Sunday, March 18, 2007

The Need for Universal Health Care

From Wikipedia, the free encyclopedia

Universal health care is a state in which all residents of a geographic or political entity have their health care paid for, regardless of medical condition or financial status. This philosophy is practiced in many countries, especially first world nations such as Canada, the United Kingdom, France and Italy.

Types of universal health care

Universal health care is a broad concept and has been implemented in several ways. These implementations tend to differ primarily in their socialistic or capitalistic construction; for example, a system where health care is paid for by private insurance companies is capitalism, while a system where the government pays for health care through taxation would be socialism.

The Health Care System in Canada is a universal system, though some services are not covered. While often called a socialized-public system it is in fact merely publicly funded. Most services are provided by private enterprises which act as contractors, billing the government for patient care.

Single-payer health care

Single-payer health care is a system whereby one party, usually the government, pays for the health care of everyone. In practice this means that the government collects taxes from the public, businesses, etc., creates an entity to administer the supply of health care and then pays health care professionals--in effect this would replace the myriad of health care companies with just one government provider.

Hybrid health care

Universal health care can be implemented without having the government pay for it in full, as in single-payer health care. Hybrid health care models emerged from efforts to reconcile the drive for expanded access and the drive against rising health care prices. This model is geared towards getting past the dichotomies that have stymied universal health care efforts, such as whether the state or federal governments should take the lead, whether the primary jurisdiction for negotiating health care should be at the market or government level and whether health care is more of an individual or societal responsibility.

Private universal health care

After governments mandate universal health care, they are often forced to supply at least some of that health care. One alternative is to deregulate the industry, and allow the principles of a free market keep costs down and encourage efficiency and innovation.

In short, universal health care can, in theory, be implemented without wealth redistribution. In actuality no such system has ever existed and all universal coverage systems require substantial government taxes and wealth redistribution. For example, if the government mandates universal health care, instead of trying to control and ration health care, they could simply enact a law whereby each person must have health insurance. People would pay for their own health insurance or find other ways of obtaining coverage, such as through employment. In practice public assistance would have to be given to those who cannot afford the cost of health care.

Funding of universal health care systems

Most European systems are financed through a mix of public and private contributions. The majority of universal health care systems are funded primarily by tax revenue (e.g. Portugal. Some nations, such as Germany, France and Japan 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. 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. For instance, according to the Drum Major Institute, a public policy, non-profit organization founded by Harry Wachtel, lawyer and advisor to Martin Luther King Jr., the estimated amount the U.S. would save each year on paperwork if it adopted single-payer health care is $161 billion. Denmark, Sweden, and Canada are some of the countries that currently employ single-payer financing of health care.

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, specialty 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.

Countries with universal health care

Argentina, Australia, Austria, Belgium, Brazil, Canada, Cuba, Denmark, Finland, France, Germany, Greece, Ireland, Israel, Italy, Japan, The Netherlands, New Zealand, Norway, Poland, Portugal, Russia, Saudi Arabia, Seychelles, South Korea, Spain, Sri Lanka, Sweden, The Republic of China (Taiwan), and the United Kingdom are among many countries that have various types of universal health care systems.

Mexico, South Africa, and Thailand 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 families and veterans, and the poor and federal law ensures public access to emergency services regardless of ability to pay; however, a system of universal health care has not been implemented. The Commonwealth of Massachusetts is attempting to implement a near-universal health care system by mandating that residents purchase health insurance by July 1, 2007. California, Maine, and Vermont also are attempting universal systems.

If a government has a public health care system, it is usually illegal for private institutions to provide healthcare insurance by offering lower prices. That is, it is an enforced government monopoly. Until recently, private health insurance was illegal in all of Canada. All insurance was supplied by the government. Recently, the Supreme Court of Quebec ruled, in Chaoulli v. Quebec that private business must be allowed to offer health insurance and compete with the public program.

Universal health care politics

There are many common arguments for and against universal health care. Those in favor of universal health care often point out that it would provide health care to the people who currently do not have it. Opponents of universal health care often argue that universal healthcare may require higher taxes. These opponents also claim that the absence of a market mechanism may slow innovation in treatment and research, and leads to rationing of care through waiting lists. Both sides of the political spectrum have also looked to more philosophical arguments, debating whether or not people have a fundamental right to have health care provided to them by their government. Other objections come from physicians, since universal health care almost always lowers wages.