The American healthcare stands out as a unique institution. Namely, the United States is the only rich democracy that does not cover everyone. In fact, at least 46 million Americans are not covered by insurance, compare to less than 5% in Germany, France, Japan, U.K., etc. (The statistics in Europe is actually less than 5%). Yet ironically, the U.S. healthcare is the most expensive. About 17 percent of the U.S. GDP funds its healthcare. (Compare to 8% in Japan, 11% in Germany, 10% in France, whose healthcare ranks 1st in the World Health Organization’s (WHO) ranking). Despite the expense, even covered Americans face the danger of being dropped by their insurance after being diagnosed with cancer, or spending months fighting with insurance company for the payment of the MRI scan, etc. In France and Germany, for instance, it is illegal for insurance to refuse coverage.

In simple words: America pays more for its healthcare but Americans are getting less.

The debate tonight is: what accounts for the difference?

Scholars both domestic and aboard have contributed numerous theories, including the cultural theory, the interests theory, and the institution theory.

Culture:
U.S. has a culture of individualism and minimal government involvement. It emphasizes on the achievement (or not achieving but merely dreaming) the American Dream. The institution started when founding fathers decided that this nation will commit to the defense of minority rights.

While culture theory may indeed offer some insights to why national healthcare did not develop, it does not account for some of the most “socialistic” aspect of American politics and society. The healthcare for veterans, or the U.S. Department of Veterans Affairs, represents one of the purest and socialistic “Beveridge Model” (the model used in the U.K.), where both the payer and provider is the government.

Interests
This theory argues that interests groups (the private medical providers, insurance companies, and rich conservatives) lobby against national healthcare. Based on this logic, US. does not have universal coverage because of strong opposition. Taking the reverse, a country that has universal coverage probably did not face a strong opposition. True? False! In fact, all democracies faced opposition before achieving universal coverage. Even today, doctors in Germany march out on strikes for a raise (In March 2006, tens of thousands of medical providers demonstrated against Merkel’s healthcare reform).

Plus, U.S. passed reforms like Medicaid and Medicare under the same oppositions. So this theory begs the question why did some legislation overcome opposition while others did not.

Institution
The American political institution also reflects its idiosyncrasies. Those of us well versed in history know that America has attempted healthcare numerous times. Many to no avail. FDR dropped healthcare after when he deemed as a necessary sacrifice to ensure the success of the New Deal (to avoid antagonizing more committee chairs). Truman, campaigning on the grounds of national healthcare and winning the Democrats 263 seats in house (making it the majority), again failed (despite 82% of the public supported some form of healthcare). Why? Due to American's unique political system, power was given to committee chairmen, who were chosen based on their seniority. While such allowed the Congress to check on the executive power, it also created, in 1949, a group of Dixiecrats who, disagreeing with Truman's social issues, blocked all of his legislative initiatives.

Healthcare once again failed.

Then, the 1950s, the era of massive mobilization of the American Medicine Association's attempt to tarnish the idea that a national healthcare is "socialized medicine."

The rest is history.

America has time after time failed to produce a universal care that is fundamental to a democracy (as mentioned before, every single rich democracies have universal coverage).

Tonight's debate: national healthcare. Please feel free to defend, challenge, or contribute. Of course, if the question "Is healthcare a moral obligation?" is raised, I will storm you down with arguments. If one does not have the right to life, does one have any rights at all?
 

If any statistics or points are doubted, privately contact me and I will guide you to the source.