Health Care (Denial of Service)

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Health Care (Denial of Service)
The Queue explores the failure by a government to deliver on its promises to the people as well as psychological games played by the government on the citizens. The United States (U.S.) health care system predominantly revolves around health insurance, an area that has experienced massive government intervention. The scenes displayed in The Queue have a significant resemblance to a majority of the issues affecting the U.S health care system. This paper evaluates the U.S. health care system and directly compares it to scenes in The Queue to show areas in which the government has failed to deliver on its promises to the people.
The Patient Protection and Affordable Care Act introduced by Barack Obama has fostered radical changes in the U.S. health care system. It endeavors to encourage people to purchase insurance policies by offering tax credits and subsidies. Medicare and Medicaid constitute two of the largest health insurance programs in the U.S. Medicare and Medicaid purposes to insure disadvantaged groups in the society – elderly, physically challenged and poor persons suffering from terminal diseases (Niles 28). The Act can be likened to the Gate in The Queue. The Gate takes up complete control of the lives of the citizens. The gate hands out the requisite paper without which a citizen cannot enjoy government services. Similarly, the Act is a game-changer in America since it determines who gets insured and who does not get insured.

Persons who are not covered by Medicare and Medicaid and who are not capable of purchasing insurance policies, risk being uninsured. Therefore, the Gate greatly compares to the Act since it determines who enjoys basic services. For Americans, the Act determines who is insured while for the citizens in The Queue, the Gate determines who gets served at government offices.
In the U.S., employers provide private health insurance programs run via employers sponsored arrangements. The employers offset a considerable amount of the total premium, say 85%, while the insured contributes the rest (15%). Individuals who are self-employed are required to sponsor their insurance policies. Individuals who sponsor their insurance programs have to meet their premium cost in full. The government drives employers and self-employed persons to purchase insurance policies by offering them tax credits and subsidies (Niles 387). These tax credits and subsidies can be likened to Certificates of True Citizenship in The Queue.
“So I go to the European bakery, but it was all shutdown. The next morning I go out early, to the bakeries in the market, but turns out they heard what happened, too. They tell me the same thing and won’t let me have any bread, either. My neighbor told me if that’s the way it is, I should file a complaint with the Gate. Told me I needed to apply for a certificate – I forget what it’s called – the one with a government stamp … She shoved her hand into her vast galabeya and pulled out a small piece of cardboard, the words Certificate of True Citizenship written upon it.” (Aziz 6)
In the U.S., the government meddles with the insurance market by providing tax credits and subsidies. The government offers tax credits and subsidies on specific insurance covers to encourage employers and insurance companies to insure persons within the stipulated bracket. Similarly, the government in The Queue offers a standing order requiring that every citizen obtains a Certificate of True Citizenship before seeking government services. Private business is also directed to render their services only to persons who have obtained Certificates of True Citizenship from the Gate. The woman ahead of Yehya in the Queue reports not have been served by her usual bakery since she did not possess a Certificate of True Citizenship. The U.S. government can be likened to the Gate in the Queue. The former interferes with the insurance market in the U.S. hindering the provision of insurance policies solely bases on market forces of demand and supply.
In the Queue, an institution dubbed the Gate governs the nation (Aziz 31). The Gate extends the authoritarian rule of the nation’s former ruler. The Gate controls all the aspects of the citizens through enacting extensive paperwork even for mundane activities (Aziz 31). The government declared that it everyone would be subjected to a deduction in their income to finance the costly paperwork. Citizens stage a violent rally in response to the Gate’s iron-clad ruling system at the central square of the city. The protest is later dubbed the Disgraceful Events (Aziz 85).
The move by the Gate to regulate the daily activities of its citizens can be likened to the intervention of the U.S. government in the insurance market. Further, the Disgraceful Events in The Queue can be likened to litigations that have been enacted against Affordable Care Act (ACA). In 2012, the lawsuit NFIB V Sebelius materialized (“Obamacare Lawsuit” n.pg). The core aim of this lawsuit was to challenge the requirement by ACA that respective states expand Medicaid coverage. The court ruled that funding by the federal government to states would not be pegged on the requirement that states expand Medicaid coverage. In 2014, Burwell V Hobby Lobby occurred (“Obamacare Lawsuit” n.pg). The lawsuit sued the federal government against compelling to offer insurance covers that encompass contraception. The court decided that third party insures should provide insurance to citizens whose employers do not include contraception covers based on religious grounds. The fore mentioned lawsuits are similar to the protests made by the citizens against the Gate. In both cases, the citizens feel that the government has contravened their rights thus the subsequent backlash against the government.
The two main characters in the novel, Yehya and Tarek are developed through the Disgraceful Events. Yehya is an ordinary citizen who get shot during the Disgraceful Events. The bullet gets lodged in Yehya’s pelvis. Tarek practices as a physician in the medical facility where Yehya seeks medical help. In light of declining health, Yehya joins the queue at the Gate to acquire a document authorizing the removal of the bullet in the abdomen. However, the government issues a standing order declaring that permission to allow the removal of bullets in victims shall only be granted to citizens exhibiting strong allegiance to the ways of the Gate.
“Permits authorizing the removal of bullets shall not be granted, except to those who prove beyond reasonable doubt, and with irrefutable evidence, their full commitment to sound morals and comportment, and to those who are issued an official certificate confirming that they are righteous citizens, or, at least, a true citizen. Certificates of True Citizenship that do not bear a signature from the Booth and the seal of the Gate shall not be recognized under any circumstances.” (Aziz 114)
This inhibits Yehya from obtaining medical help since he was allegedly shot at the ‘wrong’ place and time. This can be likened by the core constituents of ACA – Medicaid and Medicare. Both insurances covers endeavor to predominantly cover the disadvantaged groups in society – the elderly, orphaned and poor persons suffering from terminal diseases. The rest of the people not included in this bracket are required to cover their insurance costs. However, a majority of the Americans are not eligible for Medicare and Medicaid yet they cannot afford to purchase insurance cover. Consequently, they are left insured. This can be likened to the situation of Yehya whereby he is ineligible to obtain medical attention because of punitive policies by the Gate.
The U.S. government allocates vast sums of money to the health care system, but the citizens do not enjoy the quality health care they deserve. The spending of the U.S. outnumbers the combined spending by other developing nations, such as Germany, France, and Canada but the U.S. performs dismally in its health care state and mortality rate in comparison to other first world countries (OECD Health Data 2012 pg.3). The U.S. misappropriates 30 cents of every dollar spent on health care that annually sums up to $750 billion (OECD Health Data 2012 pg.3). This hefty amount that goes into waste is made up of prohibitive administrative costs as well as inappropriate delivery of care. This can be likened to the Gate’s standing order that every citizen is subjected to a deduction in their salary to finance expensive paper work. Further, this shortcoming in the U.S. health care system can be likened to the decree by the Gate that everyone obtains a Certificate of True Citizenship before seeking medical help in any hospital. In a manner similar to the Gate, the U.S. misappropriates significant amounts of funds on administrative roles instead of insuring more Americans.
The U.S. health care system is also notorious for the incoordination of its services. The governments perform dismally in coordinating health care services particularly for persons requiring medical attention from multiple health providers. Consequently, the U.S. health care system is littered with inadequate access to medical records, miscommunication as well as fragments. For instance, 30% percent of the lab tests have to be redone in the U.S. hospitals since the records cannot be found (Institute of Medicine (US) Roundtable on Evidence-Based Medicine n.pg). About 70 percent of the specialists are not furnished with the medical history of a patient, before the patient’s referral visit (Institute of Medicine (US) Roundtable on Evidence-Based Medicine n.pg). Sloppy prescription by physicians leads to the death of above 7,000 persons annually (Institute of Medicine (US) Roundtable on Evidence-Based Medicine n.pg). This can be likened to the scene in the book, The Queue, whereby the X-ray files of Yehya are altered by agents of the Gate (Aziz 42). Consequently, Tarek has a difficult time trying to recall the actual diagnosis of Yehya since he observes that Tarek’s medical records are altered though he does not know the perpetrator. Further, the governments issue a decree that no bullet was fired during the Disrespectful Events, which further compounds the inconsistencies in the medical records of Tarek. This incoordination in the medical records of Tarek leads to undue suffering leading to the health deterioration of Tarek. This can be likened to the suffering experienced by patients across hospitals in the U.S. stemming from incoordination of medical facilities.
A proportion of Americans does not access to health care at all. Approximately thirty percent of people in the U.S. are either uninsured or underinsured (Barnett and Vornovitsky 3). The prohibitive cost of accessing medical help restricts about 25 percent of people in the United States from visiting hospitals when they fall sick (Barnett and Vornovitsky 3). Further, about 20 percent of people lack the requisite medical knowledge to fill their prescriptions (Barnett and Vornovitsky 11). This can be likened to the book, The Queue, whereby people have to queue in a line that does not move to access requisite from the Gate. The requirement that everyone in need of medical attention acquires the requisite paperwork hinders a majority of the people from receiving medical help (Aziz 90).
The Gate can be compared to insurance health providers in the U.S. whereby prospective people are subjected to extensive scrutiny before obtaining insurance policies. Consequently, a good number of people are either uninsured or underinsured due to the stringent measures. Similarly, the requirement by the Gate that Certificates of True Citizenship be offered solely to persons exhibiting allegiance to the government hinders deserving citizens from accessing medical attention on time (Aziz 110). Consequently, a citizen like Yehya who was shot being in the ‘wrong’ time and place experiences deterioration in his health since he cannot easily obtain the relevant paperwork to remove the bullet from his pelvis (Aziz 90).
The Gate issues a standing order to medical professionals that they should only offer medical assistance to patients with the necessary paperwork (Aziz 45). The medical professionals found to contravene this declaration are not only subject to firing but also imprisonment.
“Sanctions Imposed on that Violation of Article 4 (A): Anyone who violates Article 4 (A), deliberately or inadvertently, shall be penalized as follows: First, s/he shall be banned for a period to be determined by a judge. After the period of his/her punishment has ended, s/he shall not be allowed to return to the same position or occupation, except after s/he undergoes a rehabilitation program, the length of which shall be specifically determined by the Gate of the Northern Building …” (Aziz 45)
Tarek hesitates to remove the bullet in Yehya’s pelvis due to the standing order issued by the Gate (Aziz 45). This can be linked to the tax deductions and subsidies offered by the government to insurance companies in the United States (Barnett and Vornovitsky 21). Health providers are in a competition to receive most of the tax deductions and subsidies from the government while also being careful to insure the ‘right’ people. The government only renders tax deduction and subsidies only to stipulated insurance covers. Thus, insurance companies strive to insure only persons in this bracket. This leaves a majority of the people in the U.S. either uninsured or underinsured.
A majority of the people in the U.S. are dissatisfied with the U.S. health care system. For instance, only 16 percent of people in the U.S. remarked to be satisfied with the health care system compared to 26 percent and 42 percent in UK and Netherlands respectively (Blendon et al. n.pg). Further, 34 percent of people in the U.S. are categorical that the health care system deserves to be overhauled compared with 15 percent and 12 percent of Britons and Canadians respectively (Blendon et al. n.pg). Thus, despite the vast resources channeled towards the health care system, American are extensively dissatisfied with it. This can be compared to the uprising dubbed the Disgraceful Events in the book, The Queue. Citizens are agitated by the authoritarian rule of governance necessitating skirmishes dubbed the Disgraceful Events (Aziz 85).
In conclusion, the book The Queue has numerous similarities with the U.S. health care system. Despite the system of ruling displayed in The Queue differing from the system of ruling in the U.S., both governments fail to deliver their promises to the people. The ruler in The Queue creates the Gate to bring the situation under control after the Disgraceful Events but miserably fails to live to their promises. People swell up in a long queue that never moves forward. Similarly, the recent reforms in the U.S. – the Patient Protection and Affordable Care Act – endeavored to avail quality health care to everyone in the United States have miserably failed the Americans. The Act has failed to live up to its promises leaving a majority of people in the U.S. (25%) either uninsured or underinsured.
Works Cited
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Press, 2016.
Barnett, Jessica C. and Marina S. Vornovitsky. Health Insurance Coverage In The United States:
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Blendon, Robert J et al. “Americans’ Views of Health Care Costs, Access, and Quality.” The
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