Universal health care is a concept which suggests that everyone deserves the right to seek help with a medical situation whenever it occurs. There should not be any fear of cost for the services offered because coverage is already provided to each person through taxpayer funding and other monetary allocations to offer help for annual checkups, vaccinations, and pre-existing conditions.
The United States is the only country of its type at its level of development to not offer complete universal access to health care services to everyone. If your income levels are low enough, then your family can qualify for Medicaid. When you reach a specific age, then you can tap into Medicare coverage. Everyone else is forced to look for insurance on the private market, as a benefit from their employer, or through the exchanges that were originally set up by the federal government through the Affordable Care Act.
Cost is the primary issue to consider with universal health care, but there can be quality concerns to look at as well with this issue. American society also faces expense issues in an approach that is distinctly not universal, so there are several advantages and disadvantages to consider here.
List of the Pros of Universal Health Care
1. The economic cost of universal health care is less than free-market systems.
When there is a universal health care system in place on a national level, then the administrators of that plan can leverage the size of their coverage pool to limit the cost of doctor visits, prescription medication, and specialist services. More people equate to an improved pricing structure that is based on the value of care given instead of the total number of services offered to a patient.
Some doctors, nurses, and other industry providers earn a lower salary with their work in the universal health care industry, but patients receive similar care without spending as much. Some medications in a universal system cost less than $10, but Americans pay over $2,000 for them because of the differences in health care.
2. It reduces the administrative costs of health care access.
Administration costs are built into the services that doctors, nurses, and specialists provide for patients with each visit. As a patient, you are dealing with multiple levels of paperwork expense, starting with the doctor’s prescription and ending with the insurance company’s evaluation of the bill. When there is a universal system in place, then everything becomes centralized to reduce the need to transfer the same information between different agencies. When there is only one bill to pay, the costs for everyone go down eventually.
“In the United States, providers charge whatever they think they can get away with, and they can get away with a lot, because it’s really difficult to put a price on not dying,” notes educator and author John Green.
3. Universal health care removes the need to be competitive for money.
Competition might be healthy in most free market systems, but it is not always that way in the world of health care. Because funding is the top priority, medical providers target the wealthiest consumers in each community to become their patients. Then doctors have the motivation to provide as many services as possible because that is how they can earn their revenues.
Universal systems tend to focus on the quality of care received first. Instead of pricing products and services outside of what the average person can afford, profits are set aside for the purpose of provide care as a right. That doesn’t mean you won’t pay each month for the care you receive, but it does mean that you’ll still receive help even if you can’t pay for it.
4. It takes the third parties out of the conversation about patient care.
There are insurance companies in the United States right now which must approve a medical service before a provider offers the care that their doctor recommends. This issue usually appears when there is a specialized need in the diagnostic process, such as a CAT scan or an MRI to confirm a diagnosis. When there is a system of universal care in place to follow, then the doctor becomes the primary administrator of the treatment plan instead.
The American system does allow for a patient to request a second opinion or demand to receive services outside of their insurance approvals, but that can also mean they will be responsible for entire cost of their care. Universal care removes this problem altogether. “Disease, sickness, and old age touch every family,” said Senator Elizabeth Warren. “Tragedy doesn’t ask who you voted for. Health care is a basic human right.”
5. Universal care also helps children to receive the care that they need.
The United States offers Medicaid to low-income families as a way to ensure that children can receive the medical attention they require. This program is a form of universal care that is available to those who qualify for it. When kids fall outside of this situation, then their access to care can go down. We define our future success or failure as a society based on the health of our next generation. If we can reduce the issues we have with chronic health concerns, weight gain, and education access, then crime levels go down, graduation rates rise, and there are fewer chronic disease costs to pay.
Although there are higher costs to pay from a taxation perspective in America to transition to a system of universal health care, the private insurance costs would get smaller. Considering the average family already pays $12,000 per year in premiums and out-of-pocket expenses and employers pay double that, there is an excellent chance that there are some savings to find.
6. It would raise the levels of health care in the labor force.
Nearly 50% of patients in the United States went to the emergency room to receive medical services because they could not afford to go anywhere else for care – despite their participation in the labor force. Emergency rooms are one of the few places where care cannot be declined, even if someone does not have the ability to pay. Universal health care extends this principle to every provider. By focusing on preventative care, having more tools to react to a health issue, and encouraging people to visit when they feel ill, we can raise productivity levels because there are fewer sick days needed.
7. It provides access to health care instead of allowing access to it.
“Having access to health care does not mean that they are guaranteed health care,” said Senator Bernie Sanders. “I have access to buying a $10 million home. I don’t have the money to do that.”
When a society has access to universal care, then it becomes more affordable to go to the doctor. Having access by itself is not enough, which is what the free-market systems suggest. African-American women die more frequently from heart disease issues in the United States because they don’t have the level of access to the medical care systems in each community. Universal care would help to solve that problem.
8. You are still paying for your health care in a universal system.
The average Canadian pays about 30% of their total health costs, while the provincial plans pay about 70%. Medical equipment, skilled nursing care, social work outside of the hospital, and some other services are not covered by the basic universal plan. You would need to access these items through a private insurer, which is usually available through an employer. The idea that you receive care for free is an idea that comes from the fee-for-service industry in the United States.
You are paying for your care through government-based policies like Medicare and tax support. Instead of paying again after you visit the doctor, your medical costs are covered if you meet the criteria in place.
9. It places health care as a responsibility for each community.
Because everyone has a stake in the costs of health care with a universal system, there is a societal desire for wellness. You will find structures in cities that encourage walking and cycling instead of driving. There are programs that encourage fitness at work. It becomes part of your responsibility to take care of yourself because visiting the doctor is an expense that you and everyone else is financing. Instead of taking that approach from a family-based perspective, this approach to health care includes everyone – no matter how much they actually pay into the system.
List of the Cons of Universal Health Care
1. It could reduce the quality of the care that some people receive.
Doctors tend to prefer universal health care over private-pay systems because it allows them to help people who might normally never visit them. When you have one medical provider available for 1,000 people, then there isn’t enough time in the day to take care of every need that someone might have. Because everyone has the right to visit the doctor for basic needs, the schedule can become overwhelming very quickly.
As doctors rush through each appointment to help as many people as possible, the overall quality of the care that they can give goes down. When you multiply this issue across an entire country, then there is the potential to have worse care offered instead of better. “Just last month [January 2018], the British Medical Journal reported a surge in rationing for various treatments, including… arthritis medication,” wrote Sally Pipes in Forbes.
2. Universal care can require a long wait time to see specialists.
Because everyone can visit the doctor whenever they choose, a lack of specialists in a community can result in a lengthy wait time to see someone for a health problem. It is not unusual for patients who cannot afford private care to wait at least 10 months to see someone about a non-life-threatening issue. Canada, which offers both private and public systems, has seen wait times above 40 weeks in some rural province areas. That means some patients are asked to live with their condition for quite some time before they can eventually get the relief they deserve.
Universal care prioritizes an emergency need. If your health requires a surgery in 30 minutes to survive, then you receive that care. When your hip goes out and a replacement becomes necessary, that is when the wait times can get long.
3. Doctors receive a limited payout with universal health care.
Many doctors decide to decline taking Medicaid or Medicare patients because of the long wait times they endure for compensation. Some decide to limit the number they receive because of this issue. Although there are systems when immediate weekly compensation occurs, most universal systems struggle to offer compensation in a timely fashion. Labor is the most significant expense in health care for most patients, so restructuring those costs becomes a top priority for the state or provincial-based administrators.
The starting salary for a junior doctor in the United Kingdom is about $33,000, which is 17% below the average income for the country. A subway operator earns double the salary of a medical professional without the need to work 100 hours per week. Even a general practitioner in the UK earns about 50% of what they do in the United States.
4. It limits the accuracy of a diagnosis for a patient.
If doctors are working 100 hours per week to support their community, then their fatigue leads to a higher risk of experiencing an inaccurate diagnosis. Diagnostic errors are common in all countries, but it can be significantly higher in areas where universal care is the standard offered to the general population.
Very Well Health says that there are six specific red flags you should consider in any situation that suggest you may have experienced a diagnostic error.
- Your institution tells you that there is something wrong.
- Your doctor isn’t listening to you during the interview portion of the appointment.
- Information searches suggest a different diagnosis is possible.
- The response to any issue you have is to provide you with a prescription.
- You have health issues which are not getting any better.
- More attempts to speak with your doctor provide discouraging results.
5. Some people may stop being careful about their approach to good health.
One of the fears that exists with a universal health care system is that some people may no longer decide that healthy choices should be a priority. There would be no financial incentive to set fitness or wellness goals because anyone could access the basic care they require for free. The only way to offset is this disadvantage is to take the approach that many Canadians have, where there is a societal stigma against poor personal care since that creates a higher financial burden on everyone else.
6. There is less funding and incentive available to develop new technologies.
The vast majority of the medical advancements which occur in the world today either come from the American free-market system of care or receive funding from it. This outcome is possible because of the innovative culture that is in place in the United States. Over 50% of the world’s new medicines from 2002-2011 came from the U.S. system of care. There are 12 of the top 20 medical device companies in the world headquartered in America, with over 3,000 new pharmaceutical products in development. It is an industry which contributes over $200 billion to the economy.
If the U.S. were to transition to a universal health care system, then some of these benefits would go away. It could even be argued that the reason why other countries can have their systems is because of the culture of innovation which is only available right now in the United States.
7. It changes the spending patterns of the government.
Universal systems can be held at the state, provincial, or national level. Canadians spend as much as 40% of the annual government budget on this expense. Unless there are experienced politicians who can manage this spending wisely, universal care systems can find themselves in debt rather quickly. When this outcome occurs, then there are usually fewer services offered to patients or each person is asked to pay more into the system.
When one looks at the history of spending in the United States, the mismanagement of the Social Security program and the amount of debt its owned from other federal budget lines is astounding. There is no reason to believe that the treatment of health care spending would take a different path.
8. There may be multiple systems to navigate with universal care.
Universal care typically provides basic services. That means a hospital stay doesn’t give you a private room to use. Dental care might not be part of the package. You may need to pay for a portion of your prescription medication if a generic option is not available for you. There are also private-pay systems, health insurance, and additional costs to navigate, creating a complex system that can sometimes increase the expenses that patients pay. Government-run programs do not have the same approach to efficiency as private opportunities, which is why many systems incorporate some elements of private care into them.
9. It can limit services to the people who need them the most.
An excellent example of this problem is found in the Medicare expense profile in the United States. About $0.25 out of every dollar is spent to provide care for the people who are within their last six years of life. Palliative care is a significant expense that these programs absorb. That is why you are finding more programs around the world privatizing this aspect of care in some way. When you are in a universal system, then administrators (not doctors) can still choose which services to cover and which receive exclusion. That means there is no guarantee that you will receive your promised care.
Verdict on the Pros and Cons of Universal Health Care
Universal health care is the standard for developed countries around the world because the goal is to offer access to everyone who might need it. The free-market systems of the United States do provide some advantages in the ability to access care at any level without requiring permission first, but it does not come without a cost. That is why the U.S. spends up to 18% of it GDP on health care expenses when everyone else is spending 10% or less.
The provision of universal care occurs in a mixed economy, which is something the United States already has. Medicaid and Medicare are already different types of this coverage which millions of people use each year. Extending this benefit to everyone would help the U.S. join up with what the rest of the world is already doing.
These universal health care pros and cons do not suggest that this system is easy to navigate or implement. What it does do is offer more access to local medical providers for those who want or need it. That is why about 56% doctors in the United States support government-sponsored care at some level.
Natalie Regoli is a seasoned writer, who is also our editor-in-chief. The goal of ConnectUs is to publish compelling content that addresses some of the biggest issues the world faces. If you would like to reach out to contact Natalie, then go here to send her a message.