America: Land of the (Not) Free (Healthcare)

By: Faye Davis

Edited by: Bridget Salice

The United States has been deemed “land of the free” since the early 1800s, and in many cases it is. It is the land of free religion, of free speech, of free press, and so much more. Many people would argue that the U.S. is one of the greatest places to live in the world, and yet as a country, we still have a long way to go. Yes, we are the land of the free in many aspects, but we are still not the land of free healthcare.

Healthcare has been a debate throughout the U.S. for many years. Questions such as “Who should have access to healthcare?” and even “Who is worthy to access of healthcare?” are being asked instead of questions like, “Why do we need access to healthcare?”

Health issues are something we all have dealt with or will deal with in the future. Whether it is treatment for the common cold, a dental checkup, a broken ankle, or even something more critical like chemotherapy or insulin treatment, medical expenses are, well, expensive. And the kicker is, they are completely necessary for the health and wellbeing of every single person. So even though we have the freedom in America to do and become whatever we please (to some extent), we don’t have the freedom to…be healthy without being put into debt?

The U.S. healthcare system is not a universal healthcare system – instead, it is a hodgepodge compilation of public, private, and government-funded insurance plans. However, there is still a large percentage of the U.S. population who have no insurance whatsoever, and therefore no way to cover medical bills. According to the article Backgrounder: Making Sense of The US Healthcare System, an estimated 33 million Americans remain uninsured. This leads to more and more Americans not seeking healthcare until it is absolutely the only option left. When they finally do seek healthcare – if it is not too late – many Americans are put into debt from having to pay the medical bills without the aid of insurance. To give an example of just how high these medical bills may be, about 140,000 Americans have to pay more than $100,000 in medications per year – medications they need to survive.

In order to best compare how the US healthcare system stands against a universal healthcare system, which is by definition, equally inclusive and opportunistic for all its citizens, Canada is a prime example. Canada’s laws enforce the belief that healthcare should be based solely on the need, not whether the individual is able to pay. Under Canada’s universal healthcare system, equitable access to physician and hospital care is available through public plans. There are five components of Canada’s health care act: public administration, comprehensiveness, universality, portability, and accessibility. The key aspects of Canada’s Health Act that the U.S. is lacking, are the concepts of universality and accessibility. Universality means that everyone who is insured must be entitled to the same health services – this levels the playing field among financial classes. The law also states that healthcare must be made accessible by directly saying that the health care plan of a province, “must provide for insured health services on uniform terms and conditions and on a basis that does not impede or preclude, either directly or indirectly whether by charges made to insured persons or otherwise, reasonable access to those services by insured persons…” This means that all Canadian citizens are entitled to healthcare access.

Whether or not universal healthcare is right for the United States is not for me to say. However, here are some pros and cons of universal healthcare to aid you in making your own informed decision.

Pro: A right to healthcare will save many lives of people who are currently not insured due to financial drawbacks. A study published in the Lancet ranked the U.S. 29th out of 195 countries in preventable mortality rates. Because many people cannot afford healthcare for them and their families, they often refuse to go to the doctor even when the problem is very serious, and as a result, many people die of problems that can be treated or prevented with medical help.

Con: Financing healthcare will cause an increase in taxes.

Pro: A right to healthcare could decrease the number of bankruptcies. Medical debt is the leading reason people file for bankruptcy in the U.S., according to the National Bankruptcy Forum.

Con: A right to healthcare could increase national debt.

The best way to determine the efficacy of the U.S. healthcare system today is to look at the healthcare stories of fellow Americans. That is what the documentary on healthcare, The Waiting Room, does. Many Americans that don’t have insurance also do not have a primary care provider, or a doctor that they can go to regularly for check-ups, physicals, etc. So, in times of real need, they turn to the Emergency Room, also known as “the waiting room”. If you have ever been to an emergency room, you know that unless you are having trouble breathing, or the signs of a heart attack, you will probably be there for hours waiting for the nurse to walk out and finally call your name. Many uninsured Americans flock to the emergency room because they have nowhere else to go, no primary care physician to ask about their reoccurring back pain or flu-like symptoms. Aside from that, there are many people with more urgent matters, uninsured and insured, that have to wait longer as well, due to the population overload in our emergency departments. The Waiting Room documentary covers hundreds of real-life patients in one emergency department in a single 24 hour period. It shows their problems – medical, financial, and social.

One of the most powerful scenes for me to watch was a man who had to come into the emergency room for dialysis. Dialysis is needed for people with kidney failure to help them filter out the waste products that healthy people easily release all the time. One year of dialysis can cost up to $72,000 – however, if this is not performed, the patient will have a build-up of toxins in the body and usually die within a few weeks. The man who came into the ER for dialysis had no insurance – the doctors on site kept asking him if he had a primary care provider he could go to have this done since dialysis is not normally something done in the ER. The man became very angry since this was the only place he could afford to have it done. He kept saying he wanted to die, rather than have to go through this anymore. It was one of the most heartbreaking things I had ever seen.

The entire film was filled with shocking moments such as this one. “Our emergency room is becoming full with people as everyone is losing their insurance. Every day I see patient’s who say they have lost their Keiser insurance, haven’t had their medications for six months, and now they are coming in with chest pain, with various illnesses that could have been prevented had they had access to healthcare,” ER resident Allison Mulcahy says in the documentary, referring to the increasingly large unemployment rate and in turn, the increasingly large population of uninsured patients.

Growing up, I had been privileged enough to have health insurance. I had never considered how dire the situation could be to others, especially with chronic illnesses such as diabetes, who may pay up to $500 per month in insulin, or for children with asthma whose families may have to spend $300 per year for inhalers. Imagine how scary that would feel – to have no money to pay for the medical treatment you so desperately need to survive.

Now that I am a nursing student, I have become much more educated on the issues with healthcare in the United States. Even in my own college clinical experiences, I have had patients with issues that could have been prevented with a medication they had been prescribed in the past – a medication that they could no longer afford to pay. I have seen the worry on their faces as they ask the nurse how much exactly would this X-Ray they had been ordered cost.

It seems obvious to me that there is a problem with the way the U.S. handles healthcare needs. Such a developed country should not have so many people dying from treatable diseases or getting pushed into medical debt due to the very treatments they need to survive. It’s very ironic that the United States, a world “superpower”, doesn’t have the means to take care of its own citizens, while so many other countries, such as the United Kingdom, France, Spain, and Canada do. Universal healthcare may not be the best option for the United States, or maybe it is. There may be another viable option that may work better for the U.S. As I mentioned before, that is up to you to research and formulate your own opinion on the facts. The main point is that something should change. Our fellow Americans are dying for no reason.

For a larger pro and cons list on the argument of universal healthcare, check out I also recommend checking out the website, made with the aforementioned documentary The Waiting Room, to show a broader picture of real people struggling with the healthcare system in America. There are things we as Americans can do to change this situation. The main question you should ask yourself after evaluating the facts regarding the U.S. healthcare system is this: “What is more important, the money in my pocket or the lives being lost in my own country?”

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