A CASE FOR UNIVERSAL HEALTH CARE
Universal health care is a health coverage which is extended to all citizens of government region regardless of their ability to pay. Every citizen will be covered under a united health care system. Even the un-Incurables.
CASE FOR UNIVERSAL HEALTHCARE IN OUR COMMUNITY
INTRODUCTION
Over the last decades, Nigeria and its state has witnessed skyrocketing health care costs. Health coverage premiums have been arising on average by double- digit percentage points over the past decade, a rate of increase that is 2-3 times the rate of inflation. Because of these out-of-control health care costs, there has been a steep rise in the number of uncovered citizens. currently, more than 90% of the citizens of our state lack any form of health coverage, and thousands more are “underinsured” they have insurance but lack adequate financial protection from health care costs.
While this problem was a problem formerly confined to low-income citizens, more and more middle- class citizens are becoming directly affected by the problem. In the face of rising health care costs, fewer employers are able to provide their workers with health coverage: the percentage of employers offering health coverage has dropped tremdeously. Even if employers are able to provide health insurance benefits, the trend are towards providing high- deductible insurance that covers an ever- shrinking percentage of health care costs. The net result is that more and more employed middle- class find themselves with low- quality or no access to health care.
THE MORAL CASE FOR UNIVERSAL HEALTH CARE.
At its root, the lack of health care for all in our state is fundamentally a moral issue. Our state is one of the states in Nigeria that do not have some form of universal health care (defined as a basic guarantee of health care to all its citizens). While other regions have declared health care to be a basic right, our state treats health care as a privileged, only available to those who can afford it. In this sense, health care in our state is treated as economic good like a TV or VCR, not as a social or public good.
Many of our citizens have had to turn to various ways to get the type of health care need that they require. A good number resort to use of traditional medicine. The reason for this is because they find it cheaper and readily available. This method and its viability have never been proven by any medical research. Some others take their chances by going to the local chemist shop to receive medical treatment that may require. The problem with this is that people that operate these shops are not qualified to render the kind of help that recipients require. Other people have been known to visit healing of prayer houses, or just wait to die. In some other cases, people who actually visited a doctor, but were sent for things like further tested or x-rays, never completed their treatment because they did not have the money.
Our company also discovered a sicking trend people who were admitted to hospitals for procedures or ailments, but cannot afford to pay for their hospitalization were held hostage by these hospitals or encouraged to give up priced family inheritances like land in order to off-set their bills. Even in some government owned hospitals, medical personnel have been rumored to demand bribes from patients before treatment. Doctors have been known to ask patients to visit their private clinics in order to charge them higher fees for these procedures. The rate at which we lose women during child birth is not encouraging. The average life span in our state is 49 years, while the world average is 75. This is because our people cannot afford the high cost of medical treatment in our state.
The current challenge in our healthcare systems necessitates a critical look in our healthcare delivery systems to find ways to withstand the challenges.
It is an open fact that Nigeria, Anambra state inclusive is leading in numerous health hazards statistics world over. Examples are as follows:
2nd in mortality rate in maternal and child healthcare in the world (World bank).
2nd mortality rate in children under the age of five in the world (WHO).
3rd in HIV aids case in the world (USAID).
1st in new cancer cases in the world (Nigeria Ministry of Health).
These are to be mentioned but a few.
THE ECONOMIC CASE FOR UNIVERSAL HEALTH CARE
The central question surrounding the economic case for universal health care is whether achieving health care for all is financially feasible. The answer to this question comes in three parts:
How much would it cost it to achieve healthcare?
What are the costs of not achieving universal care?
Do the costs of achieving universal health care outweigh the benefits?
How much would it cost it to achieve healthcare?
There are number of costs involved with achieving universal health care.
The additional health care that would be used the uninsured if they had insurance: E.g. the so called fee-for service instituted by the NHIS.
The costs of covering the out- of pocket costs the uninsured currently pay.
The cost of covering uncompensated care costs provided by hospitals, physicians, and other providers to the uninsured
What are the costs of not achieving universal care?
Fewer years of participation in the workforce i.e. high mortality rate. For instance, the average life spans for our citizens have been put at 49years according to world health organization (WHO).
Developmental losses for children from mostly poor families due to poor health.
Costs to public programs due to fear of participation.
COST OF HIGH RATES OF UNINSURANCE TO COMMUNITIES
Lower health care delivery capacity.
Impaired access to emergency departments.
Weakened local economy due to poor health and high mortality.
Adverse effect on public health
Unnecessary use of ER, and under-use.
Lack of penetrative care and adequate care of chronic disease.
THE CULTURAL CASE FOR UNIVERSAL HEALTHCARE
“Economic goods that can be valued in monetary terms are not the only kinds of goods that we value having. Providing certain important goods like health care to all members of society has its own value” lack of universal health care in our state not only has hidden costs, it represents lost opportunities, to more fully realize important social and political ideas that account for our nation’s political stability and vitality. Extending the social benefit of universal health care would help us make implicit and explicit democratic political commitments of equal opportunity and mutual concern and respect more meaningful and concrete.
These two quotes from the institute of medicine’s report on the uninsured capture the essence of the cultural argument for universal health care- the idea that universal health care is not just consistent with our state’s values but demanded by them. Clearly it is extremely challenging to define our values as a whole, and what follows are generalizations that may not apply to every citizens of our state.
HOW CAN THE EXPENSE OF HEALTH COVERAGE BE ATHREAT TO OUR COMMUNITY?
Having a close family: the stress borne by families with members who have extremely high health care costs or who are ill because they cannot access health care has been documented in several studies. Dealing with hospital bills and prescription costs is often stressful financially; even to well to do families. Children in particular are harmed by familial stress and developmental delays from not receiving health care, both of which can lead to behavioral problems and loss of potential.
Having the freedom to make decision about life: the freedom to make decisions about one’s life includes having the financial resources to pursue one’s goals. More explicitly, the “job lock” phenomena, in which millions of citizens stay with job they don’t like because it provides health coverage, is a clear barrier to being able to freely make decisions about how your life plays out.
Being able to provide for yourself and your family: with health care premiums increasing 2-3 times the rate of inflation and increases in average monthly earnings, employers are forcing employees to pay a greater share of the health insurance premiums. In addition, employers are increasingly passing their increased health insurance costs to employees by not raising wages. Health insurance is a form of compensation even though it is not counted as salary, and if businesses want to keep total compensation per worker steady, they often hold wages the same when health insurance premiums increase. Finally, private health insurance is trending towards high- deductible insurance that provides less protection against health care costs than before. All of these conspire to the amount the average citizens are paying both to have health insurance and to use the health care system.
THE UNINSURED
The most visible victims of our state’s decision to treat care as the 4.5 millions citizens who lack insurance or healthcare coverage. In contrast to prevailing stereotypes, 80% of the uninsured are hardworking citizens who are employed or come from working family. However, they are unable to obtain coverage through their job either because their employer does not offer it or that the employer share of the premium is too expensive, or they are not eligible for health coverage for health coverage(e.g. they are part-time or have not worked long enough at the job).
The problems of accessing health care for the uninsured have been detailed extensively.
The uninsured or those without health coverage are less likely to be able to fill prescriptions and more likely to pay much more of their money out –of pocket for prescription.
The uninsured are 3-4 times more likely than those with insurance to report problems getting needed medical care, even for serious conditions.
The uninsured are less likely to have a regular source of health care.
The uninsured are less likely to get needed penetrative care.
The uninsured are less likely to be forced to delay medical services, affecting the timeline of diagnosis and thus the prognosis of the diseases process.
The uninsured are less likely to receive poor care for chronic disease.
As result of these difficulties in accessing health care, the non-partisan institute of Medicine estimates that the uninsured have an excess annual mortality rate of 25%. This increased mortality translates into 80,000 excess deaths for people between age 25- 64 per year, which is of comparable magnitude to the number of people in this age group who die each year from diabetes, stroke, HIV, and homicide.
The suffering caused by lack of coverage goes far beyond the purely physical suffering experienced by uninsured individuals. Emotionally, lack of health coverage contributes to anxiety, familial stress, depression, and fear. Financially, medical costs are major cause of personal bankruptcy. Even without bankruptcy, the financial strain on families can be significant and potentially ruinous.
In the end, while all of these facts and figures are sobering, they cannot capture the true human dimension of the suffering caused by lack of health coverage. To truly understand this dimension. One has merely to turn to the numerous horror stories in the media that portray the victims of our states inability to guarantee health care to all the patients who are forced to decide between pills and food, the patient diagnosed with inoperable late-stage cancer after not receiving penetrative care, and so on. The stories of these patients may seem like isolated anecdotes for some, but for the vast majority of our citizens, these stories hit disturbingly close home. The victims are friends, neighbors, and increasingly, family members.
CONCLUSION
It is tempting to believe that the current design of health care system is untenable-that the system is on the verge of collapse. Yet, countless of reforms have proclaimed the impending doom of the health care system throughout the years, only to see our health system morph into an externally different yet still fundamentally flawed entity. The only way we can avoid repeating this abysmal cycle is fully engage the central questions underlying this issue. Is it indeed acceptable to deny people health care based on their ability to pay?. Or is healthcare a basic need that should be provided to every citizen as a matter of course? If the answer is latter, than we need to overcome the remarkable inertia of our health care system and create a society in which health care is available to all.
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