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Universal Healthcare

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Universal healthcare refers to national healthcare programs which provide all citizens with access to healthcare. Various countries have a single-payer system based on the government paying for the healthcare services. Universal or national healthcare systems are of three types: "national health insurance, national health system, and socialized health insurance" (Niles 299). The United States healthcare system is government funded and is employer-employee based. Citizens older than 65 years of age are provided 100% healthcare coverage with the Medicare program, while people younger than 65 years of age are provided with 82% coverage through "employer-based insurance, Medicaid, Indian Health Services, Veterans Administration (TRICARE) and the federal government employee program" (Niles 300).

Thesis Statement: The purpose of this paper is to investigate the concept of universal healthcare in relation to its global implementation, and examine the significance and implications of the Healthcare Bill in the United States.

Universal Healthcare in Selected Countries

National health insurance in Canada is implemented through delivery of care by private providers, but funding is by the government through general taxes. National health systems such as in Great Britain are based on provision of both healthcare and infrastructure for healthcare delivery by the government with the help of taxes. In socialized health insurance systems as in Japan and Germany, while private providers deliver healthcare, the government ensures that both employers and employees contribute financially to sickness funds at not-for-profit insurance companies who pay the healthcare providers (Niles 299). Switzerland's unique healthcare system requires all residents to purchase health insurance; hence it may be considered to have universal healthcare coverage. However, individuals bear the entire cost of insurance plans, since Swiss employers do not provide or contribute to health insurance.

France's healthcare system which is considered to be an almost ideal one, is similar in some respects to that of Germany and Japan. The country's expense on healthcare is the third most expensive in the world, at 11.1% of its gross domestic product. France has several health insurance funds regulated by the government, and overall provides universal healthcare coverage to nearly 99% of its citizens. Payroll taxes form the greatest sources of funding, while income taxes, general social contribution taxes on income, various revenues, and supplemental policies from private-for-profit health insurers generally paid for by employers. France's national healthcare system pays 100% costs for 30 chronic health conditions including cancer and diabetes. Additionally, citizens who are very ill can avail of increased healthcare coverage; this is unlike the United States system "where individuals may go financially bankrupt because of their cost sharing during a chronic disease" (Niles 301). Despite France's budget issues caused by its healthcare system's m billion-dollar deficit and other problems, comparatively, the French have the highest satisfaction level about their healthcare system.

On the other hand, all countries including France have flaws in their universal health insurance systems. Similar to the United States, Japan's elderly people use the healthcare system the most due to increased graying of the population. As a result, Japan's healthcare expenditure is expected to rise dramatically in the next few years, like the U.S. Medicare program's out-of-control expenditure. Similarly, Switzerland's healthcare system is expensive, though it restricts exorbitant charges.

Universal Healthcare in the United States

Establishing a universal healthcare system in the United States may not solve the problems of the system. The main difference between the U.S. and other countries pertain to the controls the governments of the latter place on "pharmaceutical prices and the health insurers" (Niles 304), thus limiting their own profitability in order to provide their citizens with increased healthcare access. Another difference is the collectivist attitude or citizens' willingness to pay more, to facilitate access to healthcare by all the members of the country's population.

For nearly a century, Democratic presidents of the United States have unsuccessfully attempted to introduce changes to the nation's health care system. Significantly, President Barack Obama succeeded in overhauling the nation's health care system. He signed legislation on March 23, 2010 guaranteeing medical insurance coverage to over thirty million Americans who lacked it. The historically momentous bill makes more than 95% of Americans eligible for health coverage, "adds 16 million people to the Medicaid rolls; and subsidizes private coverage for low- and middle- income people" (The New York Times, April 5, 2010). The legislation also ensures that private insurance companies are monitored more closely.

The healthcare Bill of March 2010 is believed to herald an era of reform in the U.S. healthcare system. Despite America's medical technology being of the highest quality, the health care system has been mediocre in every aspect, and too expensive for a major section of the population. Both Medicare and Medicaid were confronted with immense increases in future costs due to new technologies, growing numbers of people enrolled, a confusing network of complex and uncoordinated administrative functions, and an absence of effective care and treatment. Cost-effectiveness and effective outcomes of care were not taken into account while rationing care. The Medicare program attempting to curb costs through a focus on reimbursement approaches were moderated by the political power of "hospitals, health professional groups, and their lobbies" (Mechanic 181). Medicaid is a major cost for the states as well as the federal government, constituting nearly one-fifth of all state expenditures. The location of residence is related to the extent



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