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Universal health care

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Universal health care is a health care system in which all residents of a geographic or political entity have their health care paid for, regardless of medical condition or financial status.<ref>Massachusetts Nursing Association. "Single Payer Health Care: A Nurses Guide to Single Payer Reform."</ref> Universal health care systems vary in what services are covered completely, covered partially, or not covered at all.

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[edit] Funding of universal health care systems

Most European systems are financed through a mix of public and private contributions.<ref name="Bentes">Bentes M, Dias CM, Sakellarides C, Bankauskaite V. Health Care Systems in Transition: Portuagal. WHO Regional Offices for Europe on behalf of the European Observatory on Health Systems and Policies, 2004.</ref> The majority of universal health care systems are funded primarily by tax revenue (e.g. Portugal<ref name="Bentes"/>). Some nations, such as Germany, France<ref name="Physicians 1">Physicians for a National Health Program"International Health Systems".</ref> and Japan<ref name="Chua">Chua, Kao-Ping. "Single Payer 101". February 10, 2006.</ref> employ a multi-payer system in which health care is funded by private and public contributions.

"Single-payer" describes a type of financing system in which a single entity, typically a government-run organization, acts as the administrator (or "payer") to collect all health care fees, and pay out all health care costs.<ref name="PNHP">Physicians for a National Health Program. "What is Single Payer?".</ref> Some advocates of universal health care assert that single-payer systems save money that could be used directly towards health care by reducing administrative waste.<ref name="PNHP"/> Denmark, Sweden, and Canada are some of the countries that employ single-payer financing of health care.<ref name="Chua"/>

A distinction is also made between municipal and national healthcare funding. For example, one model is that the bulk of the healthcare is funded by the municipality, speciality healthcare is provided and possibly funded by a larger entity, such as a municipal co-operation board or the state, and the medications are paid by a state agency.

[edit] Countries with universal health care

Argentina,<ref name="G20">"Health Care Systems and Health Market Reform in the G20 Countries." Prepared for the World Economic Forum by Ernst & Young. January 3, 2006.</ref> Australia,<ref name="Physicians 1"/><ref name="G20"/> Austria,<ref name="Physicians 1"/> Belgium,<ref name="Physicians 1"/> Canada,<ref name="Physicians 1"/> Cuba,<ref name="Physicians 1"/> Denmark,<ref name="Physicians 1"/> Finland,<ref name="Physicians 1"/> France,<ref name="Physicians 1"/><ref name="G20"/> Germany,<ref name="Physicians 1"/> Greece,<ref name="G20"/><ref>http://www.photius.com/countries/greece/society/greece_society_health_care.html Greece Health Care</ref> Ireland,<ref>Health care in Ireland</ref> Israel,<ref>"The Health Care System in Israel- An Historical Perspective." Israel Ministry of Foreign Affairs. Retrieved June 7, 2006.</ref> Italy,<ref name="G20"/><ref>Apolone G, Lattuada L. "Health coverage in Italy." J Ambul Care Manage. 2003 Oct-Dec;26(4):378-82. PMID 14567285.</ref> Japan,<ref name="Physicians 1"/> The Netherlands,<ref name="Physicians 1"/> New Zealand,<ref name="Physicians 1"/> Norway,<ref name="Physicians 1"/> Portugal,<ref name="Bentes"/> Russia,<ref name="G20"/> Saudi Arabia,<ref name="G20"/> Seychelles,<ref>Ministry of Health - Seychelles</ref> South Korea<ref name="G20"/> Spain,<ref name="Physicians 1"/> Sri Lanka,<ref>Health Care System: Sri Lanka</ref> Sweden,<ref name="Physicians 1"/> The Republic of China (Taiwan),<ref name="Physicians 1"/> and the United Kingdom<ref name="Physicians 1"/><ref name="G20"/> are among many countries that have various types of universal health care systems.

Mexico,<ref name="G20"/> South Africa,<ref name="Physicians 1"/><ref name="G20"/> and Thailand<ref>"The Universal Coverage Policy of Thailand: An Introduction."</ref> are among those nations attempting to implement universal health care systems.

In the United States, certain publicly funded health care programs help to provide for the elderly, disabled, military service familes and veterans, and the poor<ref>Centers for Medicare & Medicaid Services. CMS Programs & Information. Retrieved August 30, 2006.</ref> and federal law ensures public access to emergency services regardless of ability to pay;<ref>Centers for Medicare & Medicaid Services. Emergency Medical Treatment & Labor Act. Retrieved August 30, 2006.</ref> however, a system of universal health care has not been implemented. Massachusetts is attempting to implement a near-universal health care system by mandating that residents purchase health insurance by July 1, 2007.<ref> Fahrenthold DA. "Mass. Bill Requires Health Coverage." Washington Post. Wednesday, April 5, 2006; Page A01.</ref>

[edit] Support for universal health care

Common arguments waged from supporters of universal health care systems are:

  • Health care is a right<ref name="CESR">Center for Economic and Social Rights. "The Right to Health in the United States of America: What Does it Mean?" October 29, 2004.</ref><ref name="NHCHC">National Health Care for the Homeless Council. "Human Rights, Homelessness and Health Care".</ref> or entitlement.<ref>Kereiakes DJ, Willerson JT. "US health care: entitlement or privilege?." Circulation. 2004 Mar 30;109(12):1460-2.</ref>
  • Ensuring the health of all citizens benefits a nation economically.<ref>William F. May. [http://www.religion-online.org/showarticle.asp?title=106 "The Ethical Foundations of Health Care Reform." The Christian Century, June 1-8, 1994, pp. 572-576.</ref>
  • Provides coverage to all citizens regardless of ability to pay.<ref name="Messerli">Messerli, Joe. "Should the Government Provide Free Universal Health Care for All Americans?" BalancedPolitics.org. March 1, 2006.</ref>
  • Health care is increasingly unaffordable for businesses and individuals.<ref name="Messerli"/>
  • Universal health care would provide for uninsured adults who may forego treatment needed for chronic health conditions.<ref>http://covertheuninsured.org/media/docs/release050205a.pdf</ref>
  • Providing access to medical treatment to those who cannot afford it themselves reduces the severity of epidemics by reducing the number of disease carriers.
  • Reduces wastefulness and inefficiencies in the delivery of health care.<ref name="Messerli"/>
  • Aligns incentives for investment in long term health-care productivity, preventive care, and better management of chronic conditions.<ref>"The Best Care Anywhere" by Phillip Longman, Washington Monthly, January 2005.</ref>
  • Encourages patients to seek preventive care enabling problems to be detected and treated earlier.<ref name="Messerli"/>
  • A centralized national database makes diagnosis and treatment easier for doctors.<ref name="Messerli"/>
  • Medical professionals can concentrate on treating patients rather than on administrative duties.<ref name="Messerli"/>
  • Profit-driven care leads to more deaths<ref>Devereaux PJ, Choi PT, Lacchetti C, Weaver B, Schunemann HJ, Haines T, Lavis JN, Grant BJ, Haslam DR, Bhandari M, Sullivan T, Cook DJ, Walter SD, Meade M, Khan H, Bhatnagar N, Guyatt GH. A systematic review and meta-analysis of studies comparing mortality rates of private for-profit and private not-for-profit hospitals. CMAJ. 2002 May 28;166(11):1399-406. PMID 12054406. Free Full Text.</ref> and is more expensive.<ref>Devereaux PJ, Heels-Ansdell D, Lacchetti C, Haines T, Burns KE, Cook DJ, Ravindran N, Walter SD, McDonald H, Stone SB, Patel R, Bhandari M, Schunemann HJ, Choi PT, Bayoumi AM, Lavis JN, Sullivan T, Stoddart G, Guyatt GH. Payments for care at private for-profit and private not-for-profit hospitals: a systematic review and meta-analysis. CMAJ. 2004 Jun 8;170(12):1817-24. PMID 15184339. Free Full Text.</ref>
  • Universal health care can act as a subsidy to business, at no cost to the business. The Big Three of U.S. car manufacturers cite health-care provision as a reason for their ongoing financial travails. The cost of health insurance to U.S. car manufacturers adds between USD 900 and USD 1,400 to each car made in the U.S.A.<ref>"Detroit's big three seek White House help" Guardian Unlimited, November 15, 2006</ref>
  • The profit motive adversely affects the cost and quality of health care.<ref>http://news.pajamasmedia.com/2006/05/18/8722240_Book_tells_how_p.shtml</ref>

[edit] Opposition to universal health care

Common arguments waged from opponents of universal health care systems are:

  • Health care is not a right.<ref name="Goodman">Goodman, John. "Five Myths of Socialized Medicine." Cato Institute: Cato's Letter. Winter, 2005.</ref><ref name="Sade">Sade RM. "Medical care as a right: a refutation." N Engl J Med. 1971 Dec 2;285(23):1288-92. PMID 5113728. (Reprinted as "The Political Fallacy that Medical Care is a Right.")</ref> Individuals no more have a right to be protected from natural phenomena as the government has the power to levitate individuals in defiance of gravity, which itself is an act of nature like old age and disease.<ref> Kelley, David E. 2003. A Life of One's Own. Cato Institute</ref>
  • Providing health care is not the responsibility of government.<ref>http://www.cato.org/pubs/pas/pa565.pdf</ref>
  • Increased waiting times, which can result in unnecessary deaths.<ref name="Goodman"/><ref>http://www.cato-at-liberty.org/2006/05/02/depends-on-what-the-meaning-of-universal-is/</ref>
  • Poorer quality of care.<ref name="Goodman"/><ref name="Messerli"/>
  • Unequal access and health disparities still exist in some universal health care systems.<ref name="Goodman"/>
  • Government agencies are less efficient due to bureaucracy.<ref name="Messerli"/><ref name="Goodman"/> Administrative duties, by doctors, are the result of medical centralization and over-regulation, and are not natural to the profession. In fact, before heavy regulation of the health care and insurance industries, doctor visits to the elderly, and free care, or low cost care to impoverished patients was common; governments regulated this form of charity out of existence.<ref>Kelley, David E. 2003. A Life of One's Own. Cato Institute</ref> Universal health care plans will add more inefficiency to the medical system because of more bureaucratic oversight and more paperwork, which will lead to less doctor patient visits.<ref>http://www.cato.org/pubs/handbook/hb109/hb_109-7.pdf</ref>
  • Profit motives, competition, and individual ingenuity lead to greater cost control and effectiveness.<ref name="Messerli"/>
  • Uninsured citizens can sometimes still receive emergency care from alternative sources such as nonprofits and government-run hospitals.<ref name="Messerli"/>
  • Government-mandated procedures reduce doctor flexibility.<ref name="Messerli"/>
  • Healthy people who take care of themselves have to pay for the burden of those who smoke, are obese, etc.<ref name="Messerli"/>
  • Loss of private practice options and possible reduced pay dissuades many would-be doctors from pursuing the profession.<ref name="Messerli"/>
  • Causes loss of insurance industry jobs and other business closures in the private sector.<ref name="Messerli"/>
  • Eliminates a right to privacy between doctors and patients as governments demand power to oversee health of citizens.<ref>http://www.cato.org/pub_display.php?pub_id=3057</ref>
  • Empirical evidence on single payer insurance programs demonstrates that the cost exceeds the expectations of advocates.<ref>http://www.cato.org/pub_display.php?pub_id=3057</ref>
  • Governments, such as Canada, have outlawed medical care if the service is paid for by private individual funds. This results as governments attempt to control costs by gaining or enforcing monopsony power.<ref>http://www.cato-at-liberty.org/2006/08/23/revolt-against-canadian-health-care-system-continues/</ref>

[edit] References

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[edit] External links

[edit] Supporting universal health care

[edit] Opposing universal health care

[edit] Neutral

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