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Universal Healthcare Coverage

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Map of the different healthcare systems used by each country

Healthcare is defined as the process of caring, improving and curing those with physical and mental illnesses, injuries and diseases.[1]Health care is a basic universal and fundamental right that all individuals deserve access to. There are different types of healthcare systems, including universal healthcare coverage, and free market healthcare. Under universal healthcare, all citizens have access to healthcare, regardless of social standing and income.[2] The main objective of universal healthcare coverage is to provide a sense of protection for those who are unable to afford quality health care. The World Health Organization recognized that “the enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being without distinction of race, religion, and political belief, economic or social condition”. [3]

Question: Why should healthcare be a public policy instead of a marketable good or service?

Objectives of Healthcare

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The idea of commodification of everything is the white whale of neoliberalism. The idea that markets can decide everything perfectly, however, fails when it comes to the more basic aspect of human survival and human nature. In terms of healthcare, it is comparable to other social needs such as safety. If economics is about optimization, then to make healthcare work optimally, in accordance with its overall goals, a different approach needs to be taken.

To understand why means looking at the goals of healthcare: To save as many lives as possible. If this is the case, is it compatible with a profit motive? To place a financial incentive on wellbeing, implies that individuals who can pay extra for better care, have more value than those who cannot. Not only does making healthcare a commodity deny access to those who would need it more, but it creates perverse incentives within the healthcare system, such as increasing profit through pricing, reducing expenses through reduction in quality of care, and the selling of services to the highest bidder. The problem with commodifying a necessity is, everyone needs it at some point but makes it inaccessible to some, as saving people is no longer the goal, but increasing revenues.

Poor communities within society suffer from corruption the most. In the case of healthcare, “corruption might mean the difference between life and death for those in need of urgent care.” [4] Those who are unable to afford healthcare, are denied access to good health, and to life itself. This causes a vast majority of society’s populations to suffer from diseases and illnesses, but they are unable to seek aid due to the high costs of healthcare.

Efficient Healthcare

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"An efficient healthcare system can contribute to a country's economy, development and industrialization". [1]

Canada’s healthcare is ranked no. 1 worldwide, followed by Denmark and Sweden, [5] all three of which have healthcare systems that are free and mainly covered by their government, proving that a country’s healthcare system, that doesn’t focus on profit, but rather, the lives, health and well-being of its citizens, is efficient and effective.

The goals of healthcare is to prevent death and disability, maintenance and enhancement of quality of life, and personal growth. Outpatient goals are to provide rehabilitation treatment, as well as mental health services. To improve people's independence in performing tasks of daily living, and ability to communicate. The inpatient goal is to provide any immediate assistance or challenges that the person is facing, to correspond their goals, adaptations and assistive devices that need to be implemented.[6]

In countries where the costs of healthcare are not covered by their governments, insurance frauds and other loopholes are made popular within these systems, further corrupting them. Due to this, “hundreds of millions of dollars are lost each year to insurance fraud and corruption”.[4] With a free health care system, the rise of these corruptions, causing millions of dollars to be lost on an annual basis, would rapidly decrease and eliminate. These finances lost would be dollars gained, under a free health care structure, which can be used to maintain and further improve a healthcare system in which everyone benefits.

Inpatient vs. Outpatient Care

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Healthcare can be expensive for many reasons, including wages. Specialist workers also command high reimbursements. Additionally, in and out of emergency services receive patients that are more likely to have severe health problems including chest pains, or asthma attacks, which are considered more expensive to treat. Outpatient care, includes surgeries in one area that are specifically identified and described, and which shares the costs needed for procedures or operations that do not require overnight admissions of faculty. In addition outpatient care is less expensive than inpatient care. Inpatient care is costly, due to the facility fee and its requirements of physicians and surgeons.

"The key points of inpatient, by improving efficiency, can make inpatient care more cost-effective. It also helps to improve the quality of care. Clinical policies and protocols give physicians standards by which to assess the efficiency of the care they provide. For a complex case, one physician should act as 'commander', and doctors covering on weekends should be empowered to discharge. Other tips include using consultants and allied services efficiently, as well as evaluating whether traditional care approaches are justified".[7]

Consequences of Commodifying Healthcare

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There are many consequences that come with free market healthcare, including several examples, where budget cuts caused loopholes to be used in the system. The following are real life examples of the consequences of commodifying healthcare.

Ticket Scalping

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‘Should patients be able to jump the queue for medical care simply because they can afford to pay extra?’ [8] Top hospitals in Beijing are charging patients to queue in line. Due to budget cuts, many public hospitals in rural areas have been closing down, causing long lines in hospitals in the city. Patients queue up for long periods of time, including overnight to even up to multiple days at a time, just to be able to get an appointment to see the doctor. Some patients have found a loophole in this system, and buy their tickets from scalpers. Those who can afford to pay others to queue in line for them, are dong so, without needing to physically wait in line for hours to days at a time. The affluent are able to take advantage of this system, while the poor are deprived of a spot in line, which creates a system where the affluent have an easier access to healthcare, than the poor.

Concierge Doctors

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In the U.S. doctor appointments involve long hours of waiting, and must be scheduled weeks to months in advance to spend three hours to see the doctor for 10 minutes. This is due to the fact that physicians in general practice aren’t paid much for routine appointments. Therefore, in order to make a decent living, thousands and thousands of patients are seen by one doctor, causing physicians to have to get through up to thirty appointments in one day. Due to this, physicians have opted to a different method to perform their medical practice. For annual fees ranging from $1,500 to $25,000, patients are guaranteed same-day, or next-day appointments. To convert to this service, doctors drastically reduce the number of patients they have, causing their patients to choose between the new service, or finding another doctor. [8] This system help only a few, while forcing majority to suffer the long waits of physicians, which enables the affluent to jump the queue for medical care, while leaving a greater number of the population without access to basic healthcare and the means of survival.

Selling Blood

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The problem with buying blood is illustrated: Poorer people use selling blood as a way to pay bills, while wealthier people assume they don’t need to give blood, because someone else is being paid to do so. This leads to an exploitative situation where only poor people give blood and only for money, leading to contamination and waste.[8]


Commodification makes healthcare inefficient. Having hospitals competing through pricing means lower quality of care, causing doctors and nurses to work less likely in an area where their skills may be needed if they can live more comfortably elsewhere. Specialist care becomes less available, as money incentivizing care means, those who specialize are also looking to profit and will only offer their services where they are best compensated. Their skills are transferable, but the lives and well-being of patients, aren't. This creates a paradox within the healthcare system, if profit is incentivized. In order to compete, hospitals have to lower costs. The issue with this is, hospitals are unlike other businesses. They do not simply sell items and goods. They must maintain a quality of care to remain effective, or the consequences includes loss of human lives, due to citizens being unable to receive the care they need, at the price provided; in turn, causing supply and demand to become highly inelastic. Doctors will become scarce, as medical student prospects are no longer incentivized to become medical professionals, due to the high educational requirements. However, lowering the standards won't create more doctors either, it will only reduces their effectiveness. While there are preventative measures any healthcare system can implement, including over the counter medications, vaccinations and education, there will still always be a need for healthcare since people always get sick and you cannot prevent every disease or illness.

By looking at the overall needs of society, in terms of healthcare, this illustrates how focusing on market profiteering in economics eliminates key parts of human nature, such as altruism, and instead of using economics only as a way to gain efficiency for the sake of profit, it's important to consider how it can be used to optimize and serve the needs of society. In terms of healthcare: to serve everyone in society with the highest quality of care at the lowest possible cost. Due to this, a universal healthcare system makes access to healthcare for all, more efficient and effective than other systems.

References

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  1. ^ a b "Health care", Wikipedia, 2020-03-24, retrieved 2020-03-27
  2. ^ "Right to health", Wikipedia, 2020-02-19, retrieved 2020-03-29
  3. ^ Basic documents: forty-ninth edition (including amendments adopted up to 31 May 2019) (PDF). Geneva: World Health Organization. 2020.
  4. ^ a b Moszynski, Peter (2006-02-04). "Corruption in health care "kills en masse"". BMJ : British Medical Journal. 332 (7536): 257. ISSN 0959-8138. PMC 1360388.
  5. ^ Radu, Sintia. "Countries With the Most Well-Developed Public Health Care Systems". U.S. News.{{cite web}}: CS1 maint: url-status (link)
  6. ^ cskopecce (2019-06-18). "Inpatient vs. Outpatient: Comparing Two Types of Patient Care". www.sgu.edu. Retrieved 2020-03-29.
  7. ^ McCleave, Spencer. "Tips for Making Inpatient Care More Efficient". FPM.{{cite web}}: CS1 maint: url-status (link)
  8. ^ a b c Sandel, Michael (2012). What Money Can't Buy. United States of America: Farrar, Straus and Giroux. pp. 25–8. ISBN 978-0-374-53365-6.