International treaties recognize the fundamental right to healthcare, which makes the majority of countries to provide universal health care coverage for their citizens. In the United States, the right to healthcare is being adopted gradually in a way that is unstable as the judicial and political branches the United States government grant rights that are vulnerable and incomplete as they are eroded over time. The enactment of affordable care act (ACA) did not change the fundamental regime weakness of the American healthcare rights as many people remained uninsured after ACA took full effect as it gives unstable rights to people. In addition, potential attrition of ACA rights is to come about because of its constitutional weakness and access to health care according to Orentlicher & David (2012).
Insurance covers majorly take up health care access either from employers or from the private sector based insurance cover that is government based for the public and private sector employees. Most of the spending on healthcare comes from the government health expenditure programs such as the Tricare, Medicare and the state children health insurance program (SCHIP) (Hammaker, Knadig & Tomlinson, 2017). Medicare is an insurance program funded by the federal government to provide health care to the old, disabled young and those with renal failure in dialysis. Medicaid as insurance jointly financed by federal and state governments for individuals with low income and Tricare health insurance offers medical care for the military personnel and the retirees. Majority of Americans are insured by the state whereas the remaining population left uninsured
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Over time, the right to health care in America has been weak because of the court’s rejection of what is perceived as positive rights under the constitution as the constitution is limited to reasons that are viewed as negative. For instance, the law defines the government from being involved in the choices made by individuals. The American system distributes health care unevenly basing on other irrelevant factors other than necessity as there is the disparity in the society which makes it hard for individuals to access the care they desperately need. This late access makes them utilize most of the resources increasing healthcare burden. Enshrining healthcare in law as a right may result to overutilization of health resources.
Difficulty in considering health care as a right emanates from the inability of the state to meet the needs of the population without distribution disparities in the distribution and allocation of medical care. For instance, there is a big difference between provisions to individuals in different societies, as the needs of various vulnerable groups and communities vary. The United States have statutory rights to healthcare, as they are the primary source of rights to health care; however, they are being adopted gradually, for example, the case of Medicare and Medicaid. These statutory rights are limited in nature as seniors are eligible too for cover under Medicare and the majority of the poor are suitable for Medicaid cover rather than recognizing health care as universal for all persons (Sherrow, 2009). Medicaid falls short of protection for all the poor who are in need as it leaves out many who are entitled to it as many fail to enroll. The income threshold, which dictates one's legibility to Medicaid, is lower than income edge for losing cash assistance, which can make one miserable just to benefit from the government's subsidiaries.
Because of its limitations, Medicaid has only managed to reach fourth five percent of those below the federal poverty level. In recent years, Medicaid programs have poorly performed as states take uptight budgets, which have cut their Medicaid budget as national consumers spend up to fifteen percent of state budgets as rules restrict access to services such as dental services. The previous administrations had some states institute cost-cutting measures, which resulted in the reduction of enrolment in Medicaid program (Hammaker, Knadig & Tomlinson, 2017).
ACA provided the essential improvement of the Medicaid program from 2014, as individuals with incomes of 113% of the federal budget, were to be liable for coverage. However, ACA does not resolve the problems brought about by Medicaid as funding is retained a partnership between the federal government and the state which brings about variation in reimbursement rates and treatment cost from one country to the other. Families that are eligible for Medicaid are still left out to find their means to pay for treatment. ACA does not seem to differentiate low and middle-income families as it offers subsidiaries to those who earn too much to qualify for Medicaid making them inadequate to provide affordable health coverage (Orentlicher & David, 2012).
Instability of health care rights are attributed to three features first is the right to pay for health care costs but not to receive health care. The second cause of instability in health care rights is the wealthy’s willingness to fund the poor people’s health costs, which usually reduces as the availability of public programs usually brings about increased demand for healthcare, which drives the values of the programs above the previous projections (Steven, 2013). In addition, health care programs are made by partnerships between the federal government and the state rather than these programs being operated by the federal government.
The federal government should endeavor to offer the right to medical coverage and not medical care by facilitating the establishment of EMTALA, which ensures patients receive medication to stabilize emergency medical conditions other than relying on Medicare, Medicaid, and ACA where patients can only access to insurance to cover their health expenses.
In the establishment of stable health care, the government should separate the divergent interests between the rich and the poor (Wilper et al., 2009). Under Medicaid, the interests of the poor are to be separated from the interests of the wealthy because, when it expanded, they did not consider the rights of the low-income families as those who well off saw Medicaid as an additional expense. The government should put in more resources and funds to develop these medical programs to better service delivery to the needy.
Federal- state partnerships are a recipe for weak health programs, which cause instability in the right to health care as the federal government, sets minimum standards while states provide eligibility standards for their residents (Barr, 2016). Rules vary in the number of uninsured depending on the wealth and the willingness of the legislators to fund the coverage of Medicaid. Federal governments should take up the role of maintaining and financing medical programs to enhance coverage.
The federal government can choose hospitals, physicians the and professionals to treat citizens in need of medical care, for instance, the British government model where the government acts as a provider of healthcare instead of an insurer. The government can also, provide payment vouchers to everyone so that they may purchase private insurance health care plans (Thomas, 2007). These vouchers given by the state should be worth the full cost of the lowest cost plan that meets the federal requirements. Insurance providers should be restricted not to make changes to the rates for people with pre-existing medical conditions and would be compelled to accept vouchers from the public.
American health care has gone through much to make it a right although it is still gradually growing to become better. The patient protection and affordable care act (ACC) was an essential step towards the establishment of fundamental rights to health care in the United States. Much more is expected to be done by the federal government and the states to better health coverage before Americans can benefit from health care rights and receive the health care they deserve.
References
Barr, D. A. (2016). Introduction to US health policy: The organization, financing and delivery of health care in America . Baltimore (Md.: Johns Hopkins university press
Claire, A. & Velasquez, M. (1990). System overload: Pondering the ethics of America's health care system Issues in Ethics , 3, (3)
Hammaker, D. K., Knadig, T. M., & Tomlinson, S. J. (2017). Health care ethics and the law . New York, NY: Burlington, MA
Orentlicher , D . ( 2012 ). Rights to healthcare in the United States : Inherently unstable . American Journal of Law & Medicine , 38(2-3), 326-347 http://scholars.law.unlv.edu/facpub/1054
Sherrow, V. (2009). Universal healthcare . New York: Chelsea House.
Steven, T. M. D. (2013). Sustainable Healthcare Reform . Cork: BookBaby.
Thomas, J. P., (2007). Healthcare access as a right, not a privilege: a construct of western thought, Philosophy, Ethics and Humanities in Medicine , 2, (2).
Wilper A.P., Woolhandler S., Lasser K.E., McCormick D., Bor D.H., Himmelstein D.U. ( 2009 ) Health Insurance and Mortality in US Adults . Health Insurance and Mortality in US Adults .American Journal of Public Health , 99 , ( 12 ) , 2289-2295
