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Karim Mahmoud
Professor Griffin
English1102
March 31, 2014
Investigation into Different Healthcare Models

John Doe is a male in his mid 30s. He has a wife and 2 children. He recently found out
his wife is pregnant with a third. They purchased a house a few years ago when they started a
family in the suburbs of a big city. He has a good paying job with a major corporation and so he
is fortunate. John has no idea how his world is just about to come crashing down around him.
John goes to work just like any other day. His job requires that he frequently has to make long
distance trips to multiple locations via a car. On one particular trip, John has a seizure. This is
odd because he never had a seizure before. The medics come and take him to the hospital. The
doctors scan his head and find that he has a mass in his brain. Several more doctor and specialist
appointments later, and it turns out that mass is brain cancer. The brain cancer becomes larger
very quickly. In a matter of weeks, John is having memory issues, gait problems, and frequent
seizures. Because of his seizures, he loses his drivers license. Because he lost his drivers license,
he loses his job. Because he loses his job, he loses his health insurance. The health insurance that
he rarely used but payed premiums into for greater than 10 years. They have no choice. Johns
wife goes back to work in order to help make ends meet. Health care for brain cancer is
extremely expensive. Because John lost his health insurance, he decided that he has to apply to
medicaid because he needs assistance. Medicaid refuses his application due to his assets. They
state that he would have to liquidate his retirement and home before medicaid will accept him.
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He started a law suit that he is still fighting today. He is no closer to obtaining health insurance
and is having great difficulty obtaining care for a life threatening illness. I am a paramedic and I
had the fortunate experience for caring for this man. I will never forget his story. He was the first
patient that I encountered that really challenged my belief that Americas healthcare system is
the best in the world. I realize now that it is only the best healthcare system in the world for those
who have the means and those who have the means are few and far in between.
Health care is a very volatile topic. Currently, the republicans are refusing to pass a clean
spending bill in congress so that they can delay Obamacare, and are willing to shutdown the
government to do so. There appears to be no end to this dark tunnel. I believe that healthcare is
such a volatile topic due to different ideologies about government and its role in healthcare. In
the one camp, you have universal health care. In the other, you have the american system which
combines a universal healthcare system model for the poor, disabled, and elderly and a private
health care model for everyone else. My goal is to convince you that we need to get rid of our
barbaric system and change to a universal healthcare system.
Before I can implore you to evaluate different healthcare system models, I need to
provide you with evidence of the failure of our current healthcare system. There are many
documented sources that show the consequences of being uninsured, the cost effectives of health
insurance, and the publics stake in health insurance. Studies performed by the Urban institute
revealed that having health insurance would improve the health of the uninsured. By improved
their health status, their work effort and annual earnings improve by about 20% (Hadley). The
American Journal of Preventative Medicine has an article that shows that by insuring the
uninsured, the cost effectiveness is favorable (Muennig, Franks, and Gold). A classic article by
Harry Becker summarizes why healthcare is important. Insurance against unpredictable and
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unmanageable costs of illness insures the confidence needed to buy and enjoy the consumer
goods and services which constitute the standard of living for todays family (Muennig, Franks,
and Gold). Given all this data of the consequences of uninsurance, it is amazing that 20 percent
of americans are uninsured. (NIH)
By insuring the entire population, we lower healthcare costs. We already described how
those with illnesses wait until they are critically ill before they seek care and how hospitals are
mandated to provide that care regardless of compensation. By providing them with access to
care, those patients can obtain preventative care. Preventative care has been shown to be cheaper
and more effective in keeping a population healthy and productive (Lee et al.). It is also
important because a critical illness can destroy the standard of living for an individual and his
family. An article published in the Journal of Preventative medicine revealed that Insurance
against unpredictable and unmanageable costs of illness insures the confidence needed to buy
and enjoy the consumer goods and services which constitute the standard of living for todays
family (Muennig, Franks, and Gold).
Studies have shown that due to reduction in healthcare costs and improved health, we
increase the populations work effort and annual earnings by about 20% (Hadley). Current
practices by health insurance companies stifle the economy and take money that can be used to
provide care to people and funnel it to a select few. Congressional hearings of former physicians
working for large HMOs and investigative reports over the last 10 years revealed information
that studies have analyzed to shed light on current health insurance practices. Researchers found
that health insurance companies would selectively contract with a limited set of hospitals in order
to reduce their expected utility (Wedig).
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Ultimately, our current healthcare system is based on profit. Health insurance companies
are willing to do whatever they could to reduce their payout. The current healthcare system
leaves 20 % of the population uninsured. Healthcare costs are on the rise with no signs of any
stopping to the inflation. A UHC system would provide healthcare to all, reduce costs, provide
the same quality of care, and improve the quality of life of the population. All of these outcomes
will lead to improvements in our economy.
Our current healthcare model leaves a large group of individuals uninsured. According to
data from the National Institute of health, 20 percent of Americans are uninsured (NIH).
Universal Health care is the only health care model that provides access to healthcare for all. No
other health care model can effectively insure the entire population. Insuring the entire
population is a necessary goal of a healthcare model because there is certainty that everyone will
be ill and require medical care over the course of their life. Due to current moral laws, healthcare
providers are required to provide care should someone come to the hospital. Therefore, even
though we have many individuals uninsured, we still provide them with medical care at a
premium cost. The medical care we provide is at a premium cost because they usually do not
have a capacity to pay and they are treated when the illness has become critical. Medicine has an
article that shows that by insuring the uninsured, the cost effectiveness is favorable (Muennig,
Franks, and Gold). Ultimately, a UHC system will be able to provide access to care for all which
has numerous ramifications that will be discussed below.
Even with all this data, people are skeptical. Looking at studies in other countries, we
find that Columbia implemented a policy with an overarching theme similar to Obamacare,
mandatory health insurance. The researchers found that after the new policy was implemented,
mortality indexes decreased significantly and then stabilized in the 10 years after
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implementation. (Arroyave et al.) This evidence is not just stastistical analyses performed on
hypothetical populations. This is real data of real change in healthcare policy and the resultant
improvement in mortality.
Another example where UHC has demonstrated its ability to improve access and decrease
healthcare costs in multiple studies and case examples throughout the world is in Taiwan
(Arroyave et al.). The best part of UHC is that it does not come with a caveat. The level of care
provided by UHC is equitable to our current healthcare system, if not better. Studies have shown
that those who are insured under our current healthcare system would have no change in
morbidity and mortality, but those that were uninsured would have dramatic improvements in
those same statistics. Another case study similar to Columbia is that of Taiwan. The researchers
there found that after a universal health care policy was implemented, mortality indexes
decreased significantly and then stabilized in the 10 years after implementation (Arroyave et al.).
I will provide a more drastic, but what I believe should be the ultimate goal, which is
Universal Health Care. To do so, I will provide the experience of Taiwan. The country initially
had a private health care system. The country established a universal healthcare system in 1995.
It now covers 98% of the population and enrollees enjoy almost free access to healthcare.
Obviously more individuals have access to care but did it improve the health of the population?
This question appears to be the one most argued against by those who do not want UHC. They
argue that healthcare access may have increased but healthcare would suffer. Taiwans
experience proves otherwise. The authors of the study found that the universal healthcare system
showed a reduction in deaths, particularly in those age groups least likely to have been insured
previously (Lee et al.).
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The research I found was astounding. Evidence across the world is unanimous, UHC is
most successful in providing the lowest morbidity and mortality to a population at the lowest
cost. Why is it that we here in America are vehemently opposed to it? Why is it that studies
performed here in this country are very contradictory as to whether UHC would provide better
healthcare than our current system? Historically, americans are fiercely independent. Minimal
government involvement in american lives appears to be a very strong viewpoint. This appears to
be the greatest driving force in keeping americans from wanting to adopt UHC. A UHC system
is one where the people must have great trust in their government and the will to keep that
government in check. However, our mistrust of government and authority is hindering our ability
to provide care to our population.
Every westernized nation of the world employs a universal health care system. It allows
for access to care, it improves the health of the population, and there is evidence throughout the
world that it does so. Why are we trying to reinvent the wheel? Why are we trying to do
something different when there is already a system that has existed for several decades in many
countries around that world that has proven how successful it is? I do not know. I hope we make
a change soon.

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Works Cited
Arroyave, Ivan et al. The Impact of Increasing Health Insurance Coverage on Disparities in
Mortality: Health Care Reform in Colombia, 1998-2007. American Journal of Public
Health 103.3 (2013): e100e106. Print.
Becker, Harry. The Publics Stake in Health Insurance. Nursing Outlook 60.5 (2012): 305
308. ScienceDirect. Web. 12 Sept. 2013.
Hadley, Jack. Sicker and PoorerThe Consequences of Being Uninsured: A Review of the
Research on the Relationship Between Health Insurance, Medical Care Use, Health,
Work, and Income. Medical Care Research and Review 60.2 suppl (2003): 3S
75S.mcr.sagepub.com.librarylink.uncc.edu. Web. 12 Sept. 2013.
Health Costs: How the U.S. Compares With Other Countries. (n.d.). Retrieved February 25,
2013, from http://www.pbs.org/newshour/rundown/2012/10/health-costs-how-the-us-
compares-with-other-countries.html
Hidden costs, Value lost : Uninsurance in America / Committee on the Consequences of
Uninsurance, Board on Health Care Services, Institute of Medicine of the National
Academies. (2003). Washington, D.C. : National Academies Press, c2003.
Institute of Medicine (IOM). 2004. Insuring Americas Health: Principles and
Recommendations. Washington, DC:
National Academy Press.
Lee, Yue-Chune et al. The Impact of Universal National Health Insurance on Population
Health: The Experience Health Costs: How the U.S. Compares With Other Countries.
(n.d.). Retrieved February 25, 2013, from
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http://www.pbs.org/newshour/rundown/2012/10/health-costs-how-the-us-compares-with-
other-countries.html
of Taiwan. BMC Health Services Research 10.1 (2010): 225. www.biomedcentral.com. Web. 12
Sept. 2013.
Long, Sarah S. Underinsurance of Children Is Common and Effects Their Access to Care and
Their Health. The Journal of Pediatrics 162.2 (2013): 220. ScienceDirect. Web. 12 Sept.
2013.
McCabe P. Working But Uninsured: Millions of Employed Americans Uninsured and Unable
to Get Medical Care. Robert Wood Johnson Foundation. April 27, 2005.
Muennig, Peter, Peter Franks, and Marthe Gold. The Cost Effectiveness of Health Insurance.
American Journal of Preventive Medicine 28.1 (2005): 5964. ScienceDirect. Web. 12
Sept. 2013.

U.S. Census Bureau. Income Stable, Poverty Up, Numbers of Americans With and Without
Health Insurance
Rise, Census Bureau Reports. August 26, 2004.
Wedig, Gerard J. The Value of Consumer Choice and the Decline in Hmo Enrollments.
Economic Inquiry 51.1 (2013): 10661086. Wiley Online Library. Web. 24 Oct. 2013.