United States Public Healthcare Reform: The Fight for Accessible Healthcare


Although the United States seems like a very advanced country, it lacks one vital element to a healthy society: a public healthcare system. The United States has no adequate public healthcare system, and although progress has been made in making healthcare more accessible, many more reforms needs to be created to improve the overall health of American people. Access to healthcare is a basic right, and currently the 44 million uninsured and 38 million underinsured people in the United States are being denied that right (“Healthcare Crisis: The Uninsured”).

Personal Interest

This topic interests me because I think it is a huge problem in current day society, and I think that all people should have equal access to health care no matter who they are or where they come from. Creating an American public healthcare system has been an ongoing fight in the United States, but without one, the government is violating human rights.

I became interested in this topic when I had spine surgery last year, and I was made aware of the enormous prices of health care. My surgery was nine hours with a five day hospital stay, and the total cost was roughly $300,000. Luckily, with insurance, my family only paid $300. I’ve always thought about what if we didn’t have insurance or if it wasn’t covered? Would I have not been able to have this surgery that changed my life? I began to think about how expensive even just basic medical care would be, and how people could access it without insurance.

To read more about my personal interest, click here:

History of Creating a Public Healthcare System

While many agree that some form of public healthcare would be beneficial to the overall health of people, actually creating adequate public access to healthcare has been an ongoing congressional fight in the United States, with no impactful solution being created until 1965. Surprisingly, it took the United States an extremely long time to create a substantial system targeted towards improving the overall health of its citizens; many people don’t have enough money or accessibility to basic medical needs, which is something that needs to change. Political leaders have been able to identify the problem for a long time, but unable to create a proper solution.

In the Progressive Era the United States took “little or no action to create a National Health Insurance system” (Treviño). Although there were ideas about public health reform, nothing concrete ever formed. Many reform attempts by working class members did not succeed. President Theodore Roosevelt believed that “no country could be strong whose people were sick and poor”, and he supported a health insurance plan. However, he did not feel that “it was the government’s place to mandate reforms”, and the plans failed (Matusiak).

In 1933, President Franklin D. Roosevelt wanted his new social security legislation to include publicly funded healthcare programs. He removed the bill as blocks to healthcare legislation became increasingly common, and “fear of organized medicine’s opposition to universal health care became standard for decades” (Treviño). After this block, hospitals began offering their own insurance plans. They sold group health insurance policies to employers, who sold them to their employees and collected premiums (Treviño). Although not through the government, this was something that helped many people in regards to their health care.

President Lyndon B. Johnson signing the Social Security
Amendment in 1965

After many failed attempts at public healthcare reform, and what seemed like an endless cycle of ideas going nowhere, the first major breakthrough in creating pubic healthcare systems through the government occurred in 1965. President Lyndon B. Johnson signed the Social Security Amendments which created Medicare and Medicaid. He promised that these new programs would “improve a wide range of health and medical services for Americans of all ages” (LBJ). Medicare is designed to provide health coverage for people 65 or older, while medicaid is for people with low income. Medicaid uses “a combination of Federal, state, and local funds to pay the health care costs of those persons the states consider unable to afford them” (“Medicare and Medicaid”, New York Times).

To read more on the historical problem, click here:

Healthcare Reform in the 21st Century

Although the creation of Medicare and Medicaid were monumental, the biggest breakthrough in creating a sufficient public healthcare system in the United States was the creation of The Patient Protection and Affordable Care Act by President Barack Obama’s administration in 2010. Unfortunately, since he took office, President Donald Trump has taken apart this system and caused an increase in the number of uninsured people, and therefore a decline in overall health of the American people. After decades of fighting and rejecting plans for healthcare reform, the Affordable Care Act was a tremendous development and dramatically increased the number of insured people, and the Trump administration has managed to reverse this progress.

The Patient Protection and Affordable Care Act, known as ACA or Obamacare, has three primary goals: to “make affordable health insurance available to more people”, to “expand the Medicaid program to cover all adults with income below 138% of the federal poverty level”, and to “support innovative medical care delivery methods designed to lower the costs of health care generally” (“Affordable Care Act…”). This was one of the first times that the federal government made a large change regarding healthcare reform; it worked to make healthcare more accessible for lower class people by “provid[ing] federal funds for states to offer Medicaid coverage to anyone earning less than about $16,000 for a single person or $33,000 for a family of four” (Sanger-katz). Additionally, Obamacare “prevents insurance companies from denying coverage or charging a higher price to someone with a pre-existing health problem”, which used to be a very large problem in obtaining healthcare (Sanger-katz). Lastly, it “required individuals to have health insurance and companies to offer it to their workers”, causing a reduce in “the number of uninsured Americans by an estimated 20 million people from 2010 to 2016” (Sanger-katz). All of the changes made by the creation of Obamacare had a huge impact on the countries health overall, in fact, the “uninsured rate has fallen in every state” since it was enacted (Sanger-katz, Bui). The impact in decrease of uninsured people can be seen in the graphic below.

Graphic from the NY Times article titled “The Impact of Obamacare, in Four Maps”,
displays the progress in decreasing the number of uninsured people in the United States.

The Trump administration has weakened Obamacare by repealing the individual mandate, cutting spending, shortening the enrollment period, and more. To hear how they have been able to do that and what impact it has, watch the video below.

While Obamacare did have a big impact, it was very expensive, and the Trump administration wants to lower its spending. In 2014, the United States spent 17.2% of its GDP on health care, which is a very large number in comparison to other advanced countries (“International Health Care System Profiles”). The gap is so large that “on average, other wealthy countries spend half as much per person on healthcare than the U.S.” (Kamal). The problem is that the United States is not using this money effectively, and has “consistently had fewer physician consultations per capita than comparable countries”, (Kamal). To put it plainly, “U.S. spends far more per capita on healthcare when compared to other countries, but has less in healthcare outcomes to show for it” (Gary Price), and has the “most expensive health care system in the world” (Lillich). To be spending this amount of money, the United States should have an adequate health care system, which is not the case. Although Obamacare made tremendous progress, the United States is still behind and lacking an ample healthcare system.

United States healthcare spending in comparison to other countries.

One of the main problems with the insufficient health system is the lack of insurance, which actually has a very large effect on people. When you live without insurance, “basic care, such as a flu shot or prescription medicine, can take a financial toll on you and your family. According to Health Affairs, nearly 2 million Americans have filed for medical bankruptcy due to unexpected health problems” (“No Health Insurance…”). Furthermore, “living with no health insurance poses significant financial and medical risks” on many American people (“No Health Insurance…”).

If the Trump administration continues to weaken Obamacare, then hope for a healthy future will continue to diminish. The United States spends far too much money on health care to have such a large number of uninsured people, and Obamacare made impressive progress on cutting down the the number of people without insurance and making healthcare more accessible. The long and tiring fight for healthcare reform is far from over, and needs to regain strength to fight against the Trump Administration.

To read more on the present day problem, click here:

Call to Action: How You Can Help

Although many reforms need to come from legislation, on a micro-level an individual can make an impact on the push for reforms. The first way that an individual can make a difference is by educating themself on healthcare reforms. By obtaining information about laws and groups fighting for reform, you can understand the complexity of healthcare reforms. You can then work with groups, such as the Kaiser Family Foundation, to educate others and create more awareness. Additionally, if you were to take a ten minute break every day to exercise, “your body mass index will go down, as will your risk of diabetes and heart disease”. This will lead to fewer premature deaths in the US, which will lower health care costs (Heymann).

“The American people deserve to know exactly where their representatives stand on the Trump administration’s vicious campaign to take away their health care,” -Speaker Nancy Pelosi.

Healthcare reform march in Washington, D.C.

Many of the main changes to healthcare need to come from the government. We need to build off of Obamacare and create a more efficient system that uses money wisely. The first step in this is for the Trump administration to stop attempting to repeal Obamacare, and for the Supreme Court to uphold Obamacare. Although they succeeded in repealing the individual mandate, the Trump administration has now announced that they will not be making health care changes until 2020, the next presidential election (Feldscher). Trump plans on winning the election with a Republican-majority Congress, so he can easily destroy Obamacare; another solution to this problem would be to vote against him, and for someone that would push for change.

One of the main problems that needs to be fixed is lack of efficiency. “Health care spending in the U.S. is roughly twice that of other high-income nations”, but “Americans aren’t healthier than people in other countries” (Ducharme). In 2017, the U.S. spent $3.5 trillion on healthcare (“National Health Accounts.”), and far too much of that money is being spent when a person is dying, rather than spending money earlier to prevent people from getting sick. For example, many Americans don’t have an annual checkup because it is too expensive; therefore, they risk “missing preventive care and are more likely to suffer negative health outcomes” later on (“No Health Insurance…”).  We need to invest in preventative medicine, which will ultimately improve the health of Americans. This will make it much easier to implement a cheaper health insurance system.

If the government and Supreme Court can uphold Obamacare, and continue to improve off of it, creating a healthcare system is an achievable goal. The spending needs to be more efficient, and needs on focus on preventative medicine so that we can lower costs of health care overall. By making these changes, it is possible to improve the overall health of American people, and eventually create a public healthcare system.

To read more about solutions, click here:

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  1. April 27, 2019 by Juliana.Shank

    Great project! It was both informative and concise. You also had a great personal connection and ways for people to make change in their community. I also looked at healthcare, but in relation to mental health: Check it out 🙂

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