Lesson One, Prologue through Chapter 4, 1-65
In a 6-page research paper, not including your Works Cited page, address the following proposition with an argumentative thesis:
One camp of readers would praise T.R. Reid’s book as a heavy dose of sanity counteracting a sick American public health care policy shackled by greedy politicians and insurance functionaries, polarized pundits, fear tactics, close-mindedness, and other pathologies. Another camp of readers would repudiate Reid’s book as an ideologically fueled polemic sodden with biases, fantasies, and socialistic excesses. Which camp are you in? Support your position in a thesis with mapping components that defend your assertion. Be sure to address your opponents to show why they’re misguided in at least a page of your essay.
Your guidelines are as follows:
This research paper should present a thesis that is specific, manageable, provable, and contestable—in other words, the thesis should offer a clear position, stand, or opinion that will be proven with research. You should analyze and prove your thesis using examples and quotes from a variety of sources.
You need to research and cite from at least five sources. You must use at least 3 different types of sources.
At least one source must be from an ECC library database.
At least one source must be a book, anthology or textbook.
At least one source must be from a credible website, appropriate for academic use.
The paper should not over-rely on one main source for most of the information. Rather, it should use multiple sources and synthesize the information found in them.
This paper will be approximately 5-7 pages in length, not including the Works Cited page, which is also required. This means at least 5 full pages of text. The Works Cited page does NOT count towards length requirement.
You must use MLA format for the document, in-text citations, and Works Cited page.
You must integrate quotations and paraphrases using signal phrases and analysis or commentary.
You must sustain your argument, use transitions effectively, and use correct grammar, spelling, and punctuation. Your paper must be logically organized and focused.
Method for Your Essay
Use Toulmin Model
Introduction
Claim or Thesis
Evidence, Reasoning, and Logic That Supports Your Claim
Rebuttal Section
Conclusion, a restatement of your thesis in dramatic terms
or
Use Refutation Model
Introduce your opponents' argument
Claim: Explain why your opponents are wrong
Body Paragraphs: Point by point refutation of their reasons for having their position.
Conclusion: Restatement of thesis in dramatic form.
Either way, you'll have to address your opponents' views.
Ten Reasons for Being Against National or Universal Healthcare:
1. inefficient in the hands of clunky government
2. will raise taxes
3. free market, not socialism, increases service and products
4. decreased patient choice
5. patients will abuse free service and overburden the system
6. uninsured Americans can already receive healthcare through non-profit, charities, and emergency rooms
7. healthy people will pay for unhealthy people (obese and smokers)
8. government will restrict behavior and become intrusive
9. lower profits will disuade the best and brightest from pursuing medical careers
10. healthcare isn't a right
Ten Reasons for Supporting National or Universal Health Care
One. The U.S. Constitution guarantees to promote public welfare and to insure domestic tranquility.
Two. Other countries have universal coverage and serve their people better without being “destroyed by communism.”
Three. Universal healthcare is a moral imperative. Who are we as a people if we don’t value guaranteed healthcare for everyone?
Four. Universal healthcare is good for small and big business (except for the healthcare insurance companies).
Five. It doesn’t discriminate based on medical condition.
Six. It eradicates for-profit insurance companies who value their money over our health.
Seven. It makes a less complicated payment system saving billions of dollars over the current system, which has at least 25% waste.
Eight. Government-fueled universal healthcare is the only force big enough to take down the evils of for-profit insurance companies.
Nine. It will provide preventative medical care saving billions of dollars and saving tens of thousands of lives.
Ten. Healthcare will be affordable for all.
Lexicon
1. Pathos, Ethos, and Logos (emotion, credibility, logic) when it comes to the moral question of health care in the Prologue: Nikki White died without good cause. Wealthiest country couldn't give her standard country when less wealthy countries could. The situation is neither ethical or logical.
2. American patient's dilemma: Too rich for paid health care, welfare, and too poor for high quality health care: 20,000 Americans die every year without good reason because of our failed health care system. This does not happen in any other developed country. We aren't talking about this, but we are eating at buffets. We are blind to our detriment.
3. "Our fundamental moral decision": As Americans, we have decided not to provide health care for everyone. We don't guarantee medical care for the sick unlike every other developed country. We are morally bankrupt. Politicians in bed with health care lobby have persuaded us that universal health care is "un-American" and "communist." Are we so malleable and gullible?
4. Moral denial and numbing: Either we are in denial of our moral failing to provide health care or we are numbed to our awareness of our moral failures. T.R. Reid wants to wake us up.
5. Either/Or Fallacy (presented to us by many politicians): For many Americans, we must either keep our current health care system, as flawed as it is, or submit to the evils of socialized medicine and violate our true American nature. In fact, this is a myth: Most developed countries who provide universal health care are not socialist (3) but anti-universal health care politicians continue to push this logical fallacy. And sadly too many Americans believe them.
6. Primary motive for changing health care: We can look at economics, politics, and health reasons for changing it but the primary motive should be a moral one.
7. American Health Paradox: We spend the most money per person for medical care and we receive the worst medical care. We spend $7,400 per person while Japan, ranking high in quality medical care, spends $3,400.
8. The book's thesis: On page 8 we read we can find cost-effective ways to cover every American by borrowing methods from other countries.
9. American pride and hubris: "We're number one!" and "We'll never bow down to socialists!" are inaccurate, ignorant, and irrational and yet this mentality impedes us from positive change. This mentality is the knee-jerk (not using the brain) reaction to the proposition that we need universal health care.
10. We have a history of benefiting from borrowing from other countries in popular culture (TV shows) and even our highway system (from Germany). Why is there such a stigma with national health care?
11. Pragmatic: reasonable and practical and problem-solving as opposed to being stubborn, hard-headed, irrational. We need a pragmatic approach, not an ideological one.
12. Egalitarian: No one stands out. We're all in the middle, no extremes above or below. Canada embodies this mentality and they have universal health care with long lines for some procedures.
13. Absolutists: British will not pay a penny for any medical procedure. This is their absolute position, so they don't mind paying with health care with higher taxes.
14. Bismarck Model of Health Care: Payers get their benefits through payroll deductions, but everyone is covered with a job or not. The health care systems work non-profit. We see this system in Japan, Germany, Belgium, Switzerland, and Latin America (17).
15. Beveridge Model of Health Care: Government pays for all health care through taxes. We see this system in Britain, Italy, Spain, and Hong Kong. This system is also used in the United States Veterans Affairs or the VA.
16. National Health Insurance Model: This is a hybrid of Bismarck and Beveridge: The providers are private but the payer is a government-run insurance program. This single-payer system keeps costs down (19). We see this system in Canada, Australia, Taiwan, and South Korea.
17. Out-of-Pocket Model: Have money or die. We see this model in poor countries.
Review Questions up to Chapter 2
One. How is the death of Nikki White on page 1 a moral condemnation of America?
She died unnecessarily and without protest in a country indifferent to the moral bankruptcy of a country that doesn’t protect its people.
The moral condemnation can be further based on the fact that our health care system “has become excessively expensive, ineffective, and unjust” (8, 9). America is ranked 37th in the world for health care service based on quality and fairness (9). Yet we spend the highest percentage of our GDP on health care (9).
Japan ranks higher in health care in America but spends less per person at $3,400 vs. $7,400 per person in America (so health insurance companies getting all that money?)
Two. What dilemma was Nikki in that is like so many Americans? See page 1
She made too much money for health care under welfare but not enough money to pay for drugs needed to save her life.
Three. Why does Reid compare the cost of fighting terrorism with the cost of health care on page 2?
We spend hundreds of billions to fight terrorism based on 9/11, which killed 3,000 people, yet every year twenty thousand Americans die because of a lack of health care. This doesn’t happen in any other developed country in the world.
Four. What “moral decision” has our country made on page 2?
Whatever entitlements we enjoy, we have decided to not cover health care for our people so that at least 23 million are uninsured. We've got an "I've got mine; get yours" mentality.
Five. What is Reid’s thesis?
See page 11: “The thesis of this book is that we can find cost-effective ways to cover every American by borrowing ideas from foreign models of health care.”
Are we too arrogant to learn from other countries? Too proud? Too inclined to demonize other countries as being “socialist”?
Indeed, American exceptionalism, the belief that the American way is the best way, impedes us from looking at foreign countries and their superior methods. See page 12. Fantasies of American superiority in the face of our hideous health care ranking need to come to an end.
Indeed, politicians and others respond to health care by shouting, “But it’s socialized medicine!” It’s as if that ended the argument. This is the major political weapon.
Six. What are the flaws of the “socialized health care is against free market and low taxes” argument?
Most national health care systems are not socialized. Also, Americans already have socialized car such as the Veterans Administration.
It’s a fallacy therefore to accuse someone promoting universal health care as being socialist or un-American.
Seven. What is comparative policy analysis and why is it so important?
Find out what works in other countries, like the Super Highway, and implement it in your own country.
Eight. What are the 4 basic health care models?
On page 17 we read about
(1) The Bismarck Model, a nonprofit private plan that amounts to charity.
(2) The Beveridge Model
The government provides health care through taxes like in England. It operates like the Fire Department or a utility.
This system is what Americans think of when they think of “socialized medicine” even though they conflate the Beveridge Model with all the others.
The Beveridge Model is most purely implemented in Cuba and US Veterans Affairs, which is ironic.
(3) The National Health Insurance Model
This is a combination of the Bismarck and the Beveridge in which the government is the payer to private health care companies.
This is nonprofit and needs no marketing so the cost is cheaper than private insurance.
(4) The Out of Pocket Model
If you’re poor, you get no medical care because you live in a country that has no health care system. Only the rich can get medical care.
America has all four systems in its crazy health care amalgam. We rely on separate systems for separate classes of people (21).
Nine. If everyone agrees the American health care system is dysfunctional, then why is there resistance to change?
Knee-jerk (reacting without thinking) reflexive hostility: “Socialism is un-American!”
Hospital chains, pharmaceutical companies, insurance companies, their lobbyists all pay big money to disseminate propaganda and pay-off the politicians.
Opponents argue that bureaucrats decide who gets what kind of treatment, called “access to treatment decisions” and these decisions result in “limited choice” (24).
Americans apparently lack the moral fortitude to embrace the moral principle that informs all other developed countries: Health care should be for ALL people; however, whites get better health care than people of color while no such racial disparities exist in other developing countries (23).
You should focus on this moral argument and its strength, or not, in your essay.
Ten. All developing countries do better in the “basic measures of health care performance.” What are these measures?
Coverage
Quality
Cost Control
Choice
Grammar Review
Twelve Rules of Subject-Verb Agreement
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