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One trivial
question: “What do countries like England, France, Switzerland, Sweden,
Germany, Australia and Canada have in common?” If it wasn’t because of
Australia and Canada, “those countries are in Europe” would be a correct
answer. Well, I can assure you that this article is not about geography. What
those countries have in common is Universal Health Care. So what is Universal
Health Care (UHC)? According to World Health Organization (WHO), universal
healthcare or sometimes called universal heath coverage is “defined as
ensuring that all people can use the promotive, preventive, curative,
rehabilitative and palliative health services they need, of sufficient quality
to be effective, while also ensuring that the use of these services does not
expose the user to financial hardship.” One of the goal of UHC is to
promote “equity”, which is to ensure that quality health service is not only
affordable for the rich but also for the poor. Another goal is financial
protection against costly disease which could lead to personal bankruptcy for
some individuals. Of course, a serious disease can put one person in jeopardy,
both economically and physically. One reason is that the overwhelming financial
cost incurred through treatment could be unbearable and another reason is that
some seriously sick persons would not be able to go to work, which means their
livelihoods (source of income) are pretty much in dismal.
American HealthCare System
So another
trivial question: “What distinguishes the United States from the rest of the
above countries?” Give yourself a round of applause if you confidently answer
“No universal health care”. Surprisingly, the mere idea that the richest
country in the history of planet Earth has no universal heath coverage for her
people would leave a whole lot of people scratching their heads (including me
of course). Healthcare in America is very expensive and that’s why many
American buy health insurance policy from private insurance companies. The
problem is not everyone can afford to buy health insurance in America. Another
way American can get health insurance is through their employers. Besides,
there are other social insurance programs known as Medicare and Medicaid, but I
would not go into detail in this article.
The Complication
of UHC: Tax Hike and Moral Hazard
The goals of UHC
are desirable and commendable - a quality health service to everyone serving as
a buffer against financial hardship resulted from costly disease. But why would
the richest country in the whole wide world refuse to adopt such health care
system despite all of the benefits for the people? Does it manifest the
perception that America leaves the people in a situation in which they only care
for themselves? Come to think of it, America has its reasons for why
universal health coverage is not rolled out. In all seriousness, no one enjoys
seeing a poverty-stricken person unable to get treatment for his sick children
or a person who has to liquidate all of his valuable assets and runs into huge
debts just because he needs the money to pay the doctor to cure his wife’s
chronic disease. You see, no one and no society dreams about this kind of
scenario, because what we all have in common is “humanity”. We do feel
compassion about the suffering of others. So UHC makes perfect sense in our
society, but the painful truth is UHC does not come without a cost. In other
words, it’s not free. Ultimately, someone out there must pay the price of
providing treatment to everyone if a country wants to make UHC a reality,
because after all universal health care system costs a great deal of money. To
finance the cost UHC for the people, the feasible way for the government to do
could be raising tax or running a large-scale government’s social insurance
program. Well, raising tax could be a headache because it hurts everybody in
the economy and jobs could also be eliminated as a results of tax hike. In
addition to the problems associated with tax increase, a huge government
insurance program run by the government might not be efficient and could cause
a lot waste and inflexibility. We have seen in many occasions that private
companies could operate more efficiently and utilize less resource compared to
the government.
And then there
is another complication. Let me ask you what you would do if electricity and
water in your house are free or cheap to say the least. Yes, you would overuse
your water and electricity like leaving the TV turned on all night or using the
air conditioner or heater carelessly. By the same token, the overutilization of
free health service when healthcare is free for everyone could also be a
daunting problem. The overutilization of health service in an inefficient way
as such is known by economists as moral hazard. As a result of people
overutilizing the service, long wait time to meet with a doctor or to get
treatment is the unintended consequence that comes along. A 2010 Commonwealth
survey indicated that 43% of Canadian had to wait 4 or more weeks to see a
specialists (http://www.healthcouncilcanada.ca/rpt_det.php?id=122). I have to clarify that one data could not represent the whole
picture of a universal health care system because in contrast to Canada, only
9% had to wait 4 or more week to see a specialist in Germany and Switzerland. I
choose this data in Canada to show the possibility that universal health
coverage system could degrade the quality of health service rather than
improving it.
Obamacare
I have to admit that this article
is far from perfect, since there are tons of stuffs that I should cover such as
America’s social insurance program administered by the government called Medicare,
state-run Medicaid and other statistics to demonstrate the problems
associated with universal health coverage. But to do so, you know that
long-hour extensive research is required. Having said that, I hope this article
will serve as an introduction to the healthcare system in America and help us
understand the pros and cons of a universal health coverage. I sincerely hope I
can add additional details in the near future.
In the coming article, we will go
through one of the most important legislation in America known as Patient
Protection and Affordable Care Act (PPACA) or commonly known as Affordable
Care Act (ACA) or even more commonly known as Obamacare. In the
meantime, you can vist WHO’s website http://www.who.int/health_financing/universal_coverage_definition/en/ for the definition of UHC. Until then, I have to get back to my
study and have a great weekend.
_____________________________________________________________
- The article is for educational
purpose. (No copyright infringement intended)
- The article does not represent
the view of any institution or organization.
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