The uninsured and health care reform in the United States

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  • 現代アメリカの無保険者問題と医療保険改革

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Abstract

There is no national health insurance in the United States. The health insurance system consists mostly of private insurance, especially employer-provided insurance. As a consequence, over 46 million people in the United States are now without health insurance. In addition, the number of uninsured people has increased rapidly in recent years because of premium increases and the loss of employer-based insurance coverage. The lack of health insurance is a great barrier to health care. The uninsured find it difficult to access and to pay for the health care services they need to improve their health. The increase of the uninsured has negative effects on individuals and the society as well. For example, the uninsured tend to have more health problems because they lack access to affordable health care and coverage. In addition, communities are at risk of losing health services because increased numbers of uninsured are unable to pay, resulting in hospitals reducing their services and health providers moving out of the community. However, only incremental reforms have been implemented until now because the conservatives have dominated the Republican Party while the liberals have lost their power in the Democratic Party. Comprehensive reform like President Clinton's health care reform failed because conservative Republicans opposed it and the Democratic Party was divided into liberals and moderates. The lack of health insurance in the United States is problematic because it leads to fundamental questions like "Is basic health care a right?" or "Should individuals or governments be responsible for health care?" Given the seriousness of the uninsured problem in the United States, health care reform is needed to guarantee a safety net for all people to receive a reasonable level of medical care.

Journal

  • Bioethics

    Bioethics 17 (1), 152-159, 2007

    Japan Association for Bioethics

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