Universal healthcare is a system in which everybody has access to a sufficient level
of healthcare, including those who can’t afford it.
universal healthcare is not the same thing as single payer, single payer is a type of
universal healthcare where coverage is provided by the government and funded through taxation.
Another popular universal healthcare system is a mandatory insurance system,
like we see in france and germany, everybody has to have health insurance, but lots of
groups contribute including the government,
employer and employees.
so if somebody can't pay the government or one of the other groups will make up the difference
In this video we will look at the pros and cons of universal healthcare which I have
divided into 3 groups which can be used as a criteria to measure other healthcare systems,
You’ve got universality, which represents how much of the population,
price the cost of the system and the quality of the healthcare that is
provided.
The biggest pro of universal healthcare is its name- universality.
What this means is that everybody gets covered, and no one is left uninsured,
something which does not happen in countries like the United States which do not have a
universal healthcare system. Universal healthcar systems can be funded
through taxation x like in the UK and Canada,
or like systems in France and Germany that insist upon each citizen having some
sort of insurance plan, paid for by employers,
government and people themselves,
and if people can’t pay the government makes up the difference.
Germany’s system is slightly different from France’s in that the actual provision of
healthcare, the doctor’s nurses and hospitals, are fully
private, whilst being funded by the state. Regardless of which type of universal healthcare
system is used, costs are shared out amongst everybody through a process called pooling,
which means all the money is put into a common fund and used according to each person’s
need, and not based on how much they can pay
A con of universal healthcare is that although this universality covers everybody, it doesn’t
necessarily cover all health conditions or treatments.
In the UK for example, which has a single-payer healthcare system
dentists and opticians and have to be paid for by people past a certain age,
and certain procedures not considered urgent by the NHS
have to come out of pocket. As well as this, in a universal healthcare
system inequality of healthcare provision can still occur-
richer people can still pay for better or healthcare that is provided faster.
This can be especially hard on the people left on the government provided or mandatory
insurance plans because of the way a lack of competition there can reduce quality, but
we’ll find out about that later.
Our next group of arguments concerns the cost of universal healthcare. x
In the French system people can be reimbursed up to 100% of their healthcare costs
and the system is free at the point of use in Canada and the UK.
According to the world health organisation Per capita the UK, German and Canadian governments
only spent $5000 on healthcare in 2015 whereas the US spent around $10000. So ironically,
in the US, for a country in which the government is supposed to have less of a foothold in
the healthcare system, it spends around double what universal healthcare systems spend.
This fact seems to contradict a con of universal healthcare that proponents of the free market
system like to bring up. How can one argue that universal health care
systems are more expensive than free market system when the US, running a free market
system, spends more? Although one could say that this spending
argument thus falls flat, the argument that there is a lot more bureaucracy in countries
like Canada and the UK does seem to have some wieght x
As well as this, attempts to universalise the american healthcare system through Obamacare
have led to prices going up on certain insurance plans for the richest, which I think underlines
one of the key differences between universal healthcare and free market healthcare. Source
(https://www.forbes.com/sites/theapothecary/2016/07/28/overwhelming-evidence-that-obamacare-caused-premiums-to-increase-substantially/#4544da1915be) In a universal system, everybody pays what
they can, with the rich thus being able to pay more
whereas in a free market system in which healthcare is more like a commodity, people pay according
to what they need, if they need more treatment, they pay more regardless of whether they are
rich or poor. Obamacare was an attempt to tilt healthcare
in the US to a more universal style system where everybody is covered, and people pay
what they can leading to the burden being placed on the
rich through increased premiums, much like we see in systems that are funded through
progressive taxation like in Canada and the UK.
The final group of arguments concerning universal healthcare provision concerns quality.
Opponents of universal healthcare have argued that as well as the higher taxation,
it leads to healthcare provision needing to be rationed so that everybody gets a piece.
The argument goes that this rationing comes in the form of increased waiting times in
universal systems; the UK for example has an 18 week limit on
non-urgent, or elective surgery but this is often exceeded. (source, NHS.co.uk)
The Fact that countries measure waiting times in different ways, or that some do not have
a national database makes comparison with other countries quite difficult.
Also, if we look at national indicators of quality of healthcare like life expectancy
and infant mortality, OECD statistics the US’ system falls way behind universal healthcare
systems. x However one could argue that at least in a
free market system consumers are able to vote with their feet and go for other options,
thus improving the system through competition. The inability to do this in universal systems
can be represented as particularly unfair when we think about how the richest in society
can do exactly that, they can completely bypass NHS waiting times
by buying private healthcare, whereas the poorest in society cannot
To conclude, the main pros of universal healthcare are that it provides a certain level of coverage
for everybody, with the costs being helped for those who
can’t pay. Contrary to arguments that this leads to lower
quality healthcare through rationing, statistical measures of health by country such as life
expectancy and infant mortality shows countries such as the UK,
canada, france and germany
outperforming the US. However money does have to come from somewhere,
usually via higher taxes in the previously mentioned countries excluding the US.
as well as this complete equity of healthcare does not exist in universal systems, richer
people can buy better healthcare. Add to that the fact that with greater government
influence in the healthcare system comes a lack of choice to the consumer as well as
greater bureaucracy. Which system is better? comment in the comment
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