The American health care system has been largely criticized over the last couple of years as administratively burdening, financially inefficient and inaccessible leaving millions of people uninsured without any medical care at all.  But let us look now at the other side of the spectrum: the universal health care systems adopted in most of the European countries. 

 

The founding idea of universal health care systems is based upon providing health care coverage to all or as widely as possible through some form of government action.  The idea took different forms in different countries throughout Europe according to various socio-economic and cultural circumstances.  In Scandinavian countries and the United Kingdom, for example, the government has a high degree of control in developing and providing health care, basing the eligibility criteria upon residency and not on one’s ability to pay.  In these countries every facet of health care is covered primarily from tax revenues, so that beneficiaries need not pay anything.  Other countries such as France and Serbia developed systems based on mandatory medical insurance with contributory insurance rates deducted from salaries or income, which are usually jointly funded by employers and beneficiaries.  The insurance rates, however, are kept low through subsidies, thus they are considerably lower than US rates.  Sometimes the health care funds are derived from a mixture of insurance premiums and government taxes, and many countries use mixed public-private systems to deliver universal health care.

 

Although the idea was first achieved on a national level in Germany, in the 1880s, through reforms conducted by Otto von Bismarck, one of the most socialized systems of universal health care today is the English health care system provided by the National Health Service (NHS).  The NHS services are available to all irrespective of an individual’s ability to pay.  The services include among other things; primary care, long-term health care, dentistry, psychiatric care, in-patient care.  Hospitals provide treatment either free or at minimal charges with certain exceptions for optical and dental care (which are still free for elderly, unemployed, children and people on low incomes).  Private health care paid by private insurance coexists with the NHS, but it only covers approximately 10% of the population, providing merely acute care from specialists.  

 

As idealistic as it sounds, the idea of a universal health care system is not without problems in its practical application.  Critics of universal health care often argue that by keeping medical care out of the free market, hospitals are overcrowded, wait times are extended, quality of service is considerably reduced and freedom of choice is impinged.  They tend to forget, however, that millions of people do not have any choice at all under the present US system.  Whilst neither system is perfect, opting for reasonable quality service through coverage for all instead of high quality health care for the rich minority, seems to be more compliant with the ideas of social justice and equality.   What is more, the French universal health care experience shows that a universal health care system is actually more cost effective than the US system.  In fact, in 2000, French Government’s health expenditures amounted to 9.5% of its gross domestic product (GDP) compared with 13.0% of GDP in the United States.  Therefore, the belief that the US cannot afford to cover the uninsured is not completely true.  The reason why the health care in the US is so expensive is because it has been privatized.  Privatization is largely accepted as a positive change in a society.  However, this is not the case with health.  The health care system could remain private but would need to be severely regulated.  For instance, in the UK, the water and gas supply has been privatized but tightly regulated.  Recently these private companies asked the government to allow them to increase their charges by 10% but the government’s response was to instruct them to reduce their charges by 2%.  This is not the case with the US health care system where prices rage rampant. Another alternative to regulation is nationalization, which is exactly the opposite of privatization.  That would mean that the US could have one health care provider.  This saves costs, because at the moment there are dozens of private health care providers each with their own high costs of renting premises, employing the same departments for each individual company and so on.  The government would reduce these costs greatly and could have one single federal department doing the job for the whole nation.  These are simply known as economies of scale in business terms. 

 

In addition, these few companies in the US health care market do not compete on price among themselves but quality of service, like any oligopolistic market.  This means they also compete over employees and so they increase their salaries in order to get better ones but this in turn means higher costs for a patient who has a terminal disease and must sell her house, drop out of college, or take a second job in order to simply stay alive.  Indeed, private companies are more efficient and do probably provide a higher quality of health care and responsibility than the government would, but that is simply not good enough, considering their prices. 

 

Finally, health care in the 21st century must become a fundamental human right, not a commodity.  People die because they do not have the cash flow to have a preventive surgery or examination.  Could you imagine how healthier our whole nation could be if everybody could see a doctor for a regular check-up and therefore detect early signs of a disease or to simply prevent the disease from spreading among other people?  At present, the H1N1 virus is a threat, and I am afraid to think about how the uninsured would cope with a pandemic without insurance.  However skeptical and critical you may be of the new system, the fact is we are witnessing significant change in the American health care, which will touch many lives. There is still a long way to go before the final draft of the Health Care Act is completely shaped and all of its aspects agreed upon, but one thing is certain without doubt: the US, as one of the strongest economies in the world, can follow through and rise to the challenge of reforming the health care system in whichever form it is adopted.     

 

Bo Miljanovic

This entry was posted on Wednesday, December 9th, 2009 at 6:32 pm and is filed under human rights, international, law, politics. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.