Affirmative Action – Opinion Paper Economics
The current U.S health reform legislation contains affirmative action in which health care and insurance should be made accessible and available to all people, and especially the minority groups. The support for the policy is based on the observation that the U.S is plagued with large health disparities that are related to socioeconomic circumstances such as race, ethnicity, age, employment status, and education among others. The current affirmative action for the health care industry is meant to give a chance to the minority groups to access quality and affordable health care, and thus close the gap of unequal health care in the population. The affirmative action also requires that students from ethnic minority groups are given a chance to study and graduate in medical school. This is a remarkable action to take but it should be known that to achieve this goal, the country spends a lot of money, at the risk of losing competency in health provision.
Affirmative action should not be applied to health business because in the long term it will lead to further deterioration of health care. First, affirmative action in health care is very costly and with time, there will be no adequate funds to support the policy, leading to worse health disparities. Second, affirmative action emphasizes more on recruiting health professionals based on their cultural background rather than their competency. In cases where less-competent people are recruited, the quality of health care will reduce ultimately. Third, affirmative action shows a misplacement of government priorities and divides the nation’s sense of unity, and instead promotes inequality. Fourth, affirmative action increases government’s control on personal social matters, and this can be equated to infringement of individuals’ rights to choice, privacy and freedom.
High Cost and Tax Burden
Affirmative action on health care is very costly and increases taxation burden to the tax payer and with time, there will be no adequate funds to support the universal health care system (Conover, p.8). Instead, the cost and affordability of health care will increase and further lead to inaccessibility of health care to the minority groups. The current health care law requires that everyone-employed and non-employed, insured and non-insured, old and young, among other cohorts should access not only affordable care but should be quality as well. The positive side of the new health law is that it increases the number of Americans with health insurance coverage (Tanner, p. 4). However, to make this happen, the federal requires a lot of money to fund the universal health care system and this definitely means that there will be an extra burden to the tax payer. Conover (p. 8) analyzes the claim that the current health care law proposes affordable health care to all the Americans and finds that it is more costly than estimated. Conover (p. 8) argues that the materialization of all the costs of the Patient Protection and Affordable Act results to a $550 billion, and this is more than half the $3. 85 estimated bill’s cost. Consequently, the total excess taxation burden would amount to over $1.5 trillion which equals a $10.31 per dollar of deficit reduction. To cater for this deficit, Congress may decide to finance the expenditure through borrowing than raising the current taxes. However, this will further increase the total burden associated with the tax. On the other hand, the Congressional Budget Office (CBO) admits that the health care reform has a huge impact on the federal budget and that the current costs are just estimates yet to be proven (Elmendorf, p. 2). However, through the legislation, the Congressional Budget office and the Joint Committee of Taxation assert that the Tricare Affirmation Act will not have a significant impact on the federal budget (CBO, p. 1) and that there will be less commitment of federal budget to health care after the first 10 year initiation period (CBO, p. 2). However, as much as the CBO and JTC argue that the health legislation will reduce future federal budget deficits, this estimate is in law as written and the budgetary impact can be different when implementation occurs (Elmendorf, p. 15). Congress seems to commit scarce tax resources without fully accounting for the costs and benefits of the health legislation, especially when it concerns the heavy taxation burden (Conover, p. 9; Tanner, p. 19). As a result of the looming budgetary deficit, millions of Americans will still be uninsured by 2019, the taxation burden will increase, and American employees and businesses will face higher premiums for medical cover (Tanner, pp. 15-22).
Affirmative action vs. Competency
Affirmative action emphasizes more on recruiting health professionals based on their cultural background rather than their competency (Cannon, p. 37). Other than the Patient Protection and Affordable Act of 2010 the new health care law requires that health settings and schools engage in recruiting medical students from minority groups. The legislation promises grants and contracts to medical schools and training hospitals that have a higher diversity of racial make up. Moreover, these institutions are required to recruit students on the basis of racial preference. On the positive side, having a higher number of physicians from minority groups will assist in solving problems of language and cultural barriers between physician and patient this is a remarkable action that will lead to provision of better care for the minority groups (Barton, p. 321). However, this is an uninformed decision as far as the Civil Rights Commission is concerned. Barton (p. 325) argues that studies by the Civil Rights Commission show that health disparities in minority groups is not as a result of lack of physicians in these groups. Moreover, encouraging the recruitment of doctors on basis of race is unconstitutional and promotes nationwide inequality. Ability and competency should be used in physician recruitment as opposed to racial background. Reverse discrimination is a poor strategy for addressing racial disadvantages.
Misplaced Government Priorities and national Divide
Affirmative action shows a misplacement of government priorities and divides the nation’s sense of unity, and instead promotes inequality (Cannon, p. 36). Tanner (p. 7) argues that the government should have considered cutting the health costs and expanding the coverage of health provision rather than emphasizing on cultural competency in health provision and receiving.
The government has taken upon itself the responsibility to take care of the personal needs of people through funding for their health matters, and this is an advantage especially for people from low socioeconomic backgrounds who could not afford quality health care through primary physicians. Richardson (p. 335) analyzes the expenses that the Massachusetts State incurs in federal provision of health fund. The Massachusetts health care initiative that includes supplemental payment to hospital and Medicaid for unfunded care increased from $ 1.04 billion to $ 1.86 billion between 2006 and 2009 and the federal government continues to pay for expenses that relate to unpaid funds. Richardson (p. 336) observes that in Massachusetts alone the federal government spends 33 percent more per person on health care than the national average and the state’s annual health care initiative is expected to increase by $409 million in 2010, even after the federal government compensates half the expenditure. The results are even higher when the other states are included. The affirmative health action on the other hand, therefore seems to be a liability whereby the government spends more and creates less (Crane, p. 2). Definitely, this will further lead to a handicapped economy. Probably, the government’s priority should have been to focus on employment and education. With most of the Americans, including the minorities, being educated and employed, most people will be able to afford their own health care and the government could have directed these health care funds to other notable projects of better economic impact.
On the positive side, the affirmative action is meant to bring some sort of national unity through social cohesion by using the single payer health plan (Barton p. 317). Barton (p. 317) argues that an affirmative action on health will end Jim Crow practices, eliminate subtle segregation forms and ensure nondiscriminatory treatment in integrated settings. However, this social cohesion effort is not viewed as such. Fulwood (p.1) argues that the government’s perspective of assisting the racial minorities has been interpreted as crippling the White Americans. This may not true but one thing is clear, the gap between the racial majority and minority will continue to widen as a result of the affirmative action.
Personal Responsibility vs. Government Responsibility
Affirmative action increases government’s control on personal social matters and this can be equated to infringement of individuals’ rights to choice, privacy and freedom (Crane, p. 2; Cannon, p. 36; Hoffman, p.8). The health care legislation makes it mandatory for everyone to have a health insurance cover and also for business to provide health benefits to all its workers failure at which fines are charged (Cannon, p. 37; Richardson, p. 336). Additionally, Richardson (p. 335) reports that a number of Americans in the Massachusetts State (one of the states in which most people signed for the mandatory health insurance) signed up for health insurance not because of the mandate to insure their health, but because the insurance was heavily subsidized and free. Crane (p. 2) questions whether it is the president’s responsibility to mandate health on individuals. Social aspects like health are better left to individual decisions rather than being made a national matter.
Affirmative action policy should be refuted for health care provision. Other than bearing high costs for the government and tax burden to the tax payers, it further disintegrates national unity and promotes inequality. Worse, the policy shows that the government hampers with important economic priorities such as provision of quality education and employment which will assist in minimizing the necessity of affirmative action. Students aspiring to be doctors should prove their qualification through exercising ability and competency skills as opposed to their racial background.
Barton, David Smith. Racial and ethnic health disparities and the unfinished Civil Rights Agenda, Health Affairs, vol. 24(2): 317-324. Accessed November 9, 2010, from http://content.healthaffairs.org/cgi/reprint/24/2/317
Cannon, Michael. U.S. Healthcare: What hath Obama wrought? Diplomat Magazine, 2010, May: pp 36-37. Accessed from http://www.cato.org/pubs/articles/cannon-what-hath- obama-wrought.pdf
CBO. Cost estimate: H.R. 4887 Tricare Affirmation Act, CBO. 2010, March 24, p.1. Retrieved November, from http://www.cbo.gov/ftpdocs/114xx/doc11422/hr4887.pdf
CBO. Comparison of projected enrollment in Medicare advantage plans and subsidies for extra benefits not covered by Medicare under current law and under reconciliation legislation…as passed by senate, CBO, 2010, March 19, pp 1-3. Retrieved November 9, 2010, from http://www.cbo.gov/ftpdocs/113xx/doc11379/MAComparisons.pdf
Crane, Edward. Obamacare: Medical Malpractice. Cato Policy Report, 2009, June: p.2
Conover, Christopher. Congress should account for the excess burden of taxation. CATO Policy Analysis no. 669, 2010, October 13: pp 1-12. Accessed November 9, 2010 from http://www.cato.org/pubs/policy_report/v31n3/cpr31n3-2.pdf
Elmendorf, Douglas. The effects of health reform on the federal budget. Presentation to the World Health Care congress, CBO. 2010, April 12, pp. 1-15. Retrieved November 9, 2010, from http://www.cbo.gov/ftpdocs/114xx/doc11439/WHCC_Presentation-4-12- 10.pdf
Fulwood III Sam. Release: Race and beyond: Obama should speak up. Center for American Progress, 2010, July 27. Accessed November 9, 2010 from http://www.americanprogress.org/pressroom/releases/2010/07/fulwood_race_beyondh tml
Hoffman, A. Oil and water: Mixing individual mandates, fragmented markets and health reform. American Journal of Law & Medicine, 2010, vol. 36(1): 7-77.
Richardson, Craig. Mandatory health insurance: lessons from the Massachusetts. Cato Journal, 2009, vol. 29(2): 335-351. Accessed November 9, 2010 from
Tanner, Michael. Bad medicine: A guide to the real costs and consequences of the new Health Care law. CATO.