SOC 280 Nationalized Healthcare Systems
SOC 280 Nationalized Healthcare Systems
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Possible Research Paper Topics
Alternative treatments
Narratives of health and recovery
Disability (mental and physical)
U.S. healthcare policy
Nationalized healthcare systems
Healthcare access and barriers
Additional at-risk populations
Additional illness experiences
Public health interventions
Metaphors and illness
Gender and the body
Race and the body
Social structure of medical education
Medicine and activism
Historical models of illness
Health education
Sexual and reproductive health
Health and social justice
Chronic illness
Bioethics and medical decision-making
Death and dying
End-of-life care
Genetic testing and diagnosis
Assisted reproductive technologies
Illness branding
Illness in literature and film
Medical experimentation
Developmental illnesses
Caregiving
Universal healthcare (also called universal health coverage, universal coverage, or universal care) is a health care system in which all residents of a particular country or region are assured access to health care. It is generally organized around providing either all residents or only those who cannot afford on their own, with either health services or the means to acquire them, with the end goal of improving health outcomes.[1]
Universal healthcare does not imply coverage for all cases and for all people – only that all people have access to healthcare when and where needed without financial hardship. Some universal healthcare systems are government-funded, while others are based on a requirement that all citizens purchase private health insurance. Universal healthcare can be determined by three critical dimensions: who is covered, what services are covered, and how much of the cost is covered.[1] It is described by the World Health Organization as a situation where citizens can access health services without incurring financial hardship.[2] The Director General of WHO describes universal health coverage as the “single most powerful concept that public health has to offer” since it unifies “services and delivers them in a comprehensive and integrated way”.[3] One of the goals with universal healthcare is to create a system of protection which provides equality of opportunity for people to enjoy the highest possible level of health.[4]
As part of Sustainable Development Goals, United Nations member states have agreed to work toward worldwide universal health coverage by 2030.[5]
Contents
1 History
2 Funding models
2.1 Compulsory insurance
2.2 Single payer
2.3 Tax-based financing
2.4 Social health insurance
2.5 Private insurance
2.6 Community-based health insurance
3 Implementation and comparisons
4 See also
5 References
6 External links
History
The first move towards a national health insurance system was launched in Germany in 1883, with the Sickness Insurance Law. Industrial employers were mandated to provide injury and illness insurance for their low-wage workers, and the system was funded and administered by employees and employers through “sick funds”, which were drawn from deductions in workers’ wages and from employers’ contributions. Named after Prussian Chancellor Otto von Bismarck,[clarification needed] this social health insurance model was the first form of universal care in modern times.[6] Other countries soon began to follow suit. In the United Kingdom, the National Insurance Act 1911 provided coverage for primary care (but not specialist or hospital care) for wage earners, covering about one-third of the population. The Russian Empire established a similar system in 1912, and other industrialized countries began following suit. By the 1930s, similar systems existed in virtually all of Western and Central Europe. Japan introduced an employee health insurance law in 1927, expanding further upon it in 1935 and 1940. Following the Russian Revolution of 1917, the Soviet Union established a fully public and centralized health care system in 1920.[7][8] However, it was not a truly universal system at that point, as rural residents were not covered.
In New Zealand, a universal health care system was created in a series of steps, from 1939 to 1941.[9][10] In Australia, the state of Queensland introduced a free public hospital system in 1946.
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Following World War II, universal health care systems began to be set up around the world. On July 5, 1948, the United Kingdom launched its universal National Health Service. Universal health care was next introduced in the Nordic countries of Sweden (1955),[11] Iceland (1956),[12] Norway (1956),[13] Denmark (1961)[14] and Finland (1964).[15] Universal health insurance was introduced in Japan in 1961, and in Canada through stages, starting with the province of Saskatchewan in 1962, followed by the rest of Canada from 1968 to 1972.[9][16] A public healthcare system was introduced in Egypt following the Egyptian revolution of 1952. Centralized public healthcare systems were set up in the Eastern bloc countries. The Soviet Union extended universal health care to its rural residents in 1969.[9][17] Kuwait and Bahrain introduced their universal healthcare systems in 1950 and 1957 respectively (prior to independence).[18] Italy introduced its Servizio Sanitario Nazionale (National Health Service) in 1978. Universal health insurance was implemented in Australia in 1975 with the Medibank, which led to universal coverage under the current Medicare system from 1984.
From the 1970s to the 2000s, Southern and Western European countries began introducing universal coverage, most of them building upon previous health insurance programs to cover the whole population. For example, France built upon its 1928 national health insurance system, with subsequent legislation covering a larger and larger percentage of the population, until the remaining 1% of the population that was uninsured received coverage in 2000.[19][20] Single payer healthcare systems were introduced in Finland (1972), Portugal (1979), Cyprus (1980), Spain (1986) and Iceland (1990). Switzerland introduced a universal healthcare system based on an insurance mandate in 1994.[21][18] In addition, universal health coverage was introduced in some Asian countries, including South Korea (1989), Taiwan (1995), Singapore (1993), Israel (1995) and Thailand (2001).
Following the collapse of the Soviet Union, Russia retained and reformed its universal health care system,[22] as did other now-independent former Soviet republics and Eastern bloc countries.
Beyond the 1990s, many countries in Latin America, the Caribbean, Africa and the Asia-Pacific region, including developing countries, took steps to bring their populations under universal health coverage, including China which has the largest universal health care system in the world[23] and Brazil’s SUS[24] which improved coverage up to 80% of the population.[25] India introduced a tax-payer funded decentralised universal healthcare system that helped reduce mortality rates and malnutrition.[26] A 2012 study examined progress being made by these countries, focusing on nine in particular: Ghana, Rwanda, Nigeria, Mali, Kenya, Indonesia, the Philippines and Vietnam.[27][28]
Currently, most industrialized countries and many developing countries operate some form of publicly funded health care with universal coverage as the goal. According to the National Academy of Medicine and others, the United States is the only wealthy, industrialized nation that does not provide universal health care.[29][30]
Funding models
See also: Health care economics
Universal health care in most countries has been achieved by a mixed model of funding. General taxation revenue is the primary source of funding, but in many countries it is supplemented by specific charge (which may be charged to the individual or an employer) or with the option of private payments (by direct or optional insurance) for services beyond those covered by the public system. Almost all European systems are financed through a mix of public and private contributions.[31] Most universal health care systems are funded primarily by tax revenue (as in Portugal,[31] India, Spain, Denmark and Sweden). Some nations, such as Germany, France,[32] and Japan,[33] employ a multi-payer system in which health care is funded by private and public contributions. However, much of the non-government funding comes from contributions from employers and employees to regulated non-profit sickness funds. Contributions are compulsory and defined according to law. 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, specialty healthcare is provided and possibly funded by a larger entity, such as a municipal co-operation board or the state, and medications are paid for by a state agency. A paper by Sherry A. Glied from Columbia University found that universal health care systems are modestly redistributive and that the progressivity of health care financing has limited implications for overall income inequality.[34]
