Privarization of Health

Introduction

In the world today, many countries are turning to private rather than public health care system. Although it seems acceptable to many, it is subjected to disagreements that may be economical, political, and ethical / medical. The focus, however, is mostly on ethical issues given that it is concerned more with human life.

Albreht (448) defines privatisation as the process of shifting the ownership as well as functions of the government from being managed by public institutions to being controlled by private organizations that may be either non profit making or for profit. In most European countries, discussions relating to the concept of privatization are very hot and more often than not, they play a big role in determining political agendas.

To a majority of people, privatization provides solutions for various problems and health care is thought of as being one of the areas where the implementation of privatization could lead to improved performance (Albreht 448). This, however, is usually not the case as many people feel that privation crumble the health care system.

This paper takes a look at economical, political as well as ethical and medical arguments regarding the subject of privatization.

Economical Aspects of Privatization

Research has indicated that quite often, the implementation of any type of privatization does not put into consideration the reasons as to why it is needed. According to Albreht (448) health systems that are purely public will suffer greatly from incompetence and also poor adjustment to the needs of patients. As a country moves towards the adoption of a private health care system, it is important to consider certain issues.

First, it should be clear to the government why privatization of the health system is critical (Albreht 448). What goals are to be achieved through privatization? Another consideration is whether or not the country should implement an extensive private health care system.

The government should also determine whether everything should be privatized or if only some components of the system have to be privatized. It is also very critical to know what parts of the system will be funded by the government and which ones will not (Albreht 448).

Also, it will be vital to know whether it is one of the government’s desires to establish a parallel system to cater for private patients with private financial sources. Finally, Albreht (448) argues that if a mixture of public and private health care systems is favored, then it is crucial to determine what control mechanisms are present or are needed so as to ensure that national resources are used in a gainful manner (Albreht 448)?

Barkun (73), talking about the health system in Canada considers funding as the key drive for the move to a private health care system. For many years, arguments about health care were focused on financial issues. An estimated 73% of the country’s health related costs were taken care of by the federal and provincial governments (Barkun 73).

This led to a serious financial crisis that saw medical expenses reduced significantly. A commission led by Romanow was established to look into this problem and give recommendations on how to reduce health care related expenditure. One of the recommendations made was to cut down the number of admissions to medical schools in Canada by 10% to reduce the amount of money transferred to these schools to support their operations (Barkun 73).

Consequently, admissions to the medical schools dropped from an estimated average of 1770 students in 1980’s and early 1990’s to 1552 students recorded between 1997 and 1998 with a number of nurses being made to retire early so as to lower expenses. The implementation of these measures subjected nurses to burn out and stress caused by the fact that they were being overworked (Barkun 73).

Despite the fact that proponents of a privatized health care system speak so passionately about it, Aguayo (1) is opposed to the idea of privatizing the health care system for economic reasons. He is of the opinion that allegations supporting a privatized health care system are baseless and without strong evidence to defend them. He cites medical incidences that happened in his life and plunged his family into serious financial challenges (Aguayo 1).

Considering that the American government did very little to improve the public health system, many Americans would be comfortable with the idea of purchasing medications over the counter rather than engaging the services of qualified private physicians who were obviously expensive. Proponents of privatization are convinced that by allowing private practitioners, services will be improved and the cost of medical services will decrease (Aguayo 1).

Rachlis (3) argues that privatization will do more harm than good. By allowing privatization, administrative costs will go up quality will be compromised and equality among the citizens of a country will decrease. Although they may seem to offer a solution as some people claim, private partnerships will only serve to increase the operational costs (Rachlis 3).

There are two main reasons why private health care turns out to be more expensive than the public health care system. First, there are huge administrative costs associated with private health insurance as opposed to the public system and secondly, it is much easier for a public system to effectively control prices through a single system than many private operators trying to do the same.

In the United States where most citizens heavily depend on the use of private health insurance, companies offering health insurance services have their own policies and modes of operation that greatly differ from one operator to another (Rachlis 13). The US government spends huge sums of money to screen sick people with intentions of denying them the opportunity to acquire insurance.

Later, claims of such unfair treatment are denied and the government is then forced to fight appeals from the affected individuals. The outcome of this is increased expenditure on health care related cases. Statistics have indicated that the US health system spends more than three times what Canada spends on health care administration costs although millions of Americans do not have insurance coverage (Rachlis 11).

Marqusee (1) argued that a privatized health care system makes use of an elaborate billing and accountancy structure and this leads to increased spending for the US government. Administration cost goes up to $400 billion in any given year and this quite high (Marqusee 1). More money disappears through marketing activities, paying share holders profits, and networking with politicians to ensure that profits remain steady no matter what happens. This is usually at the expense of the entire nation (Marqusee 1).

According to Lyons (1), America does not really have a privatized health care system. It is only there in theory but practically, none really exists. The reason why health care in the United States costs so much compared to other places is considered to be due to the fact that America has in place a health system that is managed privately but funded by the public.

The system is considered a disaster (Lyons 1). Whereas it is the private companies that to a large extent provide health services, the burden of paying for these services lies with the tax payers. The American tax payer is responsible for 60 % of the American health care budget allocation. Though this is the case, it is unfortunate that the benefits are not equally distributed to the public and only a small number of people get to enjoy the services (Lyons 1).

Politics and Privatization of Health Care

Barkun (73) talks about the genesis of privatization in Canada and argues that it is closely linked to the fact that public facilities had reached a point where having a universal health care system was no longer sustainable. A commission was set up to carry out investigations and one of the key recommendations made was to switch from a public health care system to a private one.

The commissioners argued that a private health care system would address the health issues more efficiently unlike the public system that seemed quite expensive to maintain (Barkun 73). With a private health care system in place, individuals who are able to can bear the cost of their own medical expenses while those who cannot afford to pay for these services can receive support from the government.

Although this system has been present in the United States for quite sometime, it has failed to yield acceptable results and consequently, the U.S. still lags behind countries such as Canada that use similar healthcare arrangements. In view of this, critics have argued that it would be of no value to move to a full private health care system (Burkan 73).

Schmid, Cacace, Götze and Rothgang carried out an analysis of health care regulation in Germany, England and the United States (459). Whereas in England, the state has devised mechanisms to regulate the operations of service providers, the Germany health care system is a self-regulated one with no interference by the state. The United States had a hierarchical structure of regulation in place for its health care system.

This form of regulation was regarded as being so weak and as a result activated a need for policy change. This later ushered in the era of private managed care. The presence of managed care resulted into hierarchical governing structures that to some extent substituted the regulatory function of the government (Schmid et al. 459). Schmid et al further argued that the state can compensate for its reduced spending on health care by taking an active role in regulating the operations of service providers (459).

Skinner and Rovere (1) have argued that the increased rate of taxation will not in any way sustain the health care system. They recommend that leaders should re-introduce private payment in the medical sector (Skinner & Rovere 1).

A number of people have argued that the issue of privatization has been exaggerated by the politicians (Steinbrook 1663). Michael McBane, the national coordinator of the Canadian Health Coalition, argued that the public health care system can easily get destabilized by the increased use of a private health care system.

By interfering with the public system, advocates of the private system hope to make more money for themselves at the expense of people’s lives (Steinbrook 1663). There are arguments that wealthy people want to evade paying tax to meet the health care needs of everyone else. By turning down the public system the motivation is to pass on the cost of health care from the government down to patients and employers (Steinbrook 1663).

Fisk (1) discovered that politicians in Canada were very crafty in their attacks to the Canadian health care system. Rather than being confrontational and directly attacking the health care system, they preferred to take an indirect approach. The idea behind the hidden attacks directed to the system by politicians was so that they may not be seen to be on the opposing side. The result of their attacks was a weakened health system that could not provide services as expected forcing people to turn to for-profit health care service providers (Fisk 1).

Brody (1) argues that politicians are always just concerned about themselves and when it comes to looking for votes, they will do anything to get them. This includes trying to convince the voters that they are their side when they actually are not (Brody 1).

Ethical / Medical Aspects of Privatization

Some people have made claims that it does not really matter who delivers the service as long as it is the public that is paying for it. They recommend that the government should allow health care insurers to bid for clinical services so as to give patients the freedom to choose from where to source medical services (Rachlis 16). A comparison of the quality of health care provided to dialysis patients by for profit organizations and not for profit organizations in the United States revealed some shocking statistics.

The death rate witnessed at the for profit dialysis clinics was found to be 8% higher than at the not for profit clinics. For profit organizations had a smaller number of staff members who also were not well trained. These clinics also did the dialysis sessions for shorter periods and used reduced doses. Clearly, the goal for the private profit making organizations was to maximize profits and minimize costs as much as possible (Rachlis 16).

Armstrong, Armstrong and Fuller (23) also pointed out that the main concern of profit organizations is to make profit. Consequently, whatever resources could have been channeled towards improving health services are diverted to the pockets of share holders. The desire to make profit tops the agenda of these organizations and the health of patients is not an important consideration.

Even though private clinics argue that they exist to complement the public system and help to reduce the long waiting queues, their services are very much compromised putting the life of patients at risk. They are notorious for providing worse services as well as engaging the services of employees with lower skills to pay them lower wages to make higher profits (Armstrong et al. 24).

An important consideration that has been omitted in discussions regarding privatization is the need to ensure universal access to valuable health care services. Given the fact that a private health care system will serve only those who are willing and are able to pay for the services, there is no equality among the people (Armstrong et al. 24).

A study by Marqusee (1) indicated that the number of doctors and nurses in the United States is two and a half times that of those in UK and ten times that of those in India.

Moreover, the United States spends quite a substantial amount of money on health care; 15 % of the GDP is channeled to health care and this figure is higher than any other country’s allocation (Marqusee 1). Despite these statistics indicating that the US government is doing much more than others, the health system in the United States is worse than that of other countries like Canada.

This apparently, is the result of a disorganized health care system that is controlled by priorities set by private companies out to make profit (Marqusee 1). Research has shown that the American health care system leaves out up to about 45 million Americans without health insurance. Most other people are left with incomplete or very expensive health coverage (Marqusee 1).

According to a study done by the Institute of Medicine, an estimated number of at least 18,000 Americans succumb to death ahead of time simply because they do not have access to health insurance (Marqusee 1). Compared to Britain, the United States uses two and a half times more on health care but this does not lead to any better results; life expectancy is greatly reduced in the US. With a child mortality rate of 33%, more children die in America than in the United Kingdom (Marqusee 1).

Conclusion

The health of a country is very critical and it is important for the government to make quality health care affordable for every one and not just a few capable people. Poor health will reduce a country’s health force drastically and more often than not, most people will be forced to spend most of their time visiting clinics than working. The ripple effect of this will be reduced income to the country and it also means that the country will have to spend enormous resources in meeting the country’s health challenge.

It is therefore very important for the government of the United States to reform its health care system into one that that will fully or at least to a greater extent, meet the health needs of the Americans. From the discussion presented in this paper, it is apparent that there is so much that the U.S. government seems to be doing but the results are not visible.

Instead, the citizens are left to suffer in the hands of business owners who only care about nothing else but making profits. It is quite unfair for the government to continue to using public funds for projects that are not addressing the health needs of the nation like they are expected to.

For political reasons, a privatized health care system may end up benefiting only a few individuals while the masses suffer. The U.S. government should probably implement a public health care system with a very strict control system to ensure its integrity. The set health care standards must not be compromised.

Annotated Bibliography

Aguayo Miguel. Privatized Health Care: US System is Not the Way To Go. Toronto: Toronto Star Newspapers Limited. 2001. Web. 25th April, 2011. < http://www.commondreams.org/views01/0213-01.htm>.

The author of this article wrote to give reasons as to why the American health system was not an option for the United States. His arguments are based on his encounter with American system while he lived there.

Albreht, Tit. Privatization processes in health care in Europe—a move in the right direction, a ‘trendy’ option, or a step back? European Journal of Public Health, 19(5): 448 – 450.

The author discusses viewpoints of different people regarding the subject of privatization in Europe. There is also mention of the reasons for privatization and talks about the economical aspects of privatization.

Armstrong, Pat., Armstrong, Hugh. & Fuller, Colleen. Health Care, Limited: The Privatization of Medicare. Ottawa: CCPA Research Associates. 2000. Web. 25th April, 2011. <http://www.profitisnotthecure.com/documents/health_care_ltd.pdf>.

The article discusses the challenges that face privatization. Problems that result from privatization are considered and the effects of a poor health care system to pubic are also explained.

Barkun, Harvey. The case against increased privatization of Canadian health care: whither health care? McGill Journal of Medicine, 11(1): 73 – 74.

This article gives some statistics about the health care system in Canada. The Canadian health care system is also compared with other systems such as that of the United States.

Brody, Howard. Competing plans for affordable care. Texas: Corpus Christi. 2011. Web. 25th April, 2011. <http://www.caller.com/news/2011/apr/24/competing-plans-for-affordable-care/>.

The author of this article discusses views given by health experts and some by politicians regarding health matters. Health experts argue that good health habits will result into improved health and reduced need for health care.

Fisk, Milton. Privatization by Stealth: Canadian Health Care in Crisis. Detroit: Solidarity. 2000. Web. 25th April, 2011. <http://www.solidarity-us.org/current/node/1679>.

The author discusses the challenges faced by the Canadian health care system and also talks about other issues such how politicians indirectly attack the heath system with an eventual goal of ensuring that it fails to work.

Lyons, Todd. US Health Care: Why Privatization Is Inefficient – Part 1 of 4. Tampa, FL: GovLoop. 2010. Web. 25th April, 2011. < http://www.govloop.com/profiles/blogs/us-health-care-why>.

The author presents a critical argument about the American Health care system and tries to explain why the public is made to suffer because of a poor health system in place.

Marqusee, Mike. The Privatization of Health Care. USA: Counterpunch. 2006. Web. 25th April, 2011. <http://www.counterpunch.org/marqusee01312006.html>.

The author discusses the poor state of the American health care system and compares it to that of other countries to show how unproductive it was.

Rachlis, Michael. Privatized Health Care Won’t Deliver. Wellsley, MA: Willesley Institute. 2007. Web. 25th April, 2011. <http://wellesleyinstitute.com/files/privatizedhealthcarewontdeliver.pdf>.

Though focusing on the situation in Canadian, this article explains why privatization is not the way to go. Shortcomings of a privatized system are highlighted and among others, the feeling of the general public about privatization is captured.

Schmid, Achim., Cacace, Mirella., Götze, Ralf & Rothgang, Heinz. Explaining Health Care System Change: Problem Pressure and the Emergence of “Hybrid” Health Care Systems. Journal of Health Politics, Policy and Law, 35(4): 454 – 486.

This article looks at the role played by the state in the management of the health care. This is done by studying out countries belonging to the Organization for Economic Co-operation and Development (OECD) to determine government roles in financing, service provision and regulation.

Skinner, Brett J. & Rovere, Mark: Without some privatization, medicare will collapse. Ontario: National Post. 2011. Web. 25th April, 2011. < http://fullcomment.nationalpost.com/2011/04/19/brett-j-skinner-and-mark-rovere-without-some-privatization-medicare-will-collapse/>.

The authors of this article have given statistics to show why privatization is necessary. Their argument is that the government will not be in a position to sustain the health care system without privatization.

Steinbrook, Robert. Private Health Care in Canada. New England Journal of Medicine, 2006; 354:1661-1664. 2006.

This article gives an elaborate discussion regarding the Canadian health care system. The legal aspects of the health care system, the public view of the system and the place of politics are also talked about.

Works Cited

Aguayo Miguel. Privatized Health Care: US System is Not the Way To Go. Toronto: Toronto Star Newspapers Limited. 2001. Web. 25th April, 2011. < http://www.commondreams.org/views01/0213-01.htm>.

Albreht, Tit. Privatization Processes in Health Care in Europe—a move in the right direction, a ‘trendy’ option, or a step back? European Journal of Public Health, 19(5): 448 – 450.

Armstrong, Pat., Armstrong, Hugh. & Fuller, Colleen. Health Care, Limited: The Privatization of Medicare. Ottawa: CCPA Research Associates. 2000. Web. 25th April, 2011. <http://www.profitisnotthecure.com/documents/health_care_ltd.pdf>.

Barkun, Harvey. The Case Against Increased Privatization of Canadian Health Care: Whither Health Care? McGill Journal of Medicine, 11(1): 73 – 74.

Brody, Howard. Competing Plans for Affordable Care. Texas: Corpus Christi. 2011. Web. 25th April, 2011. <http://www.caller.com/news/2011/apr/24/competing-plans-for-affordable-care/>.

Fisk, Milton. Privatization by Stealth: Canadian Health Care in Crisis. Detroit: Solidarity. 2000. Web. 25th April, 2011. <http://www.solidarity-us.org/current/node/1679>.

Lyons, Todd. US Health Care: Why Privatization Is Inefficient – Part 1 of 4. Tampa, FL: GovLoop. 2010. Web. 25th April, 2011. < http://www.govloop.com/profiles/blogs/us-health-care-why>.

Marqusee, Mike. The Privatization of Health Care. USA: Counterpunch. 2006. Web. 25th April, 2011. <http://www.counterpunch.org/marqusee01312006.html>.

Rachlis, Michael. Privatized Health Care Won’t Deliver. Wellsley, MA: Willesley Institute. 2007. Web. 25th April, 2011. <http://wellesleyinstitute.com/files/privatizedhealthcarewontdeliver.pdf>.

Schmid, Achim., Cacace, Mirella., Götze, Ralf & Rothgang, Heinz. Explaining Health Care System Change: Problem Pressure and the Emergence of “Hybrid” Health Care Systems. Journal of Health Politics, Policy and Law, 35(4): 454 – 486.

Skinner, Brett J. & Rovere, Mark: Without some Privatization, Medicare will Collapse. Ontario: National Post. 2011. Web. 25th April, 2011. < http://fullcomment.nationalpost.com/2011/04/19/brett-j-skinner-and-mark-rovere-without-some-privatization-medicare-will-collapse/>.

Steinbrook, Robert. Private Health Care in Canada. New England Journal of Medicine, 2006; 354:1661-1664. 2006.