Question

Explain at least three (3) of the most common reasons why all Americans don't have access to health care in the United States even after the ACA. Express your opinion about whether you think access to health care is a right or privilege. Explain your reasoning and provide references as needed to support your opinion.

Answer 1

Ans) Reasons why all Americans don't have access to health care in the United States even after the ACA:

No. 1: We don’t want it
- One key reason is the unique political culture in America. As a nation that began on the back of immigrants with an entrepreneurial spirit and without a feudal system to ingrain a rigid social structure, Americans are more likely to be individualistic.

- These protesters show how they feel about big government. From the Associated Press
In other words, Americans, and conservatives in particular, have a strong belief in classical liberalism and the idea that the government should play a limited role in society. Given that universal coverage inherently clashes with this belief in individualism and limited government, it is perhaps not surprising that it has never been enacted in America even as it has been enacted elsewhere.

Public opinion certainly supports this idea. Survey research conducted by the International Social Survey Program has found that a lower percentage of Americans believe health care for the sick is a government responsibility than individuals in other advanced countries like Canada, the U.K., Germany or Sweden.

No. 2: Interest groups don’t want it
- Even as American political culture helps to explain the health care debate in America, culture is far from the only reason America lacks universal coverage. Another factor that has limited debate about national health insurance is the role of interest groups in influencing the political process. The legislative battle over the content of the ACA, for example, generated US$1.2 billion in lobbying in 2009 alone.

- The insurance industry was a key player in this process, spending over $100 million to help shape the ACA and keep private insurers, as opposed to the government, as the key cog in American health care.

- Recent reports suggest that lobbyists are already preparing to fight a potential “public option” under the ACA. Should any attempt at comprehensive national health insurance ever be made, lobbyists would certainly mobilize to prevent its implementation.

No. 3: Entitlement programs are hard in general to enact
- A third reason America lacks universal health coverage and the 2016 candidates have avoided the topic altogether is that America’s political institutions make it difficult for massive entitlement programs to be enacted. As policy experts have pointed out in studies of the U.S. health system, the country doesn’t “have a comprehensive national health insurance system because American political institutions are structurally biased against this kind of comprehensive reform.”

- The political system is prone to inertia and any attempt at comprehensive reform must pass through the obstacle course of congressional committees, budget estimates, conference committees, amendments and a potential veto while opponents of reform publicly bash the bill.

- Ultimately, the United States remains one of the only advanced industrialized nations without a comprehensive national health insurance system and with little prospect for one developing under the next president because of the many ways America is exceptional.

- Its culture is unusually individualistic, favoring personal over government responsibility; lobbyists are particularly active, spending billions to ensure that private insurers maintain their status in the health system; and our institutions are designed in a manner that limits major social policy changes from happening. As long as these facts remain, there is little reason to expect universal coverage in America anytime soon, regardless of who becomes president.

- While the ACA is increasing in popularity, and even health-care structures like a government-run, single-payer system are being discussed on the left, the tax bill confirms a historical trend: the United States has never fully accepted the notion of health care as a fundamental human right.