Universal Coverage: Nothing to Fear

Oct. 18, 2006 — -- Most people know that all other developed nations -- like England, Canada, Germany or Japan -- provide universal access to public health-care coverage but spend far less than we do for health care.

But most Americans worry that if the United States adopted a public system of universal health-care coverage, this wealthy nation would not be able to pay for it while still providing the kind of health care that those Americans who are now insured are used to.

The question is: If the United States did adopt a universal health-care system, would those of us who are now insured and have reasonably good access to health care be denied the health care we want or need?

Or, would health care be rationed?

The experiences of other nations could shed some light on the subject.

Every country organizes health-care financing in its own way.

A few like the United Kingdom are "single-payer" systems administered by the national government and funded from general taxes.

Others are funded by general taxes, but are, like the Canadian system, decentralized, and funded at both the national and state or local level.

Many systems, including the German, French and Japanese, are social insurance systems.

Countries also organize health-care delivery in their own way.

In some countries, health-care services are provided directly by the government, but in most countries services are provided by private hospitals and professionals.

There is one thing that all these countries have in common -- in no country does everyone get all the medical care that they want or from which they could benefit.

Resources for health care are limited and have to somehow be divided up among a country's citizens.

The United States divides up health-care resources even now, even without universal coverage. America allocates most health-care resources on the basis of whether or not people can pay for those resources.

Most people think that kind of allocation is unfair or unjust, even irrational. The healthy baby of a wealthy family may get more medical attention than the sick baby of a low-income family.