The topic of healthcare has been an ongoing discussion for decades, dating back to

President Roosevelt in the late 1930s to President Obama in 2010. Our current President Donald

Trump, recently proposed a new healthcare reform that was dubbed Trump Care. The new act

failed to pass and failed to replace the previous healthcare legislation known as Obama Care

enacted by President Barack Obama in 2010. Healthcare is an important topic of sustainability

that needs to be discussed, and the current healthcare system needs to be amended to maximize

the number of Americans that have coverage while also maximizing the efficiency of tax payer

dollars spent on healthcare under an amended legislation. To bring about this new legislation, we

are going to need a tremendous effort on the part of the American people, to initiate political

action and bring about social justice and change. This paper will begin by showing the problem

exists and examining the cause of the problem. This paper will then transition into outlining the

action needed to fix the lack of healthcare coverage for so many people in the United States.

In 2010 before the passing of Obama Care, 47 million Americans were uninsured

(Diamond, Tracer & Whiteaker, 2016). Fast forward to 2015, roughly 10.5% of Americans under

65, or roughly 28.4 million people were still uninsured, meaning they had no coverage under

private nor public insurance, which would include Obama Care (Health Insurance Coverage,

2017). This is such a big problem that plagues the United States, currently ranked eleventh of all

countries with healthcare systems (Munro, How health care works around the world). One may

say eleventh is not that bad, however if you take into consideration that in the United States,

individual health care spending is more than double that of the United Kingdoms (Senthilingam,

2017) that view will soon change. Part of the reason there are still so many people uninsured is

because of the economics of those individuals. In 2016, there were still roughly 27 million

people who were uninsured, and of those 27 million people, 46% tried to get coverage but found
it was too expensive. Another 11% tried to get coverage but were unable to do so for reasons

undisclosed, and 9% would rather pay the fine for not having health insurance, presumably

because the fine is still more affordable than the actual health insurance would be (Diamond,

Tracer & Whiteaker, 2016). To paint the picture more clearly, the largest age group of uninsured

is between the ages of 26 and 34, translating to 5.98 million people, and the number of uninsured

between 19 and 25 years of age was 4.1 million people (Diamond, Tracer & Whiteaker, 2016). It

would make sense that the highest number of uninsured people occurs right after they are no

longer eligible to stay on their parents insurance, but the reason does not end there.

Of the 27 million people who are uninsured, 7.07 million are below the poverty line

while 7.34 million are between 1-2 times the poverty line, which is only $24,000 annually for a

family of four. The remaining 20 million people sit either 2-3 or 2-4 times the poverty line. Less

than half of the 27 million are eligible for financial assistance from the government due to their

income, in fact 56% in Illinois, 72% in Texas, 54% in California, and 64% in Florida are not

eligible to receive financial assistance which would include Medicare and other government

funded health programs (Diamond, Tracer & Whiteaker, 2016). There are 2.63 million

Americans that fall in the coverage gap where they make too much too receive assistance, but

too little to be able to afford health insurance without compromising the basic standard of living

(Diamond, Tracer & Whiteaker, 2016). Undocumented immigrants make up roughly 5.4 million

of the 27 million uninsured according to Diamond, Tracer & Whiteaker (2016). There are

roughly 11.1 million undocumented immigrants in the United States, contrary to popular belief

undocumented immigrants do pay taxes; in fact of the 8 million that are a part of the workforce,

3.4 million of that total paid social security taxes while the undocumented imigrants and their

employers contributed roughly $13 billion in payroll taxes in 2010 (Blanco, 2017). Aside from
that, we have 11.7 million of the 27 million uninsured, 6.4 million of whom are eligible for either

Medicaid and other government health programs, and 5.3 who can get tax subsidies to offset the

cost of health insurance (Diamond, Tracer & Whiteaker 2016). Really, there are only 15.3

million people that are uninsured that require new legislature to help them gain coverage. Down

from 27 million, the task ahead is still a complicated one which is why we need a new kind of

health care reform, one in which we can narrow or eliminate the number of Americans who are

without insurance.

Now while you may not be one of the 27 Americans that are uninsured, this is still a

social issue that affects everyone, not just those without coverage. The cost of treating the

uninsured is often passed along to those who are insured. It was discovered in 2009, that families

pay on average $1,100 more for their premiums and individuals pay $410 more to offset the bad

debt left behind by uninsured patients (Kingsbury, 2009). There are patients who come into

hospitals and are unable to pay for medical services; hospitals refer to this as bad debt, medical

bills they are unable to collect on. Under the affordable health care act there has only been a

median reduction of 5.6% in bad debt, however there are many instances in which bad debt has

increased as well, which skew the numbers just a bit; in fact, in Wyoming bad debt has increased

42% between 2013 and 2015 (Evans, 2016). Wyoming is one of the states that chose not to

expand Medicare under the Affordable Care Act, however even in states that did expand

Medicare, health costs are being written off on Medicare patients (Evans, 2016). This means to

receive medical treatment, even those under Medicare will need to meet their deductible up-front

if it is not an emergency room visit. So even if you have health care coverage, it is in your best

interest to help lobby for those who not have health insurance. The more people that go
uninsured are the more people whose unpaid medical bills will find themselves being paid by

someone like you.

The new health care system under the proposed amendment, would amend the current

Obamacare to maximize coverage while reducing healthcare costs per person. Throwing money

at the problem has been the go to plan for the United States in times of crisis, but proper planning

and fund reallocation will allow Obamacare/ACA to be more successful and cover all of the

uninsured that live in the United States. For this bill to be successful, it needs to cut the number

of uninsured Americans down to zero. Once that is accomplished, we can turn our attention to

reducing bad debt and decreasing deductibles for insurance premiums. Small visions only yield

small results, which is why this policy needs to eliminate the issue all together, or at least believe

that it can.

Picture this, if the United States were only to adopt Canadas health care system (ranked

tenth, only one above the U.S.), there would still be tremendous benefits; 5,400 less babies

would die in infancy, 57 million fewer adults would be without healthcare, while also avoiding

an estimated 56,000 preventable deaths, all while saving the United States roughly $1.3 trillion

in health care spending (Khazan, 2014). The Canadian healthcare system is funded similarly in

the way Medicare is funded in the United States, however the key differences are most medical

expenses are covered under it and health care spending per person does not exceed an average of

$4,609 annually, roughly $3,000 of which is publicly funded. Another number expected to

increase is the number of people who wait six or more days to see a doctor or nurse, an increase

of 17 million people, with 4.7 million more adults expected to visit the emergency room

(Khazan, 2014). It seems that this number increases because of the perceived lack of staffing to

adequately accommodate all patients. That sounds a lot like more nurses are needed, more
doctors are needed, more construction workers are needed to build new hospital and medical

facilities, cooks, carpenters and electricians all being put to work, all who will pay taxes into the

system. Amending the current health care to increase the number of insured would help

infrastructure and the economy, it would create more jobs and most importantly give more

hardworking Americans affordable healthcare coverage. That $4,609 Canadians spend on

average is less than half of what we currently spend per person for health costs annually in the

United States, if we were to get costs per person down to $4,609 we could double the number of

people who have health care which would essentially cover everyone.

With every new policy, there exist people who will challenge the authority of said policy

and will attempt to evade the requirements set for them under new legislation. If the policy is

successful, there will be no need for American citizens to be punished, however there is concern

that insurance companies will try to find loopholes within the system to deny services to certain

patients, like those with pre-existing conditions or extended hospital visits for long-term

illnesses. Under the new policy, insurance providers would not be allowed to deny customers

coverage or charge them more for coverage based on pre-existing conditions. Another

requirement of insurance companies under the new policy is to offer to extend a patients

medical bills cap another 100% for an additional fee of 25% of their deductible, and 25% of their

premium. On the other hand, insurance companies will be given more tax breaks for the more

patients they cover that do have a pre-existing condition or chronic illness. This new policy

cannot happen overnight, and one of this magnitude will take roughly 6 months to be fully

implemented, or January 1st of the new calendar year., and will be reevaluated and revised as

necessary every two years.

 To fund this new policy, if we continue to spend the American average of $9,451 per

person (Senthilingam, 2017), we will need roughly $144.7 billion to insure the remaining 15.3

million Americans that desperately need medical insurance. In 2016 alone Obamacare is

expected to cost the government $110 billion (Close,2016). Keep in mind all the previously

mentioned numbers are if we continue to spend money at the current rate of $9,451 per person. If

we are able to reduce health care spending to $4,003 per person like those citizens of the UK

(Senthilingam, 2017), we would only need roughly $61.3 billion to insure the remaining people

Americans without coverage, which we could fund with just the money currently allocated for

Obamacare. To begin steps towards creating funding for lowering insurance deductibles, we will

need to take money from other places in which it is not being allocated properly, take

government pensions for example. Across the United States, more than $2.8 trillion is owed to

retired government employees (List of highest government pension recipients in US, 2013).In

the state of Illinois, there are 12,154 retired government employees whose annual pensions total

to over $100,000, the average tax payer pension is only $15,000 (Legalized Corruption: Illinois

Top 200 Government Pensions, 2015). If we were to calculate that, we would find that is $17

billion is paid out annually in Illinois government pensions. If we were to reduce government

pensions by 50% in Illinois alone, annually we would have $34 billion. Colorados annual

government pension payout is about $4.2 billion and Nevadas is $2.25 billion (Just Another

$10 Million Government Pension, 2013), and thats not including if we reduce pensions in those

two states as well. What I am getting at is because Federal dollars for Obamacare will fund the

amended changes to the ACA with excess money left over, we should turn our attention to state

governments and also mandate that they reallocate portions of their absorbent pension funds to

provide assistance for residents of their state in paying their insurance deductible. The money for
making health care more affordable is definitely there, but we must start using it where it is

needed the most. Government pensions also gain perpetuity each year, and not an annuity. The

difference between perpetuity and annuity is perpetuity runs on forever, it has no limits and it

never ends. Annuities on the other hand, have caps meaning they end at some point and dont

exceed a certain number or threshold. We must fix this issue as well, because the problem only

gets worse if we do nothing. Even in reducing pensions by 50% in Illinois, few will make less

than double the average tax-payer pension of $15,000 (Legalized Corruption: Illinois Top 200

Government Pensions, 2015).

This policy is one that will be enacted at the Federal level, having jurisdiction in all 50

states. The department of Health and Human Services will be responsible for overseeing

education of the new policy and administrating the services under the new act. The new policy

will need to be passed through Congress to gain legality, and persuading a reluctant House and

Senate to pass this bill is surely an obstacle that will require the help of a united people, fighting

for the basic human necessity that is healthcare. As previously mentioned, this health care act

will be revisited every two years by Congress for reevaluation and changes as deemed necessary.

The only catch is, the current bill remains in effect until a policy addendum is successfully

passed. At yearly intervals that coincide with fiscal year budgets, numbers will be analyzed to

think of new ways to make health care spending even more efficient. Following its review, the

acting President will renew the bill for healthcare. At the State level, this policy will be

enforced via IRS auditing for state budgets and Congressmen representation for enforcement.

Any new policy or bill that is to be passed will require a great deal of support. The issue

of healthcare is an issue that affects all people citizens and noncitizens who live in the United

States. Insured and uninsured need to come together to back this policy to help each other while
also helping themselves. Healthcare is particularly unique because you have people of the same

occupation on both sides of the dilemma, farmers with health insurance and farmers without it;

young and old people with health insurance and young and old people without it. I know as a few

college students who get sick but will not go to the doctor for treatment because they cannot

afford health insurance and surely not the cost of a doctor visit. I know sick elderly people who

have been sent home from the hospital before they were well because their insurance company

would not pay for any additional treatment; that is very wasteful. Why spend thousands to

hundreds of thousand dollars on a patient and then stop because they are deemed uncurable?

Why not keep going, why not invest more money into their treatment and research to prevent

costly expenses in the next patient? There is absolutely no person that will not benefit from

gaining health coverage or helping someone else gain health coverage, which is why the first

step starts with getting the message out.

In order to gain an audience for our policy campaign, we will need to have President

Trump speak on the current state of healthcare in a State of the Union Address. We need this

speech to be as persuasive as it is empowering. We need Americas most powerful figure behind

us to let the rest of the country know that this problem is happening now and requires our

immediate action. We need our Commander and Chief to let the rest of the country know that

there is an issue at hand when health care premiums for families have risen 3.4% since 2015,

faster than wage growth in America (Gillespie, 2016); that there is a problem when insurance

premiums are expected to rise another 22% in 2017 (Weller & Chadbourn, 2016) and over half

of U.S. workers on a single coverage health plan have a deductible of $1,000 or more, an

increase of 20% since 2011 (Gillespie, 2016). Part of the policy plan once all Americans gain

coverage is to reduce insurance deductibles by incentivizing insurance companies to lower

deductibles to a fixed percentage based on the median household income. Once we have our

leader do this, we will begin our social media campaigns, Twitter, Facebook, and Instagram are

the way in which we can reach the millennial voters of the world. Hashtag #InsureAmerica, is

surely to get people to dig deeper into what our platform is. The power of a like or a share is

remarkable, we can send out all the statistics that have been mentioned in this proposal in under

10 minutes to more than half of the world. We will not be negligent of the need for physical

bodies and large gatherings of people to support our bill. We will start a social movement that is

organized at the state levels, hosting various info seminars and staging image events with the end

goal simply to frame the problem as a real problem. We will divvy up our agents of change by

age groups and target them strategically to gain their support of the policy. Of course, there will

be those who protest our movement, but in response we will stick to our platform, which is no

American left behindinsured today, healthy tomorrow and Tomorrow is not promised, but it

is insured. Being on the winning side of the argument affords you the benefit of not having to

prove why you are right, it is the opposing sides task to show people why we are wrong. We can

stage image events with key guest speakers such as Senator Bernie Sanders, and President

Obama who can give televised speeches using their prior ethos to gain the trust of voters to lobby

for amending the ACA with the proposed changes in this paper. The two authority figures will

alos be using their persuasive rhetoric to tell stories of a brighter future for insured Americans

and using metaphors to compare ourselves to other countries who have better healthcare systems

in place to make the vision clearer.

In an assessment of the policy aims and goals, one will find that while it is not

impossible, it is very much unrealistic and not likely to happen anytime soon. With a nation

divided on so many controversial issues, healthcare included, there is little chance that
lawmakers can come together to pass new healthcare legislation that would benefit all

Americans. The process of implementing this policy change makes perfect sense, but because the

goal of the policy is seen as a costly one it will be hard to get the support of the House and the

Senate. Currently policy makers are caught in a rift, not really wanting Obamacare, but also not

having a suitable replacement for it such, i.e. Trumpcare. While they claim Obama is too

expensive, Trumpcare had it passed would have resulted in 48 million people being uninsured

than 47 million uninsured if we were to simply repeal Obamacare (Mukherjee, 2017). The

proposed policy is very much similar to Obamacare, but it is also different in its scope of

coverage, and rules of enforcement. The main opposition I expect to encounter are life-time

politicians. Some of the congressmen and congresswomen have served for years and years on

end and are set in their ways. It is admirable that they would like to remain loyal to the views and

policies enacted during their favorite administration, but that is not what they are elected to do.

They will oppose my policy because it is too radical for their traditional views and because it

costs the government money instead of making it more money. Looking at why Trumpcare

failed, one reason is because he seemed to desperate to make it happen (Gandhi, 2017). This was

an issue because lawmakers did not want to rush into something that they felt they were being

pushed to do, although the content of the policy also was not that great. This is something my

policy can learn from. Taking the time to educate Americans on the current state of healthcare

and then gradually letting them convince themselves that this is a good policy to enact. The new

policy would be completely transparent and clearly explained unlike the misleading facets of

Trumpcare, which also helped doom the bill before it could even gain ground (Gandhi, 2017).

Another fatal flaw of the Trump administration in lobbying for Trumpcare was the Presidents

criticism of the media, especially after his failure to deliver on promises he had previously made
on his campaign trail (Gandhi, 2017). Lobbyists for my policy would embrace all media angles

because after all we do have free speech in this country, and because seeing things from a

different perspective only helps you see what you can do to make your policy even better than it

already was. My policy can work a few years from now, maybe after the next Presidential

election if we can unite the country once again on topics that are actually important and stop

dumping money into a futile effort to bring back coal mining jobs. What my policy is going to do

different from Obamacare is not exclude any American citizen from gaining healthcare, covering

20 million people over five years was notable, but it did not accomplish the bigger mission.

Republicans were against Obamacare when it was first passed in 2010, just as Democrats are

against Trumpcare now. My policy is to remain unpolarized, sticking to the issue. This new

health care policy takes a socialist approach to a societal problem, one that is to work for the

people because of the people and by the people.

In conclusion, the longwinded topic of healthcare just got even more longwinded. There

are still too many Americans that are without healthcare coverage and too many Americans with

healthcare coverage that does them no good because their deductibles are too high (Gillespie,

2016). We need to go back to square one, and start thinking about new ways to efficiently deliver

healthcare, beginning with the adoption of this new policy. The need for change is now and

while alternatives may exist, none seem to get the job done.