The issue of how to make health care systems universal health care (UHC) and sustain the improvements as long-term benefits is a debate in many countries. UHC is a prominent political plan, especially in the US and other developing nations like Russia, China, India, or Brazil. Typically, a UHC is a system that provides quality medical services to all people. Governments are responsible for offering this privilege to everyone regardless of ability to pay. Sheer costs of availing quality health services make UHC an expense of the government. In most cases, universal healthcare is funded by taxpayers’ money. The United States is among the nations that do not have effective Universal health care. The purpose of this paper is to discuss the issue of UHC in the US and how to get it implemented.
Defining the issue
Compared to other states in the western world, the US spends more capita income on health. Despite the enormous spending, general standards of health like infant mortality or life expectancy are low compared to those nations with little expenditure on health. Costs are vast, yet most Americans do not fare well. Currently, the healthcare system of the US is based on insurance coverage, and many individuals are covered by employers or are privately insured. The disadvantage of this type of coverage lies heavily on those who are unemployed, elderly, or disabled. The government’s approach to such insufficiency of coverage is through public insurance programs that were formulated under the social security amendment. The provision created Medicare- that avail medical insurance for the elderly, and Medicaid that grants coverage for individuals below specific income level.
Nevertheless, despite these programs designed to help less privileged in employment, there are about 40 million people uninsured in the US. Most are people who do not fall below the required level of income that grants Medicaid, yet employers do not provide insurance cover. Typically, insurance that is not tied to employment is costly- a burden for uninsured citizens. Two dimensions mark the crisis of the health care system in the US; the rising cost of medical services and restriction to access.
The economic dimension of sustaining UHC derives from the debate on health care spending and wealth. After the second world was, most capitalist economies invested in availing welfare services like healthcare and thus led to considerable expansion of insurance. But, notably in the US, the growth rate in total health care expenditure outdid rise in gross domestic product. Such observation stirred concern regarding the affordability in the end.
From a veneer of consensus, UHC has been a political concept. In the world of health and leadership, political perspective towards universal care is part of the ongoing debate concerning the various priorities on how to strengthen systems. Politics, demography, and economy have been considered significant structural factors that have to be developed by every state to achieve complete health coverage. Political stability is a vital element in this case for development when it comes to matters such as social security. Governing factors determine how well health care services are delivered to citizens. Transparency, efficiencies, and quick delivery of healthcare services are the primary focus with governance according to the world health organization (WHO) view.
The term sustainability was coined in the 1960s, within the domain of environmental policies. But the meaning of social sustainability has not yet been fully clarified. All the same, there is an emerging consensus on the notion that diversity, equity, interconnectedness, and democracy are all features of social sustainability. Holding the consensus in mind, about health care, it is questionable whether the UHC takes system and people closer to being socially sustainable. Undeniably, healthcare, when given universally, help achieve equality. With the introduction of universal care, various disparities service access would reduce.
Ethical Concerns
American citizens face ethical conflict regarding the subject of universal health coverage. Like the case with any ethical issues, choosing specific outcomes over others amount to a selected set of values over another. In this case, stakes are high, and every American is a vital stakeholder. A most overt conflict about UHC is the virtue of government entitlements. Most individuals in favor of UHC believes that public resources should protect the vulnerable population. Based upon such value, the group holds that those who are unable to pay or afford coverage ought to be provided with government entitlement to gain access to care. On the other hand, opposers support with a deep-seated belief that government entitlements are not the right approach to the issue of uninsured people. Many are those who believe entitlements do more harm than good. Another argument against the UHC is that system that has universal coverage involves heavy doses of rationing. What seems to be in question is whether or not citizens have a generous spirit to make sure that every American is insured. Another ethical issue is pointed in those societies which seek to promote equal opportunities by attempting to control characteristics of births. Lastly, UHC demand cost-sharing in forms of hiked taxes or health premiums for some people, a moral imperative to give the coverage outweigh the cost incurred.
Possible Options for resolving the issue
To reform the current healthcare system is a priority at state and federal levels. Among other first world nations, the US is unique such that it does not have a national policy that other countries have or payers, consumers, providers, and purchasers. Possible options that I think would resolve the issue of universal health care in the US would be implementing Beveridge, Bismarck, single-payer, or out of pocket models. In the first system, Beveridge, healthcare is availed and financed by the government via payments of tax the same as the police force. Some commonwealth nations, together with global community members, have a goal of attaining universal health coverage by 2030. As such, they have embarked on making sure people have equitable access to health services without facing financial hardships. To see that enforced, nations mobilize sufficient public funds in the form of social health insurance. The key reason for that is to keep out of the pocket-spending low. The Beveridge model uses general revenue taxation to pay for services and is usually delivered by the public sector system. Sweden, the UK, and New Zealand are an example of nations adopting this approach.
Bismarck system is a model of availing health care through insurance systems where insurers are referred to sickness funds- sponsored by joint employees and employers via payroll deductions. The plan is a contributory approach for health insurance and finances public schemes that pay for services at private providers. A prototype of this framework was established in Germany, and it benefited contributors, limiting coverage to formal sector workers- whom compulsory deduction could be made. Other nations that use this approach include Belgium, Netherlands, Switzerland, and Japan. Either way, whether a country decided to use Beveridge or Bismarck, practically, they must mobilize at least 3% of GDP.
The third option is a single-payer, which takes the element of Bismarck and Beveridge. The model uses private-sector providers although payments come from an insurance program run by the government and citizen pays to into it. Typically, there is no need for marketing, profit, or financial motive to deny claims; the insurance program would be cheaper and simple to the administration as compared to the current American style of for-profit insurance. Single-payer, also known as the NHI-system, is implemented in Canada, in newly industrialized states like South Korea and Taiwan. The last alternative is allowing a mandated system and supplement from the public. US government would require employers to ensure all their workers via a play or pay program. Suppose the employers fail to provide coverage-play, then they will be forced to pay a payroll tax that is costly than the insurance itself. The primary incentive is to have workers’ plans and with this kind of system. A significant percentage of the population would be covered in the employer-based system making it for the authority to pinpoint the few who are left out. Individuals who have no access to this form would benefit from financed insurance by an expansion of Medicaid program or introduce other policies for them.
Option with the Greatest Impact on the Profession of Nursing
Among the four-alternative provided, I think a single-payer approach would incur the most impact on the profession of nursing. Despite the goal for universal health care (UHC), which is to provide access to the majority of the public, a single pay model incurs vast influence in the nursing profession by expanding patient population, resource utilization, and cost measures. In the US, medical costs have been hiking rapidly for many years, and so has been the number of uninsured. The latter is estimated to be high as 47 million, and policy proponents suggested the adoption of a single-payer system to expand care access or affordability. Under this strategy, the government would be in charge of reimbursing most medical services that hospitals and clinics avail.
The main problem is the overuse of healthcare facilities, especially those that have expensive and advanced technologies as well as drugs. Nurses will face the induced pressure to serve a wide population of patients who have varying medical needs. Although lousy it seems, healthcare cost keeps patients from overcrowding in hospitals, and since the US is in battle with the issue of staffing, the situation could be worse for professions. The single-payer model will subject physicians to unwanted or unforeseen government oversight concerning healthcare decisions. The government may restrict the use of potential therapies and pay for the perceived differences in quality. Also, without competition in price between medical service providers, the government would be free to whatever amount it wants to healthcare workers. Already, physicians and nurses are inadequately reimbursed for services under Medicaid, and reduction in Medicare reimbursement have in the past few years have affected access and quality of care.
In conclusion, this paper aimed to discuss the issue of UHC in the US and how to get it implemented. The US government and healthcare system need to take a serious look at the facts of the country and compare the performance with that of other nations. Otherwise, the universal health care approach, although not easy to achieve overnight, will continue to be a real issue in the country.