Wednesday, February 13, 2008


Universal Health Care refers to government mandated programs that are intended to ensure all citizens, and sometimes permanent residents, of a governmental region have access to most types of health care. Patients may pay for some portion of their care directly, but most care is subsidized by taxpayers and/or by compulsory insurance.
In the 1880s, most Germans became covered under the mandatory health care system championed by Bismarck. The National Health Service (NHS), established in the United Kingdom in 1948, was the world's first universal health care system provided by government. Universal health care is provided in most developed countries and in many developing countries. The United States is the only industrialized nation that does not provide universal health care.
Universal health care programs vary widely in their structure, funding mechanisms, and the level and nature of the government's involvement. Some government health care systems allow private practitioners to provide services, and some do not. In the UK, doctors are allowed to provide services outside the government system; in Canada, some services can be offered and some cannot.

Implementation
Most of Europe has publicly sponsored and regulated health care. Countries include Austria, Belgium, Bosnia, Bulgaria, Croatia, Czech Republic, Denmark, Finland, Estonia, France, Germany, Greece, Hungary, Iceland, Ireland, Italy, Malta, the Netherlands, Norway, Lichtenstein, Luxembourg, Poland, Portugal,

Europe

Main article: National Health Service United Kingdom
Argentina, Brazil, Costa Rica, Chile, Cuba and Uruguay all have public health care provided.
Mexico is planning to launch its own universal health care network.

Americas

Main article: Health care in the United StatesUniversal health care United States
In 1984, the Canada Health Act was passed, which prohibited user fees and extra billing by doctors. In 1999, the prime minister and most premiers reaffirmed in the Social Union Framework Agreement that they are committed to health care that has "comprehensiveness, universality, portability, public administration and accessibility."

Canada
Brunei, India, Kuwait, Qatar, UAE, Saudi Arabia, Israel and Thailand have universal health care.

Asia and Africa
Thailand introduced universal coverage reforms in 2001, becoming one of only a handful of lower-middle income countries to do so. Means-tested health care for low income households was replaced by a new more comprehensive insurance scheme - originally known as the 30 baht project, in line with the small co-payment charged for treatment. People joining the scheme receive a gold card which allows them to access services in their health district, and - if necessary - to be referred for specialist treatment elsewhere. The Thai system is relatively unusual in having a single, central purchasing agency - the National Health Security Office - which channels funds to a large number of contracting units for primary care (CUPs) that co-ordinate services in local districts.

Thailand
India has partial universal health care system run by the local governments. The "government hospitals", some of which are among the best hospitals in India, provide treatment at taxpayer cost. Selected drugs are offered free of charge in some hospitals.

Oceania

Main article: Medicare (Australia) Australia
As with Australia, New Zealand's healthcare system is funded through general taxation.

New Zealand

Main article: Health care economics Economics
Universal health care in most countries has been achieved by a mixed model of funding, based on elements of compulsory safety net insurance for all (which may be levied on the individual and/or an employer), with special protections for the poor and disadvantaged (funded by taxation) with the option of private payments (either direct or via optional insurance) for services beyond that covered by the safety net.
Most all European systems are financed through a mix of public and private contributions. employ a multi-payer system in which health care is funded by private and public contributions.
A distinction is also made between municipal and national healthcare funding. For example, one model is that the bulk of the healthcare is funded by the municipality, speciality healthcare is provided and possibly funded by a larger entity, such as a municipal co-operation board or the state, and the medications are paid by a state agency.

Funding models
This is usually enforced via legislation. Sometimes there may be a choice of several funds providing a basic service (e.g. as in Germany) or sometimes just a single fund (as in Canada).

Compulsory insurance
Some countries (notably the UK) effectively have stripped away the pretence that there is insurance for the safety net and choose to fund health care directly from taxation.
Other countries with insurance-based systems effectively meet the cost of insuring those unable to insure themselves via social security arrangements funded from taxation.

Taxation
This term is used in the U.S. debate to describe a funding mechanism meeting the costs of medical care from a single fund. Although the fund holder is sometimes assumed to be the government allocating funding from taxation, its proponents do not rule out the possibility of some other mechanism. It is therefore as yet undetermined whether a future U.S. single-payer universal health care system would be funded from taxation, from compulsory insurance or a mixture of both.
See also: Single-payer healthcare and Publicly funded healthcare

Single-payer
In countries with universal coverage, private insurance is most often used as a supplement, covering what the core safety net service does not provide, Examples include elective cosmetic surgery and special comforts like private rooms. In some countries, people can use private insurance to obtain treatment more quickly than would otherwise be possible.
Where private insurance is predominant, such as in the U.S., medical (health) insurance is subject to the well-known economic problem of adverse selection which may also be referred to as a market failure. Adverse selection in insurance markets occurs because those providing insurance have limited information with which to estimate the health risks on which they may need to pay future claims. In simple terms, those with poor health are more likely to apply for insurance and more likely to need treatments requiring high insurance company payouts. Those with good health may find the cost of insurance too high for the perceived benefit, and some will remove themselves from the risk pool. This adverse selection concentrates the risk pool, thereby further raising costs. In practical terms, adverse selection means that private insurers have an economic incentive to 'weed out' bad risks in advance and provide medical insurance only to the most healthy. Among the potential solutions posited by economists are single payer systems as well as other methods of ensuring that health insurance is universal, such as by requiring all citizens to purchase insurance and limiting the ability of insurance companies to deny insurance to individuals or vary price between individuals.

Private insurance

Main article: Health care politics Politics
Whether a government mandated system of universal health care should be implemented in the U.S. remains a hotly debated political topic. Those in favor of universal health care, such as the non-partisan Institute of Medicine of the National Academies, which has called for the U.S. to implement universal health care by 2010, argue that the current rate of uninsurance creates direct and hidden costs shared by all, and that extending coverage to all would lower costs and improve quality.

United States
Common arguments forwarded by supporters of universal health care systems include:
Common arguments forwarded by opponents of universal health care systems include:

Health care is a basic human right Debate in the United States
(In alphabetical order)

California Speaks
Health care
Health care systems
Journal of Health Care for the Poor and Underserved
Massachusetts 2006 Health Reform Statute
Medicare (United States)
Physicians for a National Health Program
Publicly-funded health care
Sicko (film)
Socialized medicine
The Citadel
Two-tier health care Support

British, Canadian Experience Shows Folly of Socialized Medicine, Analyst Says. Press release, Heritage Foundation. Sept. 29, 2000.
Capitalism Magazine
Dead Meat On The Fence's short film about Canada's socialized healthcare system.
The Heartland Institutes' Health Care Issue Suite
The Problems with Socialized Health Care from Mark Valenti's Liberty Page

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