Universal health care/universal health coverage (UHC) exists when all individuals are able to access quality health care without the suffering financial hardships. The achievement of a UHC involves a political process with negotiations between different interest groups. Civil society organizations have been in recent years at the forefront as representatives of the poor and vulnerable in such negotiations by seeking to have a more equitable distribution of the responsibilities of funding the system as well as the enjoyment of the accruing benefits. In consistency with these organizations, nurses have also played a crucial role in supporting policies promoting equity, effectiveness, and efficiency in ensuring that the poor and vulnerable also enjoy quality healthcare services.
UHC has two essential components, that every person has full access to all health services, which are of high quality. These include promotion, prevention, treatment, rehabilitative, and palliative services (World Health Organization, 2013). Quality is emphasized here for there is no sense in people having access to medical facilities and equipment that are handled by unqualified or untrained individuals. The second component is that the individuals should be protected from financial risks that accompany the process of seeking healthcare. Where payments for medical assistance is required in any form, people seeking may be disadvantaged especially if they are from lower socio-economic backgrounds. The priority is on the poorest and most vulnerable with the aim of reducing the inequalities in healthcare (World Health Organization, n. d). Thus, such people may be discouraged from seeking care thereby worsening their health conditions. The most appropriate responsive measure towards this challenge is expanding coverage with compulsory prepayments, such as insurance premiums or taxes, whose pool spreads the risks associated. The key of protecting people from financial hardships is ensuring that most funds for the health system are prepaid and there are minimal if any barriers to the redistribution of these funds (Boerma et al. 2015). Customization of the contributions would be essential in order to take into account the contributors’ ability to pay.
Healthcare is a basic need for every human being. A country’s government should ensure that every person has access to quality healthcare assistance regardless of age, gender, or economic status. While most industrialized countries, such as the United Kingdom, Canada, France and others have a system of a single payer where their citizenry access healthcare without incurring financial hardships, the United Stated has not implemented such a system. Even the emerging world economies, such as Brazil and India are championing different forms of UHC by looking beyond local corporates and onto the global ones, such as the WHO and the International Monetary Fund for funding (McKee et al. 2014). While the Affordable Care Act (ACA), signed into law by President Obama, has crucial provisions it is still inadequate as a universal health care policy. Some of its significant provisions include coverage expansion reaching out and delivering health insurance coverage to all populations, assuring equity in healthcare provision across all communities and populations, training the healthcare providers in matters of cultural competency and literacy, quality improvement through innovation, and improving public health and wellness (ACA, 2010). The full implementation of the Act aims at improving Medicare’s long-term financial outlook through the inefficiencies of the Medicare Advantage Program (Clarke & Bidgood, 2013). The growth of Medicare’s payments has been extremely slow.
However, the US health care system has a myriad of private and public programs, services, products, institutions, and information, significantly challenging those seeking affordable and quality health care (Somers & Mahadevan, 2010). Any individual seeking medical assistance requires a constellation of literacy skills to understand all the critical aspects of the healthcare system, such as insurance eligibility, medications and prescriptions, medical technology, disease prevention and management among others. The ACA has a near-universal guarantee of accessibility to affordable health insurance coverage, from birth throughout to retirement (Rosenbaum, 2011). Its implementation has resulted in the insurance coverage of over 90% of the American population but millions still remain uninsured, which has led to an increase of negative health outcomes, such as higher infant mortality rates, obesity rates, and lower life expectancy as compared to other industrialized countries.
At its root, the lack of accessibility to quality health care by an American due to financial hardships is in itself a moral issue. The government ought to be the sole financier of a UHC. The financing arrangements ought to be such that people pay their premiums to their chosen insurer, the government supplements private premiums through financial support payments made directly to insurers on behalf of the individuals, direct government financial support to other related medical services, such as ambulance services. The creation and implementation of certain structures, such institutions, additional regulatory measures, new financial mechanisms, information systems, and patient-centered integrated measures would create the necessary bridge of moving from the current healthcare system and onto a universal healthcare system. Due to lack of a form of UHC, a significantly large segment of the American population pay much more for out-of-pocket prescriptions, is less likely to report a condition needing medical advice thereby delaying the timeline for diagnosis and the subsequent prognosis of the disease, and have a higher likelihood of receiving poor care for chronic diseases. A universal health care system would among other things, ensure an efficient and well-run health system where every person has access to essential medical services and technologies without experiencing financial hardships.
- Boerma, T., et al. (2015). Tracking Universal Health Coverage: First Global Monitoring Report. WHO.
- Clarke, E., & Bidgood, E., (2013). Healthcare Systems: The USA.
- McKee, M., et al. (2014). BRICS’ Role in Global Health and the Promotion of Universal Health Coverage: The Debate Continues. Bull World Health Organization, 92, pp. 452-453.
- Rosenbaum, S., (2011). The Patient Protection and Affordable Care Act: Implications for Public Health Policy and Practice. Public Health Rep, 126(1), 130-135.
- Somers, S. A., & Mahadevan, R., (2010). Health Literacy Implications of the Affordable Care Act. Centre for Health Care Strategies.
- The Patient Protection and Affordable Care Act (ACA), 2010.
- World Health Organization. (2013). Arguing for Universal Health Coverage. WHO.
- World Health Organization. (n.d). the Global Push for Universal Health Coverage. WHO.