Instructor’s Recording of Comments (This follows the review comments on the file of whole paper)

With the passage of Obama’s healthcare reform bill, major changes will be enacted to our present healthcare system.  As recent as September 23, 2010, subtle changes are already happening, with the final implementation of the program in 2014. Most of the funding for the new healthcare system will still be provided by private insurance companies. Access to the new healthcare system for many Americans, will come from tax cuts on personal income or tax cuts to small businesses, which will be used to provide employees with a private healthcare plan. But, will these changes work? Or should a government funded plan with universal coverage be implemented? There are three key words often mentioned when discussing healthcare issues: access, cost, and quality (J., M. Kronenfeld 3).  To look into these issues and the differences between a publicly financed healthcare system, and the mostly privately funded system we have in the U.S., let’s us look to our neighbors to the north, Canada, to compare. 

Of all of the countries in the industrialized world, the U.S. and South Africa are the only ones who don’t provide a government funded healthcare system, with universal coverage (U.S. 3). According to “Healthcare, reform in America”, almost all of the governments of the industrialized nations, has been a part of a process that guarantee access to many, if not most healthcare services for all citizens (Kronenfeld 2). The World Health Organization (WHO) prepared a groundbreaking study in 2000, ranking the healthcare systems of 191 countries. The U.S. ranked number 37, just behind Costa Rica (U.S. 1). All European countries, the industrialized countries in Asia, and even the oil rich countries of the Middle East, provide a government controlled healthcare system to their population that include universal coverage. Closer to home, Canada has one such system. 

If any society in the world could possibly be compared with ours, it would have to be Canada. We share many of the same aspects of our culture;  lifestyles, diets, entertainment, economy, religions, etc. It was just 50 years ago when we also shared the same healthcare systems. Both were mostly privately funded, through non-profit and for-profit health insurance companies (Health).  Healthcare cost continued to grow exponentially and Canada saw the need for change. Since the late 1960’s, Canada’s federal and provincial governments are funding an egalitarian, socialist system that provides services through private physicians and hospitals. The government sets physicians’ fees and hospital budgets. South of the border, America still relies on a free-market capitalist system to allocate medical coverage (Health). Most Americans are covered by their employer sponsored healthcare plans through private insurance companies. Some, like Blue Cross and Kaiser, are non-profit institutions, but for-profit companies fund most of the healthcare insurance plans. The elderly, disabled and those of the lower income bracket, receive healthcare from government-sponsored programs through Medicare and Medicaid. The biggest difference between the system in Canada and the U.S. is the population’s access to its healthcare system. 

It is estimated that 42.6 million people in the U.S. are without healthcare insurance (U.S. 5).  Many of those that do have a health insurance plan, are underinsured. Over half of the bankruptcies filed in the U.S. are directly related to medical expenses, and 75 percent of those, are by people who have healthcare insurance (Has). In addition to employer-sponsored plans for the middle class, people of the lowest income group in the U.S. qualify for Medicaid, which leaves the uninsured group, mostly the working poor without any healthcare coverage. In the U.S., the poor suffer more illness and die younger, in Canada, there is no association between income inequality and mortality.  Canada’s system reaches to all citizens of Canada and covers an array of services including doctor’s office visits, hospital stays, lab test, and emergency care. Private health insurance plans are also available in Canada, which provide coverage on services that are not offered by the government plan, such as medications, dental, and vision care. The Canadian government paid over 70% of the total amount spent on healthcare in 2006, compared with 46%, the amount that Washington spent.   Private insurance companies paid the lion’s share of what was spent for healthcare in the U.S. 

The amount spent by the Canadian government on healthcare in 2006 amounted to $3,673 per capita.  The U.S. government spent a whopping $6,719, almost twice as much per person (Comparing). In fact, the U.S. government spends more on healthcare per capita, than any other nation (U.S. 2 ). According to “The U.S. Health Care System: Best in the World, or Just the Most Expensive”, a report from the University of Maine, the reasons for the especially high cost of health care in the U. S. can be attributed to a number of factors, ranging from the rising costs of medical technology and prescription drugs, to the high administrative costs resulting from a complex multiple payer system in the U.S. It has been estimated that between 19.3 and 24.1 percent of the total dollars spent on health care in the U.S., is spent simply on administrative costs (U.S.). But, does the higher price transform into the best care? 

The healthcare system in the United States is by far, the most expensive in the world, but when you look at the end results, is it worth the expense?   Life expectancy and infant mortality in the U.S. is among the worse among industrialized nations. At 7.2 deaths per 1000, infant mortality in the U.S. ranks 26th among the industrialized nations, and life expectancy is ranked 24th. (U.S. 5) Infant mortality for the rich and middle class is 5.7 deaths per 1000. Canada’s still does better at 4.7 per 1000, even though the Canadian figure includes all income levels (Dressel).  These figures relate directly to the lack of access to healthcare for a large portion of our population. This data amounts to the world’s most expensive healthcare system with the poorest health.    Here now there is that nice transition and topic sentence we want to see a body paragraph begin with.

The healthcare reform bill will assuredly improve our present healthcare deficiencies. The bill, when enacted, will address the access, cost, and the quality deficiencies of our healthcare system.  Access will improve through tax cuts and the prevention of insurance denials to people with pre-existing conditions. Cost saving through reduction of chronic diseases through preventative medicine, and the computerization of patient records and administrative paperwork. It will improve quality of health due to improved access to the system for more people, and a focus on preventative medicine. But, will tax cuts translate to universal coverage for all? Will we, as a nation, change our sedentary live styles through a disease prevention program? Will the insurance companies continue to spend millions of dollars every year with lobby campaigns to derail the bill’s good intentions? And will they succeed? America’s success with universal healthcare is an experiment that remains to be played out. It is certainly a hopeful endeavor, but not foolproof.

 

Overall, this is a solid compare/contrast paper. The topic is academic, it is well organized ina clear point by point style and stays on topic throughout, it uses and integrates outside research fairly well, the tone of voice remains academic, and the MLA looks pretty solid. This paper was an A-, and would’ve been an A if the topic sentences and transitions between body paragraphs were stronger.