Time for Universal Healthcare Services
By Dr. William Roth
The U.S. is the only developed country lacking some form of a universal healthcare services. The most popular excuse for this situation is expense. Taxpayers would be unwilling to support it. The fact is, however, that such a system would end up costing less than we now pay. Based on 2002 data released by the Organization for Economic Cooperation and Development, the U.S. system costs close to $5,000 per person yearly in comparison to an average of $2,117 for the 30 OECD member nations. Of this $5,000 approximately 42% comes from taxes (Medicare, Medicaid, etc.). Forty-two percent of $5,000 is $2,100. The math says that introducing a UHS might cost an additional $17 per person in taxes while, at the same time, eliminating the individual out-of-pocket expense that currently amounts to 22% of the $5,000 as well as most of the cost of private insurance.
The other advantages of a UHS should be obvious. First, everybody, including the 40 million citizens currently lacking coverage, would receive attention. Second, doctors would not be able to turn patients away. Third, the level of care received by different segments of the population would be more equitable.
Might such an approach hurt quality? The U.S. is currently ranked 18th by the World Health Organization in terms of overall care. While this country has the largest number of well-trained specialists, in terms of general care and especially in terms of preventative care we fall far behind. How do other countries do it? Why are their statistics better than ours in so many areas? The most successful model combines UHS with private practice. Everybody has free access to treatment from the public network of community centers, specialized clinics, and hospitals. Citizens, however, can also buy private insurance or have it provided by their employer allowing them to use private practitioners. People in these countries enter the UHS for basic services - checkups, colds, flu, minor injuries -- switching to the private sector for ailments demanding more sophisticated treatments if they have private insurance.
Another argument raised by those against universal care is that people have to wait for treatment. They point to Canada as an example. Insurance in Canada is provided free to all citizens by the government. Though Canadians use this insurance to visit any doctor or facility they choose, some opt to come to the U.S. for surgery because they don't want to wait in line. The reason for this situation is simple. While approximately 70% of all physicians in the U.S. are specialists and 30% general practitioners, the reverse is true in Canada and other countries offering UHS. So while overall health maintenance is better in these countries, people might have to wait for specialized care. What those condemning the Canadian system also fail to mention is that the government there pays for people to use U.S. surgeons. This is a common practice in countries providing UHS. They share resources. England brings in doctors from mainland Europe to help handle overloads. Governments pay for citizens to cross borders and oceans for treatment when it cannot be gained immediately at home.
A final argument against UHS is that it kills incentive. In Canada where costs are capped but physicians can treat as many patients as desired, the average yearly income is approximately $250,000. In a majority of countries with UHS where doctors are salaried, yearly income runs close to this mark. At the same time, unlike the U.S., doctors in those countries do not come out of school owing hundreds of thousands of dollars. They are not, then, required to spend two years at a very low wage as an intern. Doctors in those countries come out of school owing nothing because education at all levels is free and begin earning a reasonable salary immediately.
The key question underlying this debate is whether comprehensive healthcare should be a right or a privilege. Countries with UHS obviously consider it a right and, though their approach might have weaknesses, are doing everything possible to provide it for all citizens in a cost effective manner.
The arguments against implementing this approach in the U.S., when examined closely, do not make sense. It is time for learn from and to follow the lead of countries that have it in place. It is time for the U.S. to catch up.
William Roth, a professor of management theory at DeSales for 12 years, is the author of six books. He is working with other local professionals on the comprehensive design of a universal health care system that will work in the United States.
Press Release: Time for Universal Healthcare Services by Dr. William Roth | Posted on: 10/17/2004
For more info:
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