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The United States is the only wealthy, developed nation that does not provide guaranteed health care for all of its citizens, regardless of their ability to pay. According to Families USA, a nonprofit and nonpartisan health organization, nearly 90 million Americans (almost a third of the country) went without health care for all or part of 2006-2007. Because the uninsured are less likely to get routine preventive care, they are more likely to wind up sick. That's a problem for all of us because sick people are less productive than healthy ones, and when the uninsured can't afford to pay their medical bills, health premiums go up, passing extra costs on to everyone else.
In spite of the large number of uninsured Americans, the United States spends more than $2.1 trillion each year on health care. That's more than any other nation and is expected to double by 2017. Considering how much money we spend on health care, one would expect the United States to be one of the healthiest nations in the world. But we're not. We're one of the sickest. Our rates of chronic (and often preventable) conditions like obesity, diabetes, hypertension and heart disease are on the rise, while life expectancies are on the decline. In fact, babies being born right now in 41 other countries can expect to outlive a baby born today in the United States.
This is largely because of the United States' growing gap between the rich and the poor -- how healthy a person is depends just as much on socioeconomic status as on access to health services -- but it also reflects the failed policies of politicians who view health as a personal responsibility, when arguably, it should be a right. And therein lies one of the most fundamental differences between the presidential candidates' approaches to health reform: Obama has stated health care should a right; McCain has stated it should be a responsibility. That distinction guides how they plan to address everything from Medicare reform to the obesity epidemic. To further break down those differences, we've compiled a voter guide on this year's most important health issues. Keep reading to see how the candidates compare.
1. QUALITY HEALTH CARE FOR ALL
The United States has a health crisis on its hands. Quality health care is increasingly out of reach for cash-strapped Americans whose stagnant wages can't keep up with the rising costs of health insurance. Close to 16 percent of Americans -- 48 million -- are uninsured; the number of Americans with employer-paid health insurance is in steady decline; and half of bankruptcy filers in the United States last year said medical causes were to blame. Besides being unaffordable, many health insurance policies are also discriminatory -- they refuse patients with pre-existing or chronic conditions -- and don't offer comprehensive benefits. In short, our profit-driven, privately funded health system has resulted in high-cost, low-quality, inefficient care.
- Solution: Adopt a publicly funded, universal, single-payer health care system that would guarantee quality coverage for all Americans. Coverage should include a full range of medical services -- e.g. mental health, maternity and preventive care -- similar to what members of Congress now enjoy. Unlike patchwork approaches to providing universal health care, a single-payer system not only makes sense from a human rights perspective, it's arguably the smartest choice financially. A full 60 percent of the U.S. health care system is already publicly funded through local, state and federal taxes. Taking the next step and eliminating private spending would cut waste and save money -- Public Citizen estimates it could save $286 billion in administrative costs alone.
- Obama's position: Obama has described health care as a right. His plan would create a new framework for health coverage called the National Health Insurance Exchange (NHIE), which is a public plan that would give individuals who don't already have access to care through Medicaid, the State Children's Health Insurance Program (SCHIP) or employer insurance a guaranteed way to get coverage (with full benefits), regardless of pre-existing conditions. Obama would require employers to enroll their workers in a health plan, but workers could choose to opt out. Obama's proposal is not single-payer and would not provide truly universal coverage, but it would reach nearly all children and more than half of those currently uninsured, reducing the total number of uninsured, non-elderly individuals from 17 percent to 6 percent. Read Obama's full plan. Read a nonpartisan analysis of Obama's plan.
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