Universal Health Care

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Universal Health Care (UHC) can refer to things in two distinct categories: (1) methods of paying for health care, such as health insurance; and (2) systems of providing patients with services, prescriptions, and the like. Some politicians and activists blur the distinction.

There are several different ways of paying for health care, including private insurance, government-supplied insurance, single payer health insurance or health savings accounts.

The United States has a mixture of public and private insurance programs.

Massachusetts under Mitt Romney enacted something close to universal health care,the Massachusetts Plan, and it has resulted in the predictable problem of long waiting lines for care. In the case of one physician, she does not have an opening for a routine physical for more than a year into the future.[1] Residents of Massachusetts are required to purchase insurance or else be penalized for not having it, and after purchasing the insurance they are demanding care that is straining the system of physicians.

Collective costs of a Universal system

There are many different types of care which fall under the term universal health care [2]. Some of these systems are highlighted here:

  • Single-payer health care is a system in which one entity pays for the health care of the entire population (see single-payer system). This entity is traditionally the federal or national government, and the system is paid for through taxes. Canada, Cuba and North Korea are the only three countries using this system.
  • Multi-payer health care is similar to the single-payer system, except that individuals may also choose to purchase private insurance. The United Kingdom is an example of this, with a National Health Service system available to all residents, which is paid for through a National Insurance scheme plus general taxation. People are, however, free to purchase private insurance and be treated privately if they so wish. France, Germany, Japan, Austria, Belgium and the Netherlands also use the multi-payer system.[3]
  • Tax Credits can be used to provide uninsured individuals with a discount in their taxes to use towards paying for health care.
  • Managed competition is a system which allows employers to join health care purchasing cooperatives. These cooperatives negotiate with private insurance providers to provide employees with a number of health options. The premiums are paid for in large part by the employer, and all purchasers pay the same price, regardless of their current health situation.

Ways to impose a Universal system

There are essentially only two ways to administer health care: privately or through the state. Health care in most countries is administered largely if not solely by private organizations, but some proponents of universal health care advocate socialized medicine, in which health care is primarily or soley administered and paid for by the state. Sometimes the terms socialized medicine and universal health care are used interchangeably, but this is not technically correct, as UHC can include methods other than socialized medicine.[4][5]

Current Practice and Effectiveness

An aspect of universal health care, emergency treatments, are accessible to all in the United States. David Hogberg wrote:

"... everyone in the U.S. can get care regardless of income. In 1986 the U.S. Congress passed the Emergency Medical Treatment and Active Labor Act. This requires emergency rooms to treat any person who shows up seeking medical treatment, regardless of their ability to pay." [6]

Free Market Health Care is paradoxical. Healthy people are the youngest, least able to afford care, and no incentive to plan for unlikely need for insurance. Less healthy people need more treatment but usually cannot afford the cost. The most unfortunate are those born with chronic illnesses or disabilities. Such patients may in the worst cases never in their lives earn the money they need to pay for medical treatment. Universal Health Care is seen as compassionate. It looks after those who through no fault of their own cannot look after themselves.

Most developed countries have instituted various types of universal health care, though most conservatives say with inadequate results (lengthy waiting times, for example). Cuba is another country with woefully inadequate socialized health care. In Canada, it is illegal for a doctor to "bill" a patient, but one doctor found many people suffering while waiting months or years for treatment. He sued the government, appealed all the way to the Supreme Court, and won (see Dr. Jacques Chaoulli).

France, Germany, Japan, Austria, Belgium and The Netherlands also use the multi-payer system in a style called shared responsibility. Under this scheme workers and employers are required to pay into private, non-profit, government-regulated insurance funds. The government covers the cost of the low- and no-income citizens. These insurance funds negotiate strict cost controls with the government and health care providers to keep out-of-pocket costs from skyrocketing. Private insurance can be purchased on top of the insurance fund, to pay for premium services.[3]

The World Health Organization rates France highest of all countries), though it is having trouble keeping costs in line. Similar results are found in other shared responsibility systems.[7]

Proponents of Universal Health Care

  • The American Medical Student Association [3] is a proponent of single-payer health insurance.
  • The Universal Health Care Action Network (UHCAN) [4] is an organization which promotes universal health care in general.
  • The Center for Health Care Policy Research and Analysis is a proponent of a multi-payer health care system
  • The Commonwealth Fund is a proponent for universal health care in the U.S.
  • The Economist's View supports a single-payment system in the U.S.(http://economistsview.typepad.com/economistsview/2007/04/health_care_the.html)
  • U.S. physicians for universal health care (http://www.pnhp.org/)

Opponents of Universal Health Care

Conservatives and libertarians believe that, in general, the more government control over health care, the worse it gets. For example, they argue that the U.S. produces the most new drugs and techniques because the largely unhindered free market system provides incentives for innovation and efficiency. Some conservatives and most libertarians argue that there could be even fewer restrictions and regulations, thereby improving health care even further. [8]

  • The Cato Institute [5] is in favor of free market solutions to health care, and advocates health savings accounts in combination with high-deductible private insurance plans.

See Also


  1. http://www.nytimes.com/2008/04/05/us/05doctors.html?_r=1&ex=1208232000&en=edd47716a3c98fbf&ei=5070&emc=eta1&oref=slogin
  2. American Medical Student Association, Theoretical Models for Delivering Health Care [1]
  3. 3.0 3.1 Hill, Stephen, Contra Costa Times, "Single payer not only way for universal health care
  4. American Medical Student AssociationTheoretical Models for Delivering Universal Health Care: An analysis of important concepts.
  5. MedicineNet.com MedTerms Dictionary
  6. Emergency Medical Treatment Act
  7. Christian Science Monitor, French health system gets surgery.
  8. [2]