National health care expenses are projected to reach over $2.8 trillion and be over 16 percent of the gross domestic product (GDP) by 2011 according to the Centers for Medicare & Medicaid Services (CMS) (Kaiser Family Foundation [KFF], 2007). This suggests that the overall cost of quality health care is beyond the reach of the average citizen. It is therefore necessary for the federal government to provide health care to all citizens who cannot afford it. This paper seeks to take a position on whether there is need for the federal government to provide health care to all citizens who cannot their own medical care. Towards this, the paper will analyze the pros and cons on the need on the part of the federal government to provide health care to those who cannot afford it.
Chronic disease and preventable illnesses account for approximately 72 percent of annual health care costs (American Institute for Preventive Medicine [AIPM], 2008). The primary chronic diseases and preventable illnesses that contribute to health care costs are cardiovascular disease and stroke, obesity, cancer, diabetes, and arthritis. According to the Centers for Disease Control and Prevention [CDC] (2003), there are three "modifiable health-damaging behaviors" that impact health care costs. Available literatures, medical reports, and number of personal documentaries abide to the fact that these medical complications remain the most expensive to manage. This therefore point to the fact an average citizen cannot to afford to purchase health care requirements to handle and manage these diseases. In addition to the above, the cost of maintaining these diseases always soar up due to the fact they affect one over long periods of time. The federal government has no choice but has to act to provide health care so that our life expectancy levels do not drop.
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While some of these diseases are as result of our social behaviors, the government has responsibility to institute necessary legislations and measures to ensure that its citizens are accorded high quality life styles. In this regard social behaviors that put community's life at risk should be discouraged. These behaviors are smoking, physical inactivity and poor nutrition ((p. 12). One explanation for the high cost of health care for chronic disease is the aging population. While life expectancy of Americans has risen from an average of 59 years in 1950, to a current age of 77 there has also been a parallel rise in health care costs (AIPM, 2008). The increase in health care costs has become a significant issue for businesses, federal government and the population (Health Enhancement Research Organization [HERO], 1998).This steady rise in the cost of health care services has denied many citizens the opportunity to access better health care services. This has resulted in rise many cases of chronic diseases among the poor citizens. It is upon this fact that the federal government should act quick to save this alarming condition. Towards this intervention, it is prudent to support health care bill which seeks to provide health care to those who cannot afford it.
According to the National Conference of States Legislation (NCSL, 2008) as cited by Benefits Body (2008), 32% of the budget is spent on health care costs. In an attempt to reduce these high costs, several initiatives have been advocated, including the provision of insurance incentives (such as premiums and rebates), tax credits and mandates.
According to the Federal Health Care Financing Administration (HCFA), several bills to promote wellness have been introduced in congress focusing on employer-provided solutions to influence the health of the individuals (Benefits Body, 2008). while majority are yet to sail through, the continued high health costs will eventually reign supreme and its expected that majority will be adopted. These will not control the quality of medical service to the people but also reduce the cost of the health care provision. This kind of protection should be stretched as well to incorporate those unemployed or self employed citizen who cannot afford health care services through affordable and free health care provision.
Majority of these legislations by federal and the state has focused on availing tax incentives to employers who provide qualified wellness programs to their employees (Center for Health Improvement, [CHI], 2008). One such legislation is the Healthy Workforce Act (H.R.3717/S.1753) that would provide a ten year tax credit of up to $ 200 per employee for the first 200 employees, and up to $ 100 for every employee thereafter, for employers who provide qualified comprehensive wellness programs (Benefits Body, 2008). Another bill is Wellness and Prevention Act of 2007 (H.R. 853) which would avail wellness tax credit cuts of $200 for every employee per year to those employers who would develop and implement a qualified wellness program in the work place. Other bills proposed are also aimed at inciting employers to develop wellness programs. In this regard, many employees will get access to medical services. The major shortfall of these programs is that not all people form part of what we describe as "employees". This means that not all of our people will be adequately covered.
These programs include the Work Health Implementation Program (WHIP) Act of 2007 (H.R. 1748/S. 1038) that would equalize the tax treatment of employer-subsidized off-site and on-site facility fees, dues and membership expenses for employers who use such facilities. These are government interventions to help reduce the cost of health care. It is logical to congratulate the federal government on these moves which are geared towards reducing the cost of health care as well as creating sanity among the health care providers. On this basis, free health care provision to those who cannot afford still forms the best choice the government has to improve the health indicators of the nation.
The Help America Act (H.R 2633/S.1342) on the other hand would provide an employer with credit for wellness programs and exclude employer-paid fitness facility fees from an employer's income (Benefits Body, 2008).States are also forging some legislation to cut down on health care costs. Wellness tax credits have been proposed in a lot of states such as Hawaii, Iowa, Mississippi, New Jersey, New York, among other states. For example, in California, there is a pending bill awaiting legislation that would require employers with more than 10 employees seeking to do business with the state (contracts worth $1 million and above) to provide their California employees with fitness-related benefits.
A legislation waiting in New Mexico on the other hand would offer a $200 tax credit to employers with 200 or fewer employees (and a $100 credit for those with more than 200 employees) that provide qualified and comprehensive programs for employees living in the state of New Mexico. Other states such Maryland, New Mexico and Rhode Island have mandated employers to provide smoking cessation programs within the health plan coverage they offer employees (Hewit Associates, 2008).These deductions which are done by employers on their employees salaries to cover for health care provision are expensive hence leave the employees with inadequate resources to live a meaningful lifestyle. This fact again necessitates the need for free and affordable health care services to those who cannot afford them.
According to the Midwest Office of the States Council (MOSC, 2006) as cited by Benefits Body (2008), coinciding with the growing interest among states in promoting wellness among its people are new federal policies that provide policy makers with more flexibility. For example, the provisions in the US Deficit Reduction Act (DRA) have provided the states with some space and availed wider options in the management of their Medicare programs. In the state of Virginia, Medicare recipients will soon be required to sign a member agreement, promising to show up to medical appointments, follow up a health regiment and take medications as directed. This will see them get extra benefits such as mental health counseling and home health visits. It is worth appreciating the positive role both Medicare and Medicaid programs have contributed to the provision of health services to those who cannot afford personal heath arrangement. The problem is that these two programs have experienced the highest levels of fraud in our history.
Our attempts to provide quality heath care have resulted in the development of several policies by the state to address the welfare of its state employees. The worksite wellness policies are meant at providing the foundation for state entities to develop activities and modify work environment and policies to support the health and wellbeing of state employees. In addition to the benefits for the employees, positive benefits are also bound to accrue to the families of the employees, resulting in better health for families and the community. The above policies are formulated in partnership with the office of state personnel (OSP), and the NC Department of health and Human Services Division of Public Health (DPH), where each head is supposed to create and participate in a work site wellness program within his or her own agency or university. The primary focus of these initiatives is to promote healthy lifestyles including healthy eating, physical activity, and tobacco use cessation and stress management.
It would be prudent to state that the current health care costs burden is multifaceted, placing most businesses, federal government and the entire population in a quandary when it comes to health care provision. The changes in lifestyle have particularly impacted the health of workers and the entire population at large. Poor nutrition, lack of exercise, stresses in the work place, and drug and substance abuse, to name a few issues, predisposes the population to a higher risk of developing complications that may require health care interventions. The sum of a more immobile population, a variable in fitness climate, a more complex disease base, and an increase in health care expenditure have equaled to a heavier financial burden for the Americans. The interest in the health and wellness of Americans may therefore be grounded in financial incentives. There is the belief that potential improvement to personal wellness, organizational finance and federal and state budget's expenditure can be realized through better health care policies delineation.
It is important to important to note that a nation's economic development and technological progress is directly pegged on the health of its people. In this regard, disease poses a big threat to economic development. The federal government should therefore enact health care policy that seeks to provide health care services to all the people regardless of their social and economic status. This will go along way in reducing the cost of treating chronic diseases which might be prevent way before they are contracted by the people. This health care provision will see an increase in the general life expectancy of people in the country.
In this endeavor to provide health care to services to the entire citizen, the government will not only show it commitment to diligently serve the citizen but also unify the nation thus promoting peace and economic development. It is a general knowledge that sick person cannot efficiently work and help in the development of a nation but a healthy and prudent citizen will not only work efficiently but also bring about technological progress which in turn benefits the nation.
Although some opponent of free and affordable health care services to those who cannot afford it argue that the plan is expensive to the government, I strongly disagree with them on the basis that they are blurred to an extent that they cannot see and comprehend that it is the people that give federal government through tax, business just name a few. Therefore, the plan can never be expensive since a sick nation will not be efficiently productive to guarantees a steady economic development as well as a nation survival.
Aristotle defines rhetoric as both "an art with essential principles and a changing, contextual art shaped by politics through the creation of forums that regulate its practice" (Kennedy, 1991)
Rhetorical linear theoretical flow chart
Author (ethos) - Message (Logos) -Audience (Pathos)
According to Kennedy, "Logos is the true and probable argument" (Kennedy, 1991). In this regard, logos are a proof of information that is contained in the message.
Why can't the government provide health care for those who cannot afford it?
The above question should be effectively be addressed by the government. This is because the statistics according to Kaiser Family Foundation, (2007) illustrates that; "Annual Census Bureau estimates released in August show 47 million people, or 15.8 percent of the U.S. population, were without health insurance during 2006 - a 4.9 percent increase. In 2005, census figures showed that 44.8 million people, or about 15.
3 percent of the population, lacked health insurance coverage".
Kennedy argues that it is "the reputation bestowed upon the speakers" character that Aristotle meant by ethos (Kennedy, 1991). However, other critics disagree. Wisse, for instance, states that "ethos takes on a type of authority in that it builds the speakers credibility insomuch as it is brought about only in the speech itself" (Wisse, 1989)
Aristotle describes pathos as the "persuasion though the hearers when they are led to feel emotion by the speech" (Kennedy, 1991) while Wisse (1989), defines pathos as "the arousing of emotions in the audience". The government should leave the pathos behind healthcare policies and forge a head and provide affordable Health care services to those who cannot afford it.
These are allegations which are not supported by facts. For in instance, people with the opposing views on Obama health care policy use logical fallacy to argue against it. This is evidenced with the republican calling it a death policy which is pure fallacy.
The federal government must demonstrate its ability to provide quality health care to the people who cannot afford it. This is because private health care providers are motivated by profit. In this line, the government should come to the rescue of its people who cannot afford efficient and reliable health care by drafting and adopting legislations and rules that governs health care provision sector.
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