Finding Security and Subsistence Amid the U.S. Political and Healthcare Systems

The basic requirements of the American public are not being met by the current political system. In my opinion, the basic requirements for the American public are health care, security, and a subsistence level income. Two of these areas are not addressed very realistically. Americans that are uninsured or unable to afford health care in the U.S. are crossing the borders to Canada or Mexico in order to get health care or more affordable pharmaceuticals.

The health insurance industry has grown and increased insurance prices to the point that it is unaffordable for a large number of people to either be insured for health care or to pay for health care after insurance coverage or completely out of pocket. Health care costs and the costs of reasonable health insurance have increased until they are pushing people over their budget limits or pushing non-employed spouses into employment. Another area that is not getting addressed appropriately is poverty and the distribution of riches. It is not a right in the United States to have housing and a subsistence level income. The richest parts of society have the most political power and ability to attain government aid and tax breaks. The poorest members of society have the smallest voice in politics (Birkland, pp.108-116). This is in opposition of serving society or the morality inherent in man, in my opinion. The ideology of individualism prevents subsistence from becoming a right. These are not ideals based in facts and scientific method. They are based on beliefs or ideals about nature, humanity and morality. There are different types of rights such as procedural, legal and substantive. Yet, they are based in beliefs and changing times rather than in applicable scientific research and facts (Stone,pp.324-329 & 338-341). In other terms, it is considered at this time appropriate to let the poor starve at the same time that the people that require help the least maintain the status-quo and get the most from the government.

Discrimination has been shown to exist against races, genders, and sexualities that in turn creates inequalities that perpetuate themselves in society. Structural and institutional barriers go beyond the ability of most individuals, especially disadvantaged individuals, to overcome. For this reason, individualism serves as a justification to further discriminate and keep resources from certain groups of people. Individualism is a belief or rationalization that prevents the problem of poverty in society from being addressed. The inducements in the system are primarily structured to maintain the status-quo. People are encouraged to be self-reliant. Further, socialism is considered the enemy of true democracy and is used to label programs that are created to aid the poor. Aid to Families with Dependant Children got structurally changed into a new program of Temporary Aid to Needy Families. This new program stresses quick employment in most states over education prior to employment. The new rules for the program force the participants to accept the first job they are offered regardless of the pay or the benefits. They must follow the rules for employment under the program to keep partial aid. Unfortunately, participants are not raised above the poverty level by this new program or taught employment skills that increase their incomes. The program does, however, save the state and federal government money in aid payments. The quality of life for the participants, in my opinion, is largely decreased due to this program especially for the children. The parents in these families are no longer able to stay home and care for their children. They must stay employed at low wages and poor benefits jobs and leave their children in childcare in order to maintain their aid status. The children suffer the most under this program by having to go to childcare and losing the care of their parents. The economic status of these families remains static. Apparently, the goal of the program is to save the government money at the expense of the most vulnerable and poor segments of society. This program benefits companies that utilize low wage employees in that they are required to become employed and they must accept the first job offer they are given regardless of the quality of the job. These low wage earners are partially subsidized by aid in many instances and the companies that hire them are subsidized by the government. It is a good situation for businesses and a form of forced labor for the poor, in my opinion (Stone,pp.265-272). My opinion on the quality of life being reduced by the change to Temporary Aid to Needy Families makes this a negative inducement that has a negative outcome. Yet, the goal of getting people employed and saving the government money by reducing aid payments makes the TANF program have positive results from this point of view. The perspective and the stated or implied goals of any policy strongly influence the perception of the policy as positive or negative in terms of results (Birkland, pp.157-160).

The health care industry is becoming increasingly more expensive at an alarming rate. Doctors no longer provide house visits or personal attention to patients like they had done in the past. Now, a person must go to the doctor's office or the hospital either on their own or in an expensive ambulance ride. The cost of medical care has increased until it is unaffordable for many American citizens. Health insurance that covers a percentage of the costs of medical care or covers emergency situations has become a necessity to middle Americans. People have perished outside hospital doors due to not having any health insurance or provable collateral for the hospital billing departments. Many doctors offices and clinics do not accept patients that do not have a medical insurance provider. The current rules for health care have created a structure that is considered one of the best in regard to advancements and quality. Yet, it excludes many citizens from being able to afford to utilize it. Laws governing health care are important and have benefited many people. For example, insurance companies had to offer individual coverage to people that did not have insurance coverage through their employment. Now, the coverage offered to individual coverage holders is full of exclusions to the point of being an insulting joke and has increased drastically in price. Increasingly, it is becoming a coercive environment that one either risks life, financial survival or both to navigate.

The law at first had a good influence that insurance companies have made more beneficial to themselves as a side influence in the conflict over policy and business goals (Birkland, pp.119-125 & p. 168). It is like a gamble to get insurance in order to have the odds in one's favor that any disease that is contracted is covered by the insurance company despite their exclusions and rules of participation. One late payment to the insurance company is risking coverage and having to go through the underwritting process again. Laws are important for aiding citizens. Yet, they have side influences that must be considered due to the human nature of finding loopholes and alternative routes. Medical care has increasingly become a service for the rich or upper middle class that is not available to the middle class or lower class segments of society. This is another area of life that is not addressed by our current political structure for solving problems due to the imbalance in power between individual citizens and the conglomeration of corporations and interest groups involved in this issue. It is a fine climate on the free market for insurance, pharmaceutical and health care companies. They are able to gather much political power by uniting together and using their financial resources and connections (Birkland, pp.119-125).

However, more and more Americans are not getting their health cared for. Socialism is the label that scares people from being in support of universal health care in this country. Further, there are few requirements put on the health insurance companies about covering their clients. Even physicians are losing their prestige and autonomy to the health care industries terms of service. There have been few solutions offered as this problem continues to escalate. Yet, the issue is not a problem depending on one's perspective and the research facts and resources one chooses to use as a basis for decision making (Birkland, pp.125-127). It is important to distinguish between proper sources, facts and statistics that are salient to an issue in question and dramatized accounts or information that is inaccurate or improperly calculated. Exaggerated accounts of instances of the most horrible type occurrences are used as a tactic to sway opinion such as the depiction of the "welfare queen" taking advantage of the system. This creates an emotionally laden unrealistic source of information (Birkland, pp.127-133). At the same time, this limits alternatives and gives opportunity to leaving alternatives out of the decision making process. Further, "log rolling" as a tactic gets political action for special interest groups that have influence instead of the majority of constituents. The laws on a national level have created a health care system that has the latest technology and advancements. Yet, the health care system at a local level has many citizens left outside the doors of clinics and hospitals and crossing the borders into other nations to receive medical care. The law for providing basic insurance to individuals has been followed. Yet, the administration of this coverage has been beneficial to the insurance companies through their circumnavigation of the law and ultimately their noncompliance. Fair and administratable rules are important in the forming of policy in order to realize the intended goal (Stone, pp. 284-294).

In conclusion, the most pressing interests of Americans are not served by the current system other than national defense and security. One aspect of American life that is provided for is national defense. The military has protected our country from foreign invaders and done a good job to date. This one area has been met in that the United States is still a free nation. Yet, the lives of the citizens inside the borders have not had the quality or longevity of populations in other nations. There are greater inequalities here and less of a safety net for citizens in times of trouble. More and more people are crossing the borders to get health care, and or living in poverty unhelped than in other industrialized nations. This in itself points to a problem in our political system, in my opinion.

References

Stone, Deborah (1997) Policy Paradox: The Art of Political Decision Making W W Norton & Co Inc (Np). ISBN: (0-393-97625-4).

Birkland, Thomas A. (2001) An Introduction to the Policy Process: Theories, Concepts and Models of Public Policy Making M. E. Sharpe. ISBN: (0765614898)