Introduction
Universal healthcare “refers to a system where the country’s government manages the healthcare network in order to make basic care available to every citizen” (Runzheimer & Larsen, 2010, p. 110).
Universal healthcare is also referred to as social health protection, universal coverage, universal health coverage or universal care. The main objective of universal healthcare is to enhance the accessibility and affordability of healthcare.
A majority of developed countries have implemented sound healthcare policies; however, the US lacks a well defined universal healthcare policy.
This paper aims at evaluating how universal healthcare has been approached in the UK and Canada, and compares their approach with the US.
Relevance of Universal healthcare: An analysis of the importance of having universal healthcare
Universal healthcare offers specified health benefits that are effective, easily affordable and accessible to members of the society. Universal care is governed by the extent of coverage. That is, the cost of the cover, services covered and the people covered.
In countries with healthcare systems, governments come up with committees to manage the healthcare system. Difficult but practical decisions, such as deciding how much to pay for an extra year of life, are made. Payments for procedures, surgeries and drugs are discussed and set by committees.
Universal healthcare provides for equitable distribution of resources for all people. Thus, everyone is guaranteed of some level of healthcare; a feature that enhances the general life expectancy of the people covered.
Most importantly, patients have access to primary care and basic health screening tools. Therefore, diseases that can be prevented or treated early are identified and managed accordingly.
Historical and Present Policies and Programs Addressing the Universal Healthcare: Examples from the US, UK, and Canada
Due to the high cost of medical care and low life expectancy, most countries formulated universal healthcare programs to address these issues. As indicated earlier, universal healthcare enables citizens to access basic healthcare and screening tools thus preventing the occurrence of preventable disease.
Thus, universal healthcare requires adequate funding in order to manage and implement its set objectives. Most countries employ mixed models in generating funds for the healthcare plan (Bramley-Harker & Mcdonald, 2007). The majority of the funds come from general taxation.
Other models include private payments either directly or via insurance agencies for services not offered in the public system scheme. A majority of universal healthcare systems in European countries like in the UK is funded through mixed models that incorporate public and private contributions.
A significant amount of the non governmental funding comes from employers and employees in the form of regulated, non profit funds. Such contributions are mandatory, and they vary according to one’s income.
Britain’s National Health Service generates its funds by using various schemes. A good example is community based health insurance. Community based health insurance is a private health plan that has emerged in settings where financial risk protection systems have a limited plan.
The community in involved is given the mandate to run the scheme. In addition, contributions are flexible and not risk related. Private insurance scheme is another method employed in the UK.
This insurance scheme is voluntary. The scheme encompasses policies sold by insurance firms to companies, associations, organizations and community health insurers.
Social health insurance and tax based financing are other forms of funding available in the UK. Social health insurance is compulsory. It encompasses contributions from social workers, the government, the self employed and enterprises (Bramley-Harker & Mcdonald, 2007).
The compulsory contributions are then pooled into a single or multiple funds. The scheme involves a combination of public and private providers who provide defined health packages.
Government parastatals are involved the execution of functions in this type of scheme. However, on rare occasions, private insurers may be given the opportunity to run or execute the functions.
In tax based financing, individuals are taxed on their salaries, capital gains, purchases, and a variety of various items and activities (Bramley-Harker & Mcdonald, 2007). The money gained is directed to the health scheme. The scheme involves a pooled fund across the whole population. Canada has a different approach.
Medicare in Canada, which is often called medicare, is privately run but publically financed (Irvine et al., 2002). Canada’s medicare is governed by five key components.
First, medicare ensures that care is universal. Secondly, medicare aims at providing portable healthcare. Thirdly, accessibility of healthcare is a must. Fourth, the healthcare must be comprehensive. Fifth, healthcare should be publicly administered.
Medicare in Canada is characterized by three main components. Consumers are free to choose their healthcare provider, allows for local control, and doctor autonomy. Therefore, Canadians are at liberty to choose where they intend to go for medical check up.
Canada has ten provincial governments, which are the main policy makers. They take part in planning, financing, and evaluating the provision of medicare (Irvine et al., 2002). In addition, the provincial governments have the constitutional mandate to regulate physicians’ fees and negotiating salaries for professionals in the healthcare industry.
This phenomenon however results into slight differences in the way medicare is implemented in each province. Differences arise in the provision of services beyond the hospital or physicians’ coverage. Healthcare in Canada generates its funds mainly from taxes.
Canada’s federal government regulates the disbursement of funds collected. In addition, to the taxes collected by the federal government, provinces are permitted to levy their own taxes so as to generate extra funds.
In Canada, universal healthcare is provided by medical professional in the private sector although the scheme is publically funded through provincial budgets.
Universal healthcare in the US: The patient protection and affordable care act (PPACA)
The patient protection and affordable care act is the equivalent of universal healthcare in the US. The act aims at ensuring that all Americans have a medical insurance and reducing the cost of medical care. In the US, provision of universal healthcare uses multi payer system mainly from the public and private sector.
The federal government is the chief financier of pubic health schemes while employers are the main financiers of private health schemes. Other forms of covers like compulsory insurance are enforced through legislation by encouraging residents to purchase insurance cover.
However, in actual sense it is the government that pays for the insurance. Currently, PPACA funding is generated mainly from medicare taxes. The US has the most advanced medical technologies in the world and yet accessibility to healthcare is poor due to the lack of medical insurance and administrative waste.
Medical insurance in the US is provided by both private and public insurers. However, private insurers are the major insurers.
The federal government is the chief insurance provider in public healthcare insurance. On the other hand, employers are the main private insurers. Healthcare funds are generated from taxes.
Successes and Failures of universal healthcare in the US, Canada, and UK
People should realize that healthcare affects the government’s cost. This system does control the government’s expenditure on healthcare and may lead to higher taxes.
Currently, the US spends 16 percent of its gross domestic income on healthcare, and the figure will have doubled come 2035 according to the congressional budget office (Zirkle & McNelles, 2011). Amazingly, the U.S does not have a defined universal healthcare system.
Thus, it is still not clear whether the adoption of universal healthcare system in the U.S will burden taxpayers. Taxes for healthcare are much higher in countries that have established universal healthcare systems than in the U.S. The lack of a well defined universal healthcare in the US is attributed to false driven policy debates (Light, 2003).
For example, some believe that the US cannot manage to cover the uninsured. Medical professions believe that they might lose more power in case healthcare is managed by corporations. Others only believe in the single payer scheme and yet other alternatives are available.
In addition, some argue that the US is large and diverse and that lessons relating to healthcare which, are draw from lesser countries, are irrelevant (Light, 2003). However, the US boasts of low infant mortality and high life expectancy.
In the UK, the National Health Service has significantly enhanced the quality and accessibility of healthcare (Light, 2003). This is attributed to extraordinary leadership and a solid political system that gives great control to the party in power.
The UK’s parliamentary governance structure allows for consultations between major stakeholders (Zirkle & McNelles, 2011). The National Heath Service of Britain is arguably the most successful healthcare scheme.
Although Canada has a convincing medicare scheme, it was ranked number 24 out 27 OECD countries 2002 in terms of the doctor-patient ratio (Irvine et al., 2002). This has been attributed to the failure by the federal government to provide basic equipment.
In addition, many diagnostic and therapeutic products are inaccessible. In 2008, reports from the Canadian medical association indicated that screening and treatment of selected diseases is due inaccessibility to diagnostic and therapeutic.
These diseases include cancer, heart attack, and bone and joint diseases. Furthermore, some experts warn that Canadian system of healthcare has several disadvantages.
According to Irvine et al. (2002), the system lacks accountability owing to the federal government structure. Irvine et al. (2002) also argues that decision making is politicized and that single payer government control is limits innovation.
When the three country’s healthcare schemes are compared, UK’s National Health Service tops the list followed by Canada’s medicare. UK’s healthcare is said to be free at the point of use.
Canada’s medicare is also readily accessible and affordable. However, in the US, medical care is only readily available to the insured. Due to the lack of a well defined universal healthcare plan, accessibility to medicare by the uninsured is extremely difficult.
Stakeholders Involved: A comparison
In the US, Congress is the chief policy maker. The provision of healthcare brings together both private and public healthcare providers and insurers. Thus, there is a need for consultations between policy makers in Congress and other stakeholders such medical professionals and insurance companies.
In the UK, the parliamentary system of government is the main stakeholder because it controls most of the country’s decisions including healthcare decisions. The solid parliamentary system of government encourages consultations between major stakeholders in the healthcare industry ranging from private to public.
Key stakeholders include the parliament, which formulates policies, government owned and private insurers, and healthcare providers. UK has overcome professional opposition and has set up various schemes. They include voluntary insurance schemes and limited national insurance. Others are public health services and charity care.
Canada has ten provincial governments, which are the main policy makers. They take part in developing healthcare policies. They are involved in planning, financing, and evaluating the provision of medicare.
In addition, the provincial governments have the constitutional mandate to regulate physicians’ fees and negotiating salaries for professionals in the healthcare industry.
Healthcare in Canada generates its funds mainly from taxes. Canada’s federal government then disburses the collected funds to all the ten provinces in the country. Apart from funding, medical professionals are the other key stakeholders in Canada’s medicare.
As indicated earlier, medicare is provided mainly by medical professionals in the private sector. Canada’s medicare scheme gives the consumer the freedom to choice where he or she goes for medical care.
Ethical, Social, and Moral Considerations of Universal healthcare
Universal healthcare has the social and moral responsibilities of ensuring that healthcare is readily available, accessible, and affordable. This ensures that the society is healthy thus reducing mortality rates. In ethical terms, universal healthcare enhances the quality of life through the provision of equitable healthcare.
Recommendations
The US suffers mainly from massive uninsurance meaning that healthcare is less affordable and accessible to the uninsured. Healthcare can be made accessibility and affordability through two approaches. The first step should ensure that the public health sector gets enough funding (American Hospital Association, 2008).
Secondly, the patient protection and affordable care act should be amended in order to allow for a close working relationship between healthcare providers (American Hospital Association, 2008).
Conclusion
Universal healthcare endeavors to provide easily affordable, accessible and effective basic healthcare to the community. Funding for universal health care plans may take various models.
However, in most cases the government plays a key role in raising the required funds for the citizen’s healthcare plans. Most importantly, taxation is the common source of these funds. The government alone might not succeed to provide healthcare to all citizens singlehandedly.
Both the private and public sectors need to collaborate in the provision of universal healthcare. The success of universal healthcare systems relies on proper governance and non political interference.
Universal healthcare has been proved to reduce mortality and morbidity. It is a high time the U.S government considered establishing a national, universal healthcare plan to enable all Americans access basic healthcare.
When the three country’s healthcare schemes are compared, UK’s National Health Service tops the list followed by Canada’s medicare. UK’s healthcare is said to be free at the point of use.
Canada’s medicare is also readily accessible and affordable. However, in the US, medical care is only readily available to the insured.
Other developed countries such as the UK and Canada have sound universal healthcare policies owing to their reputable policy making processes. The US government should borrow a leaf from these nations.
References
American Hospital Assocaiation. 2008. Retrived on 10 Oct.2103 from https://www.aha.org/front
Bramley-Harker, E., and Mcdonald, N. (2007). The Cost of Fairness in the Healthcare System. Journal of Management and Marketing in healthcare, 1(1), 19-28
Donald, Light. (2003). Universal Health Care: Lessons From the British Experience. American Journal of Public Health, 93(1), 1-10.
Irvine, S.et al. (2002). Background Briefing: The Canadian Health Care System. Retrived on 10 Oct.2012 from http://www.civitas.org.uk/pdf/Canada.pdf
Runzheimer, J., and Larsen, L. (2010). Medical Ethics For Dummies. New Jersey: John Wiley & Sons.
Zirkle, M., and McNelles, L. (2011). Nonattendance at a hospital-based otolaryngology clinic: A preliminary analysis within a universal healthcare system. ENT: Ear, Nose & Throat Journal, 90(8), 32-34.