Universal healthcare in selected countries - Research Paper Example

UNIVERSAL HEALTHCARE Introduction Universal healthcare refers to national healthcare programs which provide all citizens with access to healthcare. Various countries have a single-payer system based on the government paying for the healthcare services. Universal or national healthcare systems are of three types: “national health insurance, national health system, and socialized health insurance” (Niles 299). The United States healthcare system is government funded and is employer-employee based. Citizens older than 65 years of age are provided 100% healthcare coverage with the Medicare program, while people younger than 65 years of age are provided with 82% coverage through “employer-based insurance, Medicaid, Indian Health Services, Veterans Administration (TRICARE) and the federal government employee program” (Niles 300). Thesis Statement: The purpose of this paper is to investigate the concept of universal healthcare in relation to its global implementation, and examine the significance and implications of the Healthcare Bill in the United States. Universal Healthcare in Selected Countries National health insurance as in Canada is implemented through delivery of care by private providers but funding is by the government through general taxes. National health systems such as in Great Britain are based on provision of both healthcare and infrastructure for healthcare delivery by the government with the help of taxes. In socialized health insurance systems as in Japan and Germany, while private providers deliver healthcare, the government ensures that both employers and employees contribute financially to sickness funds at not-for-profit insurance companies who pay the healthcare providers (Niles 299). Switzerland’s unique healthcare system requires all residents to purchase health insurance; hence it may be considered to have universal healthcare coverage. However, individuals bear the entire cost of insurance plans, since Swiss employers do not provide or contribute to health insurance. France’s healthcare system which is considered to be an almost ideal one, is similar in some respects to that of Germany and Japan. The country’s expense on healthcare is the third most expensive in the world, at 11.1% of its gross domestic product. France has several health insurance funds regulated by the government, and overall provides universal healthcare coverage to nearly 99% of its citizens. Payroll taxes form the greatest sources of funding, while income taxes, general social contribution taxes on income, various revenues, and supplemental policies from private-for-profit health insurers generally paid for by employers. France’s national healthcare system pays 100% costs for 30 chronic health conditions including cancer and diabetes. Additionally, citizens who are very ill can avail of increased healthcare coverage; this is unlike the United States system “where individuals may go financially bankrupt because of their cost sharing during a chronic disease” (Niles 301). Despite France’s budget deficit caused by its healthcare system’s billion dollar deficit and other problems, comparatively, the French have the satisfaction level about their healthcare system. On the other hand, all countries including France have flaws in their universal health insurance systems. Similar to the United States, Japan’s elderly people use the healthcare system the most due to increased greying of the population. As a result, Japan’s healthcare expenditure is expected to rise dramatically in the next few years, like the U.S. Medicare program’s out-of-control expenditure. Similarly, Switzerland’s healthcare system is expensive, though it restricts exhorbitant charges. Universal Healthcare in the United States Establishing a universal healthcare system in the United States may not solve the problems of the system. The main difference between the U.S. and other countries pertain to the controls the governments of the latter place on “pharmaceutical prices and the health insurers” (Niles 304), thus limiting their own profitability in order to provide their citizens with increased healthcare access. Another difference is the collectivist attitude or citizens’ willingness to pay more, to facilitate access to healthcare by all the members of the country’s population. For nearly a century, Democratic presidents of the United States have unsuccessfully attempted to introduce changes to the nation’s health care system. Significantly, President Barack Obama succeeded in overhauling the nation’s health care system. He signed legislation on March 23, 2010 guaranteeing medical insurance coverage to over thirty million Americans who lacked it. The historically momentous bill makes more than 95% of Americans eligible for health coverage, “adds 16 million people to the Medicaid rolls; and subsidizes private coverage for low- and middle- income people” (The New York Times, April 5, 2010). The legislation also ensures that private insurance companies are monitored more closely. The healthcare Bill of March 2010 is believed to herald an era of reform in the U.S. healthcare system. Despite America’s medical technology being of the highest quality, the health care system has been mediocre in every aspect, and too expensive for a major section of the population. Both Medicare and Medicaid were confronted with immense increases in future costs due to new technologies, growing numbers of people enrolled, a confusing network of complex and uncoordinated administrative functions, and an absence of effective care and treatment. Cost-effectiveness and effective outcomes of care were not taken into account while rationing care. The Medicare program attempting to curb costs through a focus on reimbursement approaches were moderated by the political power of “hospitals, health professional groups, and their lobbies” (Mechanic 181). Medicaid is a major cost for the states as well as the federal government, constituting nearly one-fifth of all state expenditures. The location of residence is related to the extent of medical resources available. Significance and Implications of the U.S. Healthcare Reform Bill The health care reform plans meet three basic goals: provision of more security and stability to those who have health insurance, provision of insurance to those who do not have health insurance, and slowing the rise of health care costs for families, businesses and the government. A well-designed public option was expected to become the main source of health insurance for Americans. This hope drew most of the single-payer constituency to the public option. “This deal may have been necessary for reform, but it nonetheless limits the possibilities” (Schmitt 13). Gorin (p.83) argues in favour of public option similar to Medicare, since a public health plan can control costs better than private health plans can. Further, without competition from a public plan, private plans would have no incentive to curb costs and provide higher value in terms of treatment. However, for this approach to be effective, public and private health care plans have to be on a level playing field. Fair competition should be promoted through including preexisting health conditions, community rating, and techniques of risk assessment. Fair competition between private plans and a public option in a broadly based coalition constitutes Health Care for America Now. The above approach was opposed strongly as extremely radical, and it was warned that a public option would lead to monopoly in health care. However, those opposing this view ignore the reality of growing concentration and consolidation in the private sector. Therefore, a public option would not destroy the private insurance market or lead to a take-over by the government (Gorin 84). Though the public option approach is meritorious, transition to the new system is difficult. Competition works both ways, hence to control costs the public plan would have to reimburse providers at lower rates than private plans. If public plan rates were too low, health care providers would refuse to treat patients covered by the plan. To resolve this issue, every American should be given voucher of equal value paying for equally adequate medical coverage. Controlling costs will also be implemented through reducing the volume of service patients receive (Fisher, Goodman, Skinner & Bronner 1). A public plan could take the lead in this aspect, but patients cannot be denied treatment available through private plans. Additionally, health care practitioners in high spending regions may refuse to adjust the volume of their practice. The Reform Bill proposes increased taxation on individuals with high incomes to fund health care reform, removing wastage from Medicare and Medicaid, and decreased Medicare payment to prescription drug companies. Besides the proposals facing fierce resistance, achieving universal coverage requires a vast amount of funds (Gorin 86). Serious reform requires basic changes, especially in the introduction of limits for spending in the different areas of medical care. But these changes are difficult to implement since they threaten the medical industry’s income. Though imperfect, the public option approach is the correct one. Although putting it into practice is difficult, single-payer system would be even more so, due to lack of political support for it (Marmor, Oberlander & White 2). On the other hand, in the contemporary times of economic crises, opinion could shift toward a single-payer system. However, it is essential to note that both advocates of single-payer system and those of public option are committed to universal coverage. Hence, single-payer advocates need to join with progressives insisting on health care reform that includes a public sector plan as part of the combination. Only this strategy will help to achieve universal coverage. Adverse Outcomes of Providing Universal Healthcare With universal healthcare, “those in need of basic medical care who lack insurance, would have access to physicians, clinics, hospitals” (Bardes, Shelley & Schmidt 464) and similar facilities. However, for availing of universal healthcare, enrolment fees and monthly contributions have to be paid by individuals and small businesses who are without health insurance coverage. These costs are unaffordable to many; moreover, goods and services tend to become more expensive since employers try to recover their added healthcare contribution through customers. Secondly, with greater universal healthcare access at a lower price, the demand for medical care increases. With the implementation of a universal healthcare plan, there will be a consecutive rise in the number of people without health insurance. Over time, it is highly likely that individuals and families will prefer to not renew their health insurance because of access to universal healthcare. This will subsequently result in increasing numbers of Americans without health insurance. Further, as a result of individuals and families’ access to universal healthcare, the burden on exisiting clinics and hospitals can increase greatly. This is because of the availability of universal healthcare at minimum costs to the public (Bardes et al 464). Before healthcare reform, those without healthcare insurance often sought primary care in hospital emergency rooms. Conclusion This paper has highlighted universal healthcare in various countries, with a focus on the United States’ healthcare reform Bill and its significance. The evidence indicates that there are pros and cons to the universal healthcare systems in all the countries examined. Implementation of universal healthcare in the U.S. should take into account the adverse fallouts of the system. For achieving optimal outcomes, the Bill proposes the use of a single-payer system in a combination of public plans such as Medicare with private healthcare insurance. The competitive use of both help in controlling the costs of private insurance, and for improving the quality of healthcare provided by public options. Works Cited Bardes, Barbara A., Shelley, Mack C. & Schmidt, Steffen W. American government and politics today 2008: The essentials. Edition 14. The United States of America: Cengage Learning. (2008). Fisher, Elliot, Goodman, David, Skinner, Jonathan & Bronner, Kristen. Health care spending, quality and outcomes: More isn’t always better. A Dartmouth Atlas Project topic brief. (February 27, 2009). Gorin, Stephen H. Health care reform: The importance of a public option. Health and Social Work, 34.2 (2009): pp.83-85. Hawaii 24/7. 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