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What Is Universal Health Care?
Universal health care is a broad term that encompasses any action that a government takes to provide health care to as many people as possible. Some governments do this by setting minimum standards and regulations and some by implementing programs that cover the entire population. But the ultimate goal is health coverage for all citizens.
Pros and Cons of Universal Health Care
Universal health care is a hotly debated topic on both sides of the aisle. It is important to learn about the benefits and drawbacks that are often cited regarding a nation-wide policy like universal health care.
Pros of Universal Health Care
The most obvious pro of universal health care is that everyone has health insurance and access to medical services, and that no one goes bankrupt from medical fees. But there are other pros as well.
On the federal level, universal health care lowers health care costs for the national economy, because the government controls prices for medications and services. That streamlining trickles down to the doctors offices themselves, where doctors are able to reduce administrative costs and hire fewer staff, because they’re not forced to work with a myriad of health care companies.
Universal health care also equalizes service, with no doctors or hospitals being able to target and cater to wealthier clients. That means everyone gets the same level of care, which ultimately leads to a healthier workforce and longer life expectancy. When a person has universal health care from birth, it can also to lead to longer and healthier lives and reduce societal inequality by improving the long term prospects of poor children.
Cons of Universal Health Care
A common criticism of universal health care is that the overall quality and variety of care declines. Without the capitalist impetus to provide great care, some argue, doctors reduce their quality of care. In some countries with universal health care, patients see long wait times or even have to wait months to be seen at all. Governments focus on providing essential and lifesaving health care and may neglect to cover rare diseases or elective procedures.
Finally, universal health care is expensive. If a government is struggling with their budget, they may find that health care is taking money away from other essential programs.
Types of Universal Health Care
There are essentially three ways to provide universal health care.
The first is for government to provide healthcare directly under “socialized medicine.” In this case, all hospitals would be owned by the government and all doctors and nurses would be government employees. The United Kingdom’s National Health Service, or NHS, is an example of this type of system. Over time, it has proven to be one of the most cost effective systems. However, both doctors and patients have less choice in the range of treatments and procedures that are available to them.
The second solution is to have a single-payer system, like Canada. Under a single-payer system, the government provides health insurance for everyone, but doctor’s offices and hospitals are still private businesses or nonprofits. This type of system allows people more choice between doctors and hospitals with different approaches to care, but it also costs more than socialized medicine.
The third system is to allow private insurance companies but regulate them and mandate that everyone purchase some type of health insurance plan. Switzerland has regulated health insurance and the Affordable Care Act, which was passed in 2010, is an attempt to build a mandated health insurance system in the United States. Regulated health insurance systems allow for the most consumer choice, but they are also the most expensive.
Countries With Universal Health Care
As of 2018, 32 of the 33 developed countries have universal health care. Additionally, there are countries on every continent that offer universal health care. They include:
North and Central America: The Bahamas, Canada, Costa Rica, Cuba, Mexico, Trinidad and Tobago, United States
South America: Argentina, Brazil, Chile, Colombia, Peru
Europe: Austria, Belarus, Croatia, Czech Republic, Denmark, Finland, France, Germany, Greece, Iceland, Ireland, Italy, Luxembourg, Malta, Moldova, the Netherlands, Norway, Portugal, Romania, Russia, Serbia, Spain, Sweden, Switzerland, Turkey, Ukraine, the United Kingdom.
Africa: Algeria, Botswana, Burkina Faso, Egypt, Ghana, Mauritius, Morocco, Rwanda, Seychelles, South Africa, Tunisia
Asia: Bhutan, Georgia, Hong Kong, India, Israel, Macau, Maldives, People’s Republic of China, Singapore, Sri Lanka, Taiwan, Thailand, Australia
Oceania: Australia, New Zealand
Moving Towards Universal Health Care: Challenges
When a country moves from completely privatized health care towards a policy of universal health care, the government driving the shift often encounters a fear of change. When the United States moved to pass the Affordable Care Act, although it seemed like a drastic move at the time, it surprisingly added relatively little to the nation's overall health expenditures. 20 million people gained coverage, but insuring those people was relatively inexpensive because most of them were young people, who are much cheaper to cover than the elderly covered by Medicare.
The majority of Americans had health care even before the Affordable Care Act. Most retired people had insurance through Medicare. Most working, middle, and upper-class Americans had insurance through their employer. Those Americans at or below the poverty line were eligible for insurance through Medicaid. Those with insurance through their employers were worried that the new system would not be as good as the old system. This concern meant that Congress was unlikely to do anything that would get rid of the current employer-based health care system.
Making major changes to any public program, like health insurance, is a difficult undertaking. The existing system will only tolerate so much change at one time. Trying to do too much at once can be counterproductive. Nonetheless, health care reform is one area in which many economists feel that the most important work is yet to be done. The Affordable Care Act took the United States closer to universal coverage but still left millions uninsured.