GRPA Series: Many Countries Provide Universal Health Care Coverage to Their Citizens. Why Doesn’t the U.S.?
Let’s start here: the global community agrees that health care is a basic human right. Seventy years ago this year the Universal Declaration of Human Rights by the Office of the High Commissioner for Human Rights of the United Nations said it was so in November, 1948, stating that every human on the planet had “the right to the highest attainable standard of physical and mental health, which includes access to all medical services, sanitation, adequate food, decent housing, healthy working conditions, and a clean environment.” Fast forward to 2018, and at least 58 countries have made significant progress to achieve this ideal, enacting legislation mandating universal health care coverage of its’ citizens. The United States has not.
The United States spends more per capita on health care than any other country in the world, and yet tens of millions of Americans remain uninsured and millions more underinsured. Those who do have insurance face increasing deductibles and copayments, along with rising premiums, more gaps in coverage, and fewer in-network providers from which to choose. The U.S. leads the world in outstanding technological and pharmaceutical advancements, yet they are unavailable or unattainable for most. We have high quality of care, but only in some areas, not all.
How do we address these problems? We here in the U.S. have been actively attempting to reform our health care system for the past 50+ years – with some success. However, while many things have improved, these improvements have resulted in more fragmentation than ever, leading to more problems and a never-ending cycle of patchwork solutions. In spite of the myriad of health care programs available – Medicare, Medicaid, Employer-Based, Obamacare, Veterans Health Care, Military Retiree Coverage, Indian Healthcare and private insurance – we are only slightly closer to achieving universal health care than we were in 1965.
Given the complexity of the U.S. health care system, it would appear nearly impossible to find a solution. Many have tried, but none have effectively succeeded. To be clear, universal coverage does not mean a single-payer health care system, though one can be created to achieve it. Universal coverage means guaranteed access to affordable, quality care – and it remains elusive for millions of Americans.
What can we do? We can start with strong political leadership and courage on both sides of the aisle to put differences aside and take a bipartisan comprehensive approach to addressing the problem. This can be done – and actually was done in the late 1980’s and early 1990’s. The Bipartisan Commission on Comprehensive Health Care consisting of Democratic and Republican U.S. House and Senate health care leaders met to hammer out a solution to provide universal coverage from cradle to grave, integrating acute and long-term care programs. They reported out an effective solution for the time – and then it was promptly and unfortunately lost in the debate and ultimate defeat of the Clinton health care reform initiative in the mid-1990’s.
We can also learn from other countries. Let’s take a quick look at South Korea for example. They have universal health care coverage with affordable premiums through a national government health care program that all can buy into, with the option to purchase private coverage instead of or in addition to standard coverage. They enjoy some of the highest quality of care in the world with no wait times, a strong focus on community care and public health, and well-trained, well paid providers.
In the U.S., we face many stumbling blocks to achieving universal coverage, with politics and profits chief among them. For example, reducing high health care costs – or keeping them in check – could mean lower profits, primarily for insurers and pharmaceutical companies. Isn’t it time, though, to put patients before profits? Other countries have used advancements in technology, innovative community care models, other private sector solutions and public investments to ensure high quality care while sustaining a financially viable system. Could the right mix of something similar combined with learnings from other countries be the answer to health care woes in the U.S.? Fortunately, there is opportunity to find out as U.S. lawmakers and regulators are beginning to look at alternative solutions to improving the U.S. health care system.
By studying other countries, taking the best from each, learning from the worst of each, and politically agreeing to create something in the best interest of our citizenry, we, too, can achieve guaranteed access to affordable quality health care – for everyone. A strong, healthy population equals a strong, healthy country. It’s time to cut through the noise in Washington, D.C., and focus, once again, on one of the most basic needs of all Americans. We can start by formally recognizing that universal health care coverage is a basic human right – and then take the steps to achieve it. Americans deserve no less.