Making abortion illegal

COM2204H

PROBLEM SPEECH OUTLINE

I. Policy Proposition: The United States should have universal healthcare.

1. Definitions:

a. Universal= including or covering all without limit or exception; available equitably to all members of a society (Merriam-Webster)

b. Healthcare= efforts made to maintain physical, mental, or emotional well-being by trained and licensed professionals (Merriam-Webster)

II. Background:

1. The Affordable Care Act was passed in Congress and was signed into law by former President Barack Obama on March 23, 2010. The Affordable Care Act, known as Obamacare, is a health insurance reform legislation, making healthcare more accessible. This is the current healthcare system that we are under. (Centers for Medicare and Medicaid Services, 2010)

2. Recently, President Donald Trump has been challenging Obamacare. In June 2020, he asked the Supreme Court to overturn the Affordable Care Act. If this were successful, millions of Americans would be without health insurance. (Stolberg, New York Times, 2020)

3. During the recent presidential debate, that took place on September 29th 2020, President Trump challenged Obamacare even more and made clear of his intentions of wanting to get rid of it (Rev, 2020).

III. Claim 1: The current Obamacare system is not enough

1. Even though Obamacare expanded coverage, it did not do enough.

a. In 2018, 27.9 million nonelderly people were in uninsured, a 2.1 million increase from 2016. (Kaiser Family Foundation, 2019)

b. Similarly, according to the United States Census Bureau, 8.5% (27.5 million) of people did not have health insurance in 2018. This shows an increase from 2017, in which 7.9% (25.6 million) people didn’t have health insurance. (United States Census Bureau, 2019)

2. Costs are still very high for deductibles and other out of pocket costs.

a. The costs of having insurance is very high for many middle-class people (Kliff et al., New York Times, 2020)

b. The average plan for a 40-year-old who doesn’t qualify for a subsidy is $462 a month in 2020. This is a sharp increase from $273 in 2014. (Kliff et al., New York Times, 2020)

c. The deductibles (which is an amount a patient needs to pay before they can get coverage) are very expensive. For individuals, deductibles can be as high as $8,150 and for families, $16,300. (Kliff et al., New York Times, 2020)

d. 45% of the uninsured nonelderly people said that the reason that they are uninsured is because the cost is too high. (Kasier Family Foundation, 2019)

3. When in a life and death situation, you shouldn’t have to think about costs.

a. A woman from Massachusetts had begged people to not call an ambulance for her after she was in a subway accident. She feared about the high ambulance and hospital costs. (The Hill, 2018)

b. New York Times journalist, Marie Cramer, tweeted about the incident saying that the woman was in agony and weeping but begged people to not call an ambulance saying “’It’s $3,000. I can’t afford that.’” (Cramer, 2018)

c. In Boston, where that incident took place in, ambulances would cost closer between $1,200 to $1,900. (The Hill, 2018) Still a hefty price.

IV. Claim 2: The current pandemic, Covid-19, exposed the flaws in our current healthcare system.

1. The pandemic highlighted the health insurance crisis.

a. “More than 20 million Americans have lost their jobs since the COVID-19 pandemic upended society in March… A recent Commonwealth Fund survey found that 40% of respondents or their partner who were laid off or furloughed had employer-sponsored insurance.” (HealthLeaders Media, 2020)

2. Citizens are not able to get access to healthcare services causing outbreaks within certain communities to become worse.

a. “The U.S. health care system has a basic repeating motif…when you’re sick, you’ll come to a clinic or hospital if your issue is serious enough… The system’s job is to maintain sufficient flow and manage surges…This…model of health care fails…economically distressed people who can’t afford to access it,… people in rural communities who live far from it,… people of color who have experienced institutional racism and do not trust it, and… people with disabilities, who are challenged at every turn if they seek to access it… In the absence of a comprehensive effort to create a new locally oriented health care model, the forces that make these four groups vulnerable to COVID-19 are intensifying at breathtaking speed.” (HealthLeaders Media, 2020)

3. Our current healthcare system was not prepared enough for an inevitable catastrophic epidemic or pandemic.

a. “For years, epidemiologists have warned of possibly catastrophic epidemics of new flu-like illnesses… but the U.S. delivery system is still not ready. The Centers for Medicare and Medicaid Services does not factor in costs of stand-by capacity in its routine payments to hospitals, which limits the ability of facilities to build and maintain the extra beds and supplies that might be required.” (Harvard Business Review, 2020)

V. Claim 3: Companies raise the prices of prescription drugs, making it harder for people who rely on them to buy them.

1. The price of insulin is incredibly high, making it harder for people who rely on it to buy it.

a. Over 30 million Americans have diabetes. Having access to insulin is a matter of life and death for those with type 1 diabetes. (Diabetes Care, 2018)

b. In 1996, the price of a 1-month supply of insulin was $21. In 2001, the exact vial’s price increased from $14 to $35. In 2019, the vial is about $275. That is a 1200% increase from the original price. (American Journal of Managed Care, 2019)

c. Because of this “many people feel forced to ration their monthly prescriptions… and later suffer the ultimate sacrifice: death” (American Journal of Managed Care, 2019)

d. No one really knows why the price of insulin has been raised so much because pharmaceutical companies continue to hold their tongue when asked about it. (American Journal of Managed Care, 2019)

2. Big Pharma companies are raising the price of prescription drugs

a. Since January 1, 2020, the price of almost 500 prescription drugs have increased with the average price hike being about 5 percent. (Healthline Media, 2020)

b. “…the biggest price hike was Marplan, which is used to treat depression, at 14 percent” (Healthline Media, 2020)

c. According to a CBS news report from January 2020, “Drug prices are much higher in the U.S. than in other countries, where the governments typically negotiate with manufacturers to control costs.” (CBS News, 2020)

3. HIV medication costs are also increasing

a. A recent study from 2020 shows that the cost of antiretroviral therapy (ART), which is a HIV treatment, has increased in cost by 34% since 2012. (The Foundation for AIDS Research, 2020)

b. “… the average annual cost of recommended ART combinations ranged from about $25,000 to $35,000 in 2012. By 2018, the cost had increased to between $36,000 and $48,000-even with generic options.” (The Foundation for AIDS Research, 2020)

c. According to a medically reviewed article from 2020, Truvada is an antiretroviral that is used to prevent the transmission of HIV and has already seen an increase in price. (Healthline Media, 2020)

VI. Inherency:

1. Structural inherency= The current healthcare system in place which is The Affordable Care Act (Obamacare).

2. Attitudinal inherency= Following in the footsteps of President Trump, many Republicans want to completely get rid of Obamacare, decreasing even more access to healthcare services and insurance.

VII. Counterargument: Some Americans might argue that our current healthcare system has been good because it expanded access to healthcare.

1. While it is true that Obamacare allowed more access to healthcare, millions of Americans still remain uninsured or under high costs. As I’ve mentioned in my argument, approximately 27.5 million people do not have health insurance as of 2018 (United States Census Bureau, 2019) and that number continues to increase through the pandemic. Because of Covid-19, 40 percent of people (or their partner) who lost their job had employer-sponsored insurance causing even more people to be left uninsured (HealthLeaders Media, 2020).

VIII. Conclusion:

1. Even though Obamacare made healthcare more accessible for Americans, it is still not enough. Our current Covid-19 pandemic exposed the flaws in our current healthcare system.

Works Cited

“Universal.” Merriam-Webster.com Dictionary, Merriam-Webster, https://www.merriam-webster.com/dictionary/universal.

“Health care.” Merriam-Webster.com Dictionary, Merriam-Webster, https://www.merriam-webster.com/dictionary/health%20care.

“Background: The Affordable Care Act’s New Rules on Preventative Care”, Centers for Medicare and Medicaid Services, July 14, 2010, https://www.cms.gov/CCIIO/Resources/Fact-Sheets-and-FAQs/preventive-care-background.

Stolberg, S. G. (2020). “Trump Administration Asks Supreme Court to Strike Down Affordable Care Act”, The New York Times, https://www.nytimes.com/2020/06/26/us/politics/obamacare-trump-administration-supreme-court.html

Damico, A., Singer, N., Orgera, N., & Tolbert, J. (2019). “Key Facts about the Uninsured Population”, Kaiser Family Foundation, https://www.kff.org/uninsured/issue-brief/key-facts-about-the-uninsured-population/ - :~:text=In 2018, 27.9 million nonelderly,has grown by 1.2 million.

Upton, R. D., Barnett, J. C., & Berchick, E. R. (2019). “Health Insurance Coverage in the United States: 2018”, United States Census Bureau, https://www.census.gov/library/publications/2019/demo/p60-267.html - :~:text=Highlights&text=In 2018, 8.5 percent of,7.9 percent or 25.6 million).

Kliff, S., Sanger-Katz, M., Abelson, R., & Goodnough A. (2020). “Obamacare Turns 10. Here’s a Look at What Works and Doesn’t”, The New York Times, https://www.nytimes.com/2020/03/23/health/obamacare-aca-coverage-cost-history.html

Folley, A. (2018). “Woman begging people not to call ambulance gains national attention”, The Hill, https://thehill.com/homenews/media/395409-story-of-injured-woman-begging-people-not-to-call-ambulance-due-to-costs-gains

Cramer, M. (2018). Twitter, https://twitter.com/NYTimesCramer/status/1012814279857360896?s=20

Cheney, C. (2020). “Coronavirus Pandemic Bares U.S. Healthcare Flaws, Points to Improvements”, HealthLeaders Media, https://www.healthleadersmedia.com/clinical-care/coronavirus-pandemic-bares-us-healthcare-flaws-points-improvements

Sheervai, S. & Blumenthal, D. (2020). “Coronavirus is Exposing Deficiencies in U.S. Health Care”, Harvard Business Review, https://hbr.org/2020/03/coronavirus-is-exposing-deficiencies-in-u-s-health-care

Cefalu, W. T., Dawes, D. E., Gavlak, G., et al. (2018). “Insulin Access and Affordability Working Group: Conclusions and Recommendations”, Diabetes Care, 41, 1299-1311 https://kopernio.com/viewer?doi=10.2337%2Fdci18-0019&token=WzExOTgzNDgsIjEwLjIzMzcvZGNpMTgtMDAxOSJd.8Gj6tPv0fhiK4NOBq1FmPdkwWD0

Roberts, D. K. (2019). “The Deadly Costs of Insulin”, American Journal of Managed Care, https://www.ajmc.com/view/the-deadly-costs-of-insulin

Berger, M. (2020). “The Price of 500 Prescription Drugs Have Gone Up This Year: What to Known”, Healthline Media, https://www.healthline.com/health-news/prescription-drug-prices-have-gone-up-this-year

Cerullo, M. (2020). “2020 is three days old and drug prices are already jumping”, CBS News, https://www.cbsnews.com/news/big-pharma-companies-raised-prices-on-more-than-400-drugs-to-start-2020/

(2020). “Cost of HIV Treatment Rising”, The Foundation for AIDS Research, https://www.amfar.org/cost-of-hiv-rising/

(2020). “Donald Trump & Joe Biden 1st Presidential Debate Transcript 2020”, Rev, https://www.rev.com/blog/transcripts/donald-trump-joe-biden-1st-presidential-debate-transcript-2020