Universal Healthcare is a hot topic in this country right now. It’s something that everyone seems to have an opinion. Universal Healthcare is a system that provides quality health care to all people regardless of their ability to pay. Every citizen regardless of their financial status should have access to healthcare. Although our country has a long way to go, the introduction of Obamacare, is a start. There are three main types of Universal healthcare coverage. There is a single payer system, a two-tier system, and an insurance mandated system. The United States Affordable Care Act has moved us closer to universal healthcare, but we remain one of the only wealthy countries without a form of universal healthcare.
A single payer system is exactly as it sounds. There is only one option for healthcare. The government is usually the entity providing the coverage and paying the bills. 12 of the 32 countries with universal healthcare have adapted this model. Canada and the United Kingdom both have a single payer system. A two-tier system is again pretty self-explanatory. There are two tiers. The government offers mandated insurance to all but allows their people to purchase additional insurance if they choose. This seems like it should be a no brainer for the route to go for a country. Everyone is covered for being a citizen but if their financial position allows, they can buy additional coverage for themselves or their family. Only nine of the 32 countries have this option for their residents. Finally, the last type of universal healthcare, is Insurance mandated. This is where the government does require all of its citizens to purchase some form of public or private insurance coverage.
Insurers are not allowed to reject people for their illness. You would think that the United States falls into this category. But it does not. There are still millions of American citizens with out medical coverage. They may offer it, and penalize the uninsured, but there are so many citizens that simply can not afford the coverage set forth and offered in the market place. In 2010, The United States adapted the Affordability Care Act or as some called it, Obamacare. A shared responsibility was established so that all Americans have access to affordable and quality health care. But there are a lot of problems still to this day. There are many gaps in coverage and there are many people who can not afford the coverage that is offered to them. The number of uninsured dropped dramatically since the inception of the ACA in 2010. Which is wonderful.
But in 2016, there were still 27 million Americans without insurance. Although still a lot, that number was down from 47 million a decade prior. There are many things that were greatly improved by the implementation of the ACA. The ACA really tried to focus on preventative care. The idea that if we can get to the disease before it is introduced or before it has taken over is a great one to have. Our society can greatly benefit from this. Many dependents are having a difficult time finding a job with insurance benefits upon graduating from college. Now a dependent regardless of full-time student status, can remain on their parent’s insurance until age 26. This is a benefit that is helping my daughter greatly. She wouldn’t have coverage otherwise. One other improvement that was made regarding pre-existing conditions. This was a big one for insureds everywhere.
Prior to the Affordable Care Act, a person could be denied for coverage based on a preexisting condition. It could be something that has followed them since birth or a recently diagnosed condition. Any lapse in coverage by these individuals and they will never have their condition covered. I had a good friend that was diagnosed with leukemia the day before her husband was laid off from his job of 32 years. She worked as a hairdresser and made “Too much money” to qualify for public aid medical assistance and were told they needed to sign up for cobra, which they could not afford. By the time her husband found a job with insurance coverage, her cancer was considered pre-existing. They were in debt over a million dollars and almost lost their home if it hadn’t been for friends and family helping and donating to them. That’s so very wrong. Now, a person can not be denied based on a pre-existing condition. Our system still has so far to go. We need to get closer to the more successful healthcare programs in other countries. They are not perfect either but their Universal Healthcare is working. Our cost of healthcare per citizen is so much higher than other countries at $9892 and we are not getting nearly what they are. Why? It makes you wonder who is benefiting from our healthcare since it is not the patients.
Law makers have looked toward several countries to view their models to see if we can mimic them here in the US. The country that has been compared the most is Canada. It could be that they are the closest geographically, but they are not the best model to follow. Canada has a single payer system. Unlike the US, they do not have a population of uninsured and they do not insure undocumented immigrants. These are positive things that the US can take away from Canada. Their cost per insured is much lower than the US at $4762 and their mortality rates are much higher. But their WHO ranking is just slightly below ours. One of the biggest dissatisfiers is their wait times. On average, 56% of Canadian citizens have to wait over 4 weeks for specialized care and to see a specialist. In contrast on 4.9% of US citizens have to wait. France is another country with Universal Healthcare that the US has looked at for their two-tier model. France has a very successful model and it starts in a place that we can not compare. Their physicians are not paid nearly as much as they are in the US, but they get a benefit that most physicians would fight for. They do not have to pay for their education or insurance. Their healthcare model covers hospitals, drugs, doctors visits, and mental health. Their government even pays for house calls and child care. Most of their care is funded through payroll and income taxes and the rest of the funding comes from alcohol and tobacco taxes. The patients are really happy and the average cost is around $4600 per person. They have higher wait times to see a specialist but their life expectancy is over 85 years.
Switzerland has an insurance mandated model. This is closer to what the US currently has. The government covers about 60% of the healthcare expenses that is provided from private insurance companies. The citizens of Switzerland can buy additional insurance. They do not cover dental care and vision is only covered for kids. There are programs in place to help low income families with premiums. Their price per person is almost as high as the US at $7919. Their wait times are higher than the US at 20% , but their people are happy because of the high quality of care. I feel as if our country would benefit from a two-tier system similar to France. I feel that if we could implement a system where our doctors were given their benefit upfront by free tuition instead of heavy paychecks, they wouldn’t be so inclined to over order tests and would be physicians for the care of the patient instead of the promise of fancy cars and a substantial lifestyle. Universal healthcare is not an easy topic with an easy solution.
