The issue of universal healthcare provision in the United States remains controversial and therefore, a debatable one. While her peers offer universal health coverage (UHC) with the World Health Organization (WHO) imploring all nations and governments to roll out the scheme, the U.S. lags behind even some of the developing countries. The United Kingdom, France, and Canada as well as Japan are some of the countries that have implemented UHC and have experienced both negative and positive outcomes. Universal Health Coverage (UHC) means a government provides medical and health care services to all citizens free without any payment or considering their ability to pay. While UHC is expensive, governments fund the program using taxpayers’ money (Alspaugh et al., 2021, p 42). The purpose of this essay is to discuss the issue of UHC. The paper argues that the provision of UHC by government will have negative effects on quality of care and virtually eliminate private insurance industry and lead to ballooning of government debt.
Arguments Against Universal Health Coverage in the United States
The promise of free quality health care for all citizens may lead to limited demand and this could result in reduced access for many as there may be corresponding cut in the allocated resources for the program. The limited access will also result in longer wait times, rationed care and in most cases lower quality of care. Free-market health care ensures a balance of supply and demand of services and but increased control of the sector would reduce access to care as it will impact their decisions on when and how to go and see a physician where necessary (Al Kaabi et al., 2022). With free access to care, citizens could abuse the system and increase overutilization costs. The flooding of the system will mean that a decline in the quality of physician-patient interactions and relationships as doctors will have limited time for all patients. The right to health care could reduce the quality and availability of effective disease screening approaches and treatment. Existing evidence shows that nations with a universal right to heath care have worst outcomes from disease treatment because of limited and strain on resources (Bertram et al., 2016, p925). Again, the existing private health care providers, especially health insurers will also attempt to lower their susceptibility to malpractices like fraud and eventually lower quality, inflated costs through the development of preferred providers with no integrity and but can reward for delivery of care in a cost-effective manner.
The implementation of UHC would imply that employers and private insurers do not offer coverage that overlaps the government or the public system. This implies that government and not the insurance companies would contract medical providers and reimburse them directly. As such, many private health insurance providers may be pushed out of business and lead to massive unemployment for a significant number of people working in these companies (Crowley et al., 2020, p51). The government may also require people to purchase private health insurance or face penalties and fines like the initial provisions of the Affordable Care Act. This means that individuals would be mandated to pay for premiums to private health insurance providers or risk paying penalties to government. This will be a very unpopular move. Furthermore, the government would have to build a corresponding infrastructure to accommodate the possible rise in demand that private companies may not be willing to be part of or due to their shut down. Under the present system, private health plans allow people to save money by ensuring that patients get most cost-effective care (Supanick, 2021, p.552). Individuals enrolling in private plans enjoy reduce medical costs compared to those enrolled in publicly administered options. A core aspect of cost reduction and high quality care provision by private health plans is efficiency in service delivery and operational environment.
Universal health insurance coverage entails significant upfront costs and logistical challenges that private health providers cannot operate and deliver quality care. The huge cost of providing quality health care makes UHC a very expensive and huge undertaking for governments as the taxpayers are the ones to fund the program. The shift of nearly all private spending for health care to public ledger would necessitate very large rises in government spending, and this would have impact through a rise in taxation rates and further exacerbate the current federal deficit (Zieff et al., 2020, para22-23). The implication is that the model would lead to a rise in taxes without a corresponding increase in quality of care provided. Again, one needs to understand that several factors will also impact the implementation of UHC in the United States. These include politics, demography, the economy and governance aspects. The U.S. cannot achieve UHC without a consideration of these aspects.
Conclusively, the idea of ensuring that all citizens have access to quality medical and health care looks great. However, the actualities and practicalities always end in gloomy realties that are difficult to contemplate as argued in this paper. Perhaps the biggest disadvantage and challenge of the UHC is the government being in control of health care and being compelled to increase taxes or get funding which will lead to more budget deficits. Imperatively, even with the enactment of the ACA, the present system requires much work and no quick fixed or easy solution. Each solution or model has its pros and cons. Examples from nations that run socialized healthcare are evident that while government may run healthcare, it does not always offer solution to the question of quality.
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