right to be in sound body and to have basic health needs met.  Reports indicate that this right is covered by the state in a large percentage of highly developed nations.  Some think the United States of America is one of the most highly advanced nations in the world, and yet health care is not offered to its citizens free of charge.  It is thought that in order for America to fully reach its potential as a highly developed nation, health care must be a universal right for its citizens.  At present, almost 85 percent of Americans have some form of health insurance, be it from their employer, the government, or self-insurance (Clemmitt 697). This still leaves nearly one in seven or 45.7 million and rising Americans who have no form of affordable health insurance available to them (697).  Despite this, there has been a heated debate for a number of decades, notably during the recent 2008 presidential debate, and in Congress as to whether it is a viable path for the United States to take.  Many who oppose a national health care plan decry it as socialized medicine and push fears of a government takeover of personal privacy and health rights.  For a number of Americans and members of Congress, the biggest obstacle is the financial management of universal health care.  Those who oppose it say that there are a number of funding cuts and tax hikes that do nothing to ameliorate the care given whereas those who support it claim that if the finances are carefully monitored it will be a success; most agree that thorough research needs to be done for both sides before any decisions are made.

There has been extensive lobbying by those opposed to a government-backed health insurance plan decrying all of the financial burdens it will impose upon American citizens.  The Republican Policy Committee has released a number of policy papers describing their positions on issues debated in Congress.  A recently released paper, titled “Top Ten Facts Americans Should Know About the Baucus Bill” sums up the financial questions about current health care reform motions presently being put to vote (“Top Ten Facts”).  The paper is written in simple, concise language meant for citizens who have questions about health care reform and its potential pitfalls.  “Top Ten Facts…” makes the overall claim that the entire scope of the Baucus bill, a health care reform bill being discussed in Congress, is not being made accessible or clear to American citizens.  While it does not directly state that Americans might be being hoodwinked, it lists ten financial points that could cause issue if the bill were to be made into law (“Top Ten Facts”).  This includes potential costs, such as a “real 10 year cost of … $1.67 trillion because the main spending provisions will not go into effect until 2013” and that the Baucus bill would “expand Medicaid at a cost of nearly $300 billion” (“Top Ten Facts”) despite Medicaid being painted as unpopular with physicians and riddled with fraud.  Aside from raising costs on Americans, the paper claims that Medicare will be cut drastically in favor of a new government program.  It mentions that Medicaid, a program initiated to assist those who cannot afford medical assistance, could be skating on financial thin ice with expansion costs nearing $300 billion despite the reluctance of a number of specialists to serve the needs of those on Medicaid (“Top Ten Facts”).  The paper makes few claims to ethos:  It is written members of the Republican Party expressing the views of their colleagues and is directly from the Republican Policy Committee.  This particular paper cites thirteen sources for its points, some from government sanctioned organizations.  Despite numerous sources, a number of these are editorials and potentially out-of-context quotes from a variety of government publications.  This article makes little or no appeal to logos, but rather a strong appeal to pathos.  Instead of using specific data points in a coherent sequence, it uses hypothetical dates.  For example, the paper claims that “Medicare will start going bankrupt in 2017” (“Top Ten Facts”).  It does not present the facts and evidence of financial failure in a precise, impersonal language, but relies heavily on first person and speculation.  This approach may be effective to those who are easily swayed by dramatic words and figures, but is not effective for those who use statistics and solid facts in their decisions.

FIG 1: In states like New York, the health reform bill could hike taxes by a considerable amount

While there is a loud and substantial political objection to health care reform, those who advocate it include John Tooker, MD, MBA.  In his article “Affordable Health Insurance for All Is Possible by Means of a Pragmatic Approach” for the American Journal of Public Health, he claims that “America can attain affordable health insurance coverage for all by using a pragmatic approach.” (Tooker 106)  His paper has a substantial claim to ethos:  he has obtained an MBA, indicating that he has a sturdy grasp of how to make a program financially successful; he is also an MD, or Doctor of Medicine, proving that he is part of a number of medical professionals who support health care reform.  In writing for the American Journal of Public Health, it is safe to say that this article was written for medical professionals who wish to learn more about a financially viable method of health care reform.  Tooker states that a bipartisan approach is vital in successfully enacting a national health insurance policy.  Such an approach would include building on the current system rather than building it from the ground up, combining policies approved by Democrats and Republicans, giving states the ability to change policies to address local needs while still providing a basic benefit package, and maintain the importance of private health insurance as a viable option.  He stresses that an effective communication plan backed by Congress, the President, and both private and public sector leaders is essential in convincing the public that reform is necessary.  Tooker believes that a lack of bipartisan policy and failed communication have been the main issues stymieing past progress.  He proposes a five point strategy for effectively achieving national health insurance:  first, a congressional resolution must be passed (106-7)  This would “be the equivalent of President Kennedy’s historic speech committing the United States to a manned lunar landing by the end of the 1960s” (Tooker 107).  Tooker appeals that an advisory committee consisting of medical professionals, state officials responsible for health care, economists, normal citizens, and any other notable advisors nominated by the House and Senate should be created to vote on any resolutions.  He advocates for amending and expanding current programs like Medicaid, giving states an option to not be as strictly regulated provided they meet a minimum health care requirement, and giving citizens more incentive to get insurance coverage than not.  Tooker clearly indicates that the benefits would outweigh the costs of starting up a national program.  While Tooker concedes that the potential costs would remain unknown until a basic plan is discussed, he maintains that a nation with more healthy individuals has a more productive workforce and that a national plan would save numerous lives, notably during the flu season.  Overall, Tooker makes a solid appeal to logos in that his ideas follow a sequence that is easy to follow and each claim is well substantiated.  The ideas presented in the paper are reasonable and do not indicate a drastic change or radical restructuring of the current health care system.  He makes a small appeal to pathos by stating in the opening that “allowing the status quo to continue courts certain disaster” (106), but this is an effective appeal in that it brings a human element to the article without overtaking the facts and evidence provided.

FIG 2: 

Despite potential costs, some Americans believe the alternative, waiting, would be too costly for their health

The debate over health care reform is a heated one that requires a neutral party to collect all data and consider every side of the issue.  To this end, Marcia Clemmitt wrote an article for CQ Researcher, a paper published by Congressional Quarterly, Inc, entitled “Health Care Reform”.  This article encompasses all aspects of the health care reform debate, from its roots in the Industrial Revolution to recent past attempts at reform.  Clemmitt’s article has a strong claim to ethos in that she is the former editor in chief of the magazine Medicine & Health and has written a number of other articles for CQ Researcher.  She includes an extensive notes section and an annotated bibliography with reliable recent resources.  CQ Researcher is a peer-reviewed periodical, and is written for those interested in Congressional politics such as students, activists, and researchers.   According to Clemmitt, health care reform policies are to be carefully studied before action is taken, and that money is a serious concern of both sides.  Clemmitt analyzes a number of issues relevant to the healthcare debate, including efforts to efficiently make health insurance available to more Americans through programs like Medicare (Clemmitt).  She notes that despite efforts made to cover more citizens, “rising costs and, for some, a decision not to buy insurance, left many without coverage” (Clemmitt 707).  Clemmitt includes brief commentaries by Daniel Callahan, President Emeritus of the Hasting Center, and Devon Herrick, Senior Fellow for the National Center for Policy Analysis.  According to Callahan, health care costs rise annually “at a rate of 6 percent” and concludes that strong government controls, price checks for certain medical services and procedures, and rationing health care is the only effective way to curb the rampant spending of the system as it is today (qtd. in Clemmitt 709).  On the contrary, Herrick holds that if too many controls were to be placed on health insurance, such as the proposed $1.1 billion stimulus bill for a committee to test the efficiency of various health services, the central focus would shift from patient care to cost controls (qtd. in Clemmitt 709). Throughout the article Clemmitt makes a strong appeal to logos.  She uses clear, concise language and a sensible flow of ideas.  Each concept segues into the next and is substantiated by lengthy research and charts.  She includes such sidebars as one titled “Will Congress Tackle Soaring Health Costs” that indicates the hopes of health reformers that higher costs will force Congress to “focus on reining in costs” (qtd. in Clemmitt).  Clemmitt makes a short and effective appeal to pathos in this article.  She includes powerful pictures and charts with captions that showcase various sentiments on health reform by all levels of society.  Throughout the entire article she maintains a modicum of neutrality that effectively communicates the issues without supporting one side or the other too much.

FIG 3:  This chart shows the complexities involved in the proposed plan by Democrats.

The question of the viability of a universal health care reform for the United States essentially boils down to how well its expenses are managed.  Some say the almighty dollar is what controls a good portion of decisions, and this is a case where that is exceedingly true.  I found John Tooker’s article on a logical approach to health reform to be the most convincing.  He uses a sound approach that not only advocates small, practical steps, but takes into consideration past failures and what can be learned from them.  The way Tooker presents his case rings of the current public-option health care plan that is being advocated by President Barack Obama and motioned through Congress now, six years after he wrote the article.  While I can understand concerns for expenses skyrocketing at any change in policy by the administration, I do not agree with the fear-mongering techniques used by the Republican Policy Committee in its current policy papers to present them.  There should be more resources made available to those interested in a logical argument against reforming a system to benefit the country.  The article written by Marcia Clemmitt is well-written and is one of the few sources I found that was able to toe the line between presenting health care reform and investigating its plausibility.  I found the article to be somewhat biased towards reform in general, but on the question of financial feasibility Clemmitt keeps the article well balanced.  Is it time for health care reform?  I think it is.  I think it can be achieved if proper controls are maintained over spending.

Works Cited:

Clemmitt, Marcia. "Health-Care Reform." CQ Researcher 19.29 (2009): 693-716. CQ Researcher Online. Web. 1 Oct. 2009.

FIG 1:  Huffington Post. What Obama's Health Care Plan Means to New Yorkers. Digital image. New York Post Warns Of The Crazy Tax Armageddon That Obama Health Care Will Wreak. Huffington Post, 17 July 2009. Web. 15 Oct. 2009. <http://www.huffingtonpost.com/2009/07/17/inew-york-posti-warns-of_n_238270.html>.

FIG 2:  Huffington Post. Pro Health Care Reform Vigil Sept. 3, 2009 Blacksburg, Virginia. 2009. Photograph. Huffington Post. Views from Southwest Virginia. Joan K, 7 Sept. 2009. Web. 13 Oct. 2009. <http://open.salon.com/blog/joan_k/2009/09/07/medias_coverage_of_health_care_debate_sucks>.

FIG 3:  Brady/Joint Economic Committee, Republican Staff, Kevin. "Organizational Chart of the House Democrat's' Health Plan." Cartoon. Diana Hsieh: NoodleFood. 20 July 2009. Web. 13 Oct. 2009. <http://www.dianahsieh.com/blog/uploaded_images/gov_healthcare-776505.jpg>.

Tooker, John, MD, MBA. "Affordable Health Insurance for All is Possible by Means of a Pragmatic Approach." American Journal of Public Health 93.1 (2003): 106-09. Academic Search Premier. Web. 1 Oct. 2009.

US Senate. Republican Policy Committee. Top Ten Facts Americans Should Know About the Baucus Bill. Policy Papers. US Senate Republican Policy Committee, 25 Sept. 2009. Web. 1 Oct. 2009. <http://rpc.senate.gov/public/_files/TopFactsAboutBaucusBillFinal.pdf>.