In the United States, access to quality health care is available to those who have health insurance, either because their employers provide it, or because they can afford to purchase it independently. However, the U.S. faces a serious problem that promises to get worse: the inability of many citizens to gain access to needed health care, primarily because of cost.
Patrick & Erickson (1993) state the problem in socioeconomic terms: "Although geographical, cultural, and educational barriers limit access to care, financial barriers dominate. Poor people, near-poor people, and persons with chronic illness--especially those without public or private insurance--find it difficult to obtain health care services (p. 333). Instead of offering blanket coverage on the basis of citizenship, "the United States offers access to health services mainly on the basis of age, income, and employment" (Fox, 1993, p. 78).
The problem of lack of health care coverage is especially apparent in view of the fact that "the United States is the only industrialized country other than South America in which the public (government-financed) sector of health care is less than 60 percent . . . health care is, in fact, a very big business--the nation's third largest industry" (Reagan, 1992, p. 14).
American medical care is the most technologically advanced in the world, yet we are not necessarily the healthiest as a result. Because medical care is rationed in the U.S., with the best care going to those who can afford it, many go without adequate care. Many Americans, the poor primarily, are either grossly underinsured or uninsured entirely, as a result of individual and national neglect and mismanagement of finite technological resources. Those who argue for the status quo--that we should not reform our existing system of providing medical care--generally rely on the argument that rationed care must be avoided at all costs, when, in fact, what they ...