Universal healthcare refers to a government initiated policy or legislation that is usually aimed at providing health services to citizens in the largest sense possible. Universal health care is based on the premise that healthcare is a basic need that all citizens need to get access to at the least possible price. The government may also ensure universal healthcare by setting certain standards that all healthcare providers need to meet in their delivery of health care services to citizens (Bertram, Lauer, De Joncheere, Edejer, Hutubessy, Kieny, & Hill, 2016).
Universal health care is present in many developed and economically stable countries. However, the United States is not one of them. The federal government spends so much of its national revenue on health care unlike any other country in the world. In contrast, the cost of health services in USA remains extremely high as compared to other countries that do not spend as much on health care. Despite the fact that USA is the wealthiest economy in the world, the country does not have a universal healthcare program. This can be attributed to several factors but the biggest of them all being the ideological divide among its leaders such as the hotly contested debate on the affordable care act (Kocher, Emanuel, & DeParle, (2010). The advantages and disadvantages of universal healthcare could also be among the reasons the country has not yet adopted a universal health care program. This paper focuses on the advantages and disadvantages of universal healthcare in the US.
Schokkaert, Steel, & Van de Voorde, (2017) argues that one of the numerous advantages of the universal healthcare program is that it subsidizes the cost of healthcare services. This is possible because the government is able to negotiate and balance the cost of services all over the country. Universal health care programs often focus on making services available for all and affordable. The government therefore takes a central stance in the delivery of health services. The cost of health services is reduced by the standardization of services that require lower price, limiting exploitative competition from private firms and for profit organizations and through elimination of bureaucracies that make it difficult to deliver health services at cheaper prices such as procurement officers and suppliers. In addition, when the government trades directly with pharmaceutical industries, it is possible to benefit from economies of scale thus increasing the likelihood of lowering the prices of health care.
According to Blattner, Price, & Holtkamp, (2018) universal health care also ensures availability and access to health care. This is done in a way that government mandates hospitals to provide certain services at certain prices that are affordable by all citizens. This ensures that hospitals even at the grassroots level are able to provide the mandated basic services to clients at the standardized prices. Governments that provide universal health care often regards health care as a basic human right thus making it affordable and available to all the citizens. This helps citizens to afford services despite the wage gap among the citizens. The universal health care programs also removes other barriers and inequalities to health care thus increasing its availability and accessibility.
Universal health care programs helps in creating and sustaining a healthy population and workforce in the country explains Stigler, Macinko, Pettigrew, Kumar, & Van Weel, (2016). This is because the government is able to adopt a perspective that focuses on health of the country as a whole. The government therefore makes policies and laws that focus on making the entire population disease free. In addition, the government is able to explore a wider range of options in health care that can make a healthier workforce such as long term care, preventive and interventive medications. Following this perspective, the government is able to focus on common illnesses in a population as well as risk factors, culture or lifestyle that may predispose people to certain illnesses.
Universal health care increases government funding on health care series. More than 40% of the most common health services catered for in the universal care act are chronic diseases such as diabetes and cardiac diseases. Majority of the population especially people below the age of 50 years do not suffer from these illnesses yet they are still taxed money to cater for the universal healthcare programs. In other words, one of the biggest challenges of universal health care programs is that it often forces citizens to pay for services that they don’t consume. This is because tax payer’s money is spent on funding services that not all people consume while that money could have been used to fund other development projects that would benefit all the citizens.
Healthcare rationing is also a common challenge facing universal health care (Douthit, Kiv, Dwolatzky, & Biswas, 2015). This is often perpetuated by governments and policy shapers while seeking technical efficiency. The government may cut on various services in order to keep the costs low. Due to the generic nature of medicines, government may also pick on the cheapest drugs in the market without considering their efficiency. This may pose a serious challenge to the consumers as it may compromise the quality and number of health services available. In addition, patients are forced out of the government managed facilities to go out and seek better services in private clinics which also increases the cost of health services.
According to White, (2015) universal health care lowers the initiative that people take regarding their personal health. When health services are offered for free or at very low prices, people may fail to take care of their health as they would if the costs were direct from their pockets. This is because people often develop a tendency that fails to take care of health and focuses more on demanding health rights from the government. There is also increased likely hood of abuse of services. Owing to the fact that health services are being offered for free or at a very subsidized price, people may tend to take up services that they don’t require. This is common especially among people who don’t have chronic illnesses and rarely get ill because they often feel that they pay for services that they don’t consume.
Lorenzoni, Belloni, & Sassi, (2014) argues that universal health care may also compromise the quality of health care. The quality of health care is often compromised as health care providers do not have an initiative to improve the quality of services. This is triggered by the fact that government controls all services and prices. This prevents doctors to increase the quality of the services at additional costs as the government does not permit them. In addition health professionals may fail to provide additional services other than the basic minimum that the government provides either due to lack of motivation to focus on other areas or due to overcrowding of patients in the facility and the legal mandate to offer the government prescribed health services.
In conclusion, it is quite clear that the overall efficiency provided by the adoption of universal health care programs cannot be undermined. Comparing with other countries in the world that have adopted universal health care, it is quite clear that universal health care is an efficient way of improving the quality of care for a majority of the population as well as lowering costs of health care through good policy formulation, leadership and evidence based solutions to high costs of services. The government is also able to improve quality through setting standards, legislations and policies that regulate service delivery.
References:
Bertram, M. Y., Lauer, J. A., De Joncheere, K., Edejer, T., Hutubessy, R., Kieny, M. P., & Hill, S. R. (2016). Cost–effectiveness thresholds: pros and cons. Bulletin of the World Health Organization, 94(12), 925.
Blattner, M., Price, J., & Holtkamp, M. D. (2018). Socioeconomic class and universal healthcare: Analysis of stroke cost and outcomes in US military healthcare. Journal of the neurological sciences, 386, 64-68.
Douthit, N., Kiv, S., Dwolatzky, T., & Biswas, S. (2015). Exposing some important barriers to health care access in the rural USA. Public health, 129(6), 611-620.
Kocher, R., Emanuel, E. J., & DeParle, N. A. M. (2010). The Affordable Care Act and the future of clinical medicine: the opportunities and challenges. Annals of internal medicine, 153(8), 536-539.
Lorenzoni, L., Belloni, A., & Sassi, F. (2014). Health-care expenditure and health policy in the USA versus other high-spending OECD countries. The Lancet, 384(9937), 83-92.
Schokkaert, E., Steel, J., & Van de Voorde, C. (2017). Out-of-Pocket Payments and Subjective Unmet Need of Healthcare. Applied health economics and health policy, 15(5), 545-555.
Stigler, F. L., Macinko, J., Pettigrew, L. M., Kumar, R., & Van Weel, C. (2016). No universal health coverage without primary health care. The Lancet, 387(10030), 1811.
White, F. (2015). Primary health care and public health: foundations of universal health systems. Medical Principles and Practice, 24(2), 103-116.
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