Universal Healthcare: Is the US Ready for It?

By Brenda Pecotte


It has been in the news, brought into the presidential election, debated in medical schools, and chatted over the water fountain.  The concept is very simple; those that need medical attention should be able to receive it as designated by the government.  Is it socialistic?  Will taxes increase?  How much longer will I have to wait?  Why was it not done sooner?  What will be next?  What does it actually mean?  Is it really free?  Is it really open to everyone?  What is the hidden catch?  Can it really that simple? Is the United States ready for it?

Currently, there are approximately 47 million uninsured people in the United States, and this number is growing every day.  The cost of healthcare is quickly increasing and the accessibility is slowly decreasing.  Most people without some sort of an insurance plan go without medical attention until it is too late.  Those that do go to the doctor are often left with large bills.  Out-of-pocket costs for healthcare are currently $850 and are expected to be $1400 in 2016, by which time the government will be paying for 50% of medical related costs in the US.  In another decade, it is estimated that $1 in every $5 in the United States will be spent on healthcare (Looking for a Universal Truth by Kelley Butler, ed.). 

We, as human beings, are not 100% immune and our bodies are not completely resistant to everything in this world.  At some point and probably multiple times in each of our lives we are going to require medical attention.  The majority of the general public would agree that healthcare is a basic necessity.  The question becomes: What is the best plan of action that would be the most effective and please the majority of the population in terms of care, access, and cost?

As the topic becomes more prominent in US politics, more attention and analysis is given to other countries on their policy and implementation.  There are currently 36 countries that have a form of universal healthcare in their law, including Sweden and Costa Rica.  Both countries have well-established, but differing policies. 

Sweden is a country of 9 million people.  The majority of healthcare is decentralized to the 20 counties and 290 municipalities.  The National Board of Health and Welfare, Socialstyrelsen, sets forth and oversees the policy which states “every county council must provide residents with good-quality health services and medical care and work toward promoting good health in the entire population” (www.sweden.se).  The councils decide what would work best for their designated area.  Healthcare costs the government approximately 9% of the GDP or $25.4 billion.  Patient fees run approximately 3% and after paying a certain amount, the patient no longer pays for services or treatment.  In 2005, a stipulation was passed that if a person waits longer than 3 months for care, they can go elsewhere (to another county) and all expenses will be covered by the patient’s council.  The citizens have the opportunity to seek out private care at their own expense.  When asked about her doctor visit in Sweden, a North Park student commented that the time she waited around 3 hours to see a doctor and it was based on severity of your case. 

Costa Rica is a country of 4 million people.  Low cost healthcare is available all working citizens and their dependents and non-citizens are able to use it.  There are 29 hospitals and 250 small clinics to even the most remote areas.  The individual buys into the plan for a small monthly fee based on their annual income.  This gives them complete access to all forms of care.  It covers any pre-existing conditions and there is no monetary limit on how much care is received.  “The drawback to this coverage is the long lines and waits associated with public hospitals and clinics” (www.costarica.com).  Private insurance is available but will not cover current illnesses.  The government funded health care is regulated by the Caja Costarricense de Seguro Social. 

Both of these examples demonstrate healthcare systems that have been effective.  It must be noted that the population of the US is 33 times that of Sweden and 75 times that of Costa Rica and both are smaller areas of land.  The size and demographics of the population presents a question of accessibility and receiving of care such as wait times and quality of care and effective solutions.  Both of these countries have alternative options of care available, but that does not seem to hugely affect the quality of care that everyone receives.  Will the demand and recent shortage of quality health professionals in the US shift those qualified individuals to providing private care to those who can afford it?  Would those using the government provided healthcare receive less quality care?  Will care be given based on severity or length of wait? How should the government regulate healthcare, centralized versus state based?  Costa Rica allows non-citizens to receive care as well.  Would the US be able to accommodate this or what would be the options for non-citizens? 

There are options being presented in congress every week.  One plan is to increase tax incentives for the individual insurance market to provide lower cost health insurance to those who are uninsured.  This is not likely to happen because it does not solve the problem of controlling healthcare costs.  Another plan is to mix a private and public group insurance plan which allows individuals to choose providers but also group people to spread the coverage risk.  The third plan supports each individual paying into the government plan replacing the private, employer-based insurance.  The later two options have some validity and possibility of working in the US.  (Public-private model gets support… by Rebecca Vesely)

On a general polling of NPU students, it seems that most are in favor of universal health care because the US government needs to do something about our lack of care for those who can not afford it.  However, it was also agreed upon that whatever the solution is it will take time and many errors.  There are a lot of unknowns that will factor into the policy that is presented, such as the immigrant population, pharmaceutical industry, health care provider salaries, who maintains control, equality of quality care, patient fees, etc.  This issue is going to remain at the forefront of many peoples minds during the presidential election and as people start to enter the work force.  The real question is now put to you, is the US ready for it?