The Case for and Against
Universal Health Care
One of the hot topics of the 2020 presidential election is universal health care – especially among progressive Democrat candidates.
The reason? Health care costs in the United States are almost twice as expensive as in other developed countries, according to Consumer Reports. A study reported in Health Affairs attributes the high costs not to the quantity of health care provided to each person, but to high drug prices, doctor and nurse salaries, hospital administration costs and medical services. The result – an average household spends at least $8,000 annually in lost wages, higher insurance premiums, taxes and other out-of-pocket expenses.
Many voters, understandably, wonder whether universal health care is the answer.
Universal health care is a system where the federal government controls prices for medications and services and provides medical services to all citizens regardless of ability to pay.
The United States is the only one of 33 developed countries that does not have universal health care. However, some people in our country do qualify for government-provided care through Medicare or Medicaid because of their age, household income, or personal circumstances.
There are three ways to achieve universal health care:
- The Beveridge model is socialized medicine which focuses on public ownership of health care facilities where health care professionals work for the government. Because the government owns everything except the doctors, it decides the prices for hospitals, doctors, procedures, devices, and equipment. Cuba, because it has no private health care providers, is an example of the Beveridge model. The U.S. Veterans Health Administration in the United States also is an example.
- The Bismarck model focuses on private delivery of health care and is funded through employee and employer contributions. It costs about the same as the Beveridge model, but provides more flexibility and choices. Germany follows this model, as does the employer-based health insurance in this country.
- The National Health Insurance model focuses on private delivery of health care with publicly funded insurance. Health care professionals and hospitals are privately owned, but all citizens must fund the program. This model was developed in Canada. It is generally cheaper than the Bismarck and Beveridge models and can provide flexibility and choices since private delivery still exists. The U.S. Medicare system and U.S. Sen. Bernie Sanders' "health care for all" proposal are examples of a national health insurance system.
Not everyone in this country is sold on the idea that Universal health care will provide good, expedient coverage at a reasonable price. Here are some of the pros and cons:
Pros of Universal Health Care
- Proponents say that it lowers health care costs, because the government can leverage the size of the medical market to negotiate better prices for medical services and medicine. The result is that doctors and pharmaceutical agencies probably will be paid less.
- Fewer administrative staff members would be needed since providers would only have to deal with one government agency rather than several private insurance companies, Medicare and Medicaid. Universal health care would standardize billing procedures and coverage rules.
- The government, not insurance companies, would be the authority approving whether a patient receives a particular medical service.
- By placing more emphasis on preventative measures, universal health care would promote a healthier workforce. When people are proactive about their health, the need for emergency services decreases.
- Early childhood care can prevent future social costs, such as crime, welfare dependency and health issues.
- It forces hospitals and doctors to provide the same standard of service at a low cost instead of focusing on developing new technology and charging higher costs for the use of that technology.
- The government will be in a better position to guide the population toward healthier choices through regulations and taxes. For instance, the government could impose a "sin" taxes on cigarettes and alcohol to reduce consumption.
Cons of Universal Health Care
- Republicans estimate that Sen. Sanders' universal health care plan could cost the government $33 trillion by 2023.
- In Canada, the costs of health care can be as much as 40 percent of the government's annual budget. If the federal agency in charge of health care does not have strong management skills, the high costs associated with providing universal care can quickly overrun the budget and take funding from other areas, such as education.
- Wait times might be longer. For instance, in Canada, the wait time to see a specialist for a health problem can be almost 40 weeks. That's because the primary goal of a universal system of care is to provide basic care and emergency care only.
- Patients may not always get the care they seek, because one way to save money is to limit care to people who are in the last six years of their lives.
- When the government sets the prices, it limits how much doctors are paid. Experts are concerned that the pool of doctors will shrink because students won't want to commit to several years of expensive training to be doctors if they know they won't make much money during their careers.
- Doctors often are assigned more patients than they can handle, so they often rush through the interview and diagnostic process.
- There's less funding for innovative life-saving technologies.
- If families have to pay taxes for basic health and emergency care, AND have to pay a private insurer for specialist or elective procedures, they may end up paying more than they would without universal system.
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In this issue:
This Just In...
A Beneficiary's Guide to Filing a Life Insurance Claim
Two Medicare Enrollment Periods for 2020 Benefits
The Case for and Against
Universal Health Care
The Benefits of Purchasing Life and Disability Insurance Together