While an in-depth analysis of each of these factors is beyond the scope of this commentary, there are clear advantages and disadvantages to purely private, market-based, and governmental, universal approaches to healthcare, as well as for policies that lie somewhere in-between. For example, government backing, public will, and basic financing structure, among many other factors must be extensively considered. ĭetermining the degree to which a nation’s healthcare is “universal” is complex and is not a “black and white” issue.
In line with this, versions of universal healthcare have been implemented by countries with diverse political backgrounds (e.g., not limited to traditionally “socialist/liberal” countries), including some with very high degrees of economic freedom. Thus, universal healthcare does not necessarily preclude the role of private providers within the healthcare system, but rather ensures that equity and effectiveness of care at population and individual levels are a reference and expectation for the system as a whole. For example, Germany uses a multi-payer healthcare system in which subsidized health care is widely available for low-income citizens, yet private options-which provide the same quality and level of care as the subsidized option-are also available to higher income individuals. On the other hand, European countries like Switzerland, the Netherlands, and Germany have utilized a blended system with substantial government and market-based components. The United Kingdom’s National Health Services can be considered a fairly traditional version of universal healthcare with few options for, and minimal use of, privatized care. closer to universal healthcare by expanding health coverage for millions of Americans (e.g., via Medicaid expansion, launch of health insurance marketplaces for private coverage) including for citizens across income levels, age, race, and ethnicity.ĭiffering versions of universal healthcare are possible. Importantly, the Obama-era passage of the Affordable Care Act (ACA) sought to move the U.S.
The World Health Organization defines universal healthcare as “ensuring that all people have access to needed health services (including prevention, promotion, treatment, rehabilitation and palliation) of sufficient quality to be effective while also ensuring that the use of these services does not expose the user the financial hardship”. In contrast, the vast majority of post-industrial, Westernized nations have used various approaches to provide entirely or largely governmentally subsidized, universal healthcare to all citizens regardless of socio–economic status (SES), employment status, or ability to pay. In this approach, citizens or businesses can obtain health insurance from private (e.g., Blue Cross Blue Shield, Kaiser Permanente) insurance companies, while individuals may also qualify for public (e.g., Medicaid, Medicare, Veteran’s Affairs), government-subsidized health insurance. has historically utilized a mixed public/private approach to healthcare. Healthcare is one of the most significant socio–political topics in the United States (U.S.), and citizens currently rank “healthcare” as the most important issue when it comes to voting. Universal healthcare will better facilitate and encourage sustainable, preventive health practices and be more advantageous for the long-term public health and economy of the United States. While the implementation of universal healthcare would be complicated and challenging, we argue that shifting from a market-based system to a universal healthcare system is necessary. In particular, substantial health disparities exist in the United States, with low socio–economic status segments of the population subject to decreased access to quality healthcare and increased risk of non-communicable chronic conditions such as obesity and type II diabetes, among other determinants of poor health. On the other hand, universal healthcare may lead to a healthier populace, and thus, in the long-term, help to mitigate the economic costs of an unhealthy nation. Disadvantages of universal healthcare include significant upfront costs and logistical challenges. This commentary offers discussion on the pros and cons of universal healthcare in the United States.