Universal healthcare in the U.S. remains one of the most hotly debated and most
important issues to Americans. With advances in communication and medical device technology
and revisions in reimbursement policy, we have near universal healthcare availability in the U.S.
Having something available doesn’t mean that everyone can have access to it. Finances prohibit
many from accessing ubiquitous services, including healthcare. Even people with insurance make
decisions based on their out-of-pocket cost about when they will access healthcare services.
What we are talking about is universal healthcare financing or universal healthcare insurance.
“The U.S. has historically utilized a mixed public/private approach to healthcare (Zieff, Kerr,
Moore, & Stoner, 2020).” Zeiff, Kerr, Moore and Stoner (2020) noted that the concept of
universal healthcare is complex and not choice between distinct options. Despite noted
advantages including reducing disparities, increasing opportunities for preventative health
initiatives, and the ability to address the epidemic level of non-communicable chronic disease
and the economic strain of an unhealthy population, a key driver of debate is how would the U.S.
pay for universal coverage of healthcare costs (Zieff, Kerr, Moore, & Stoner, 2020).
The Affordable Care Act of 2010 (ACA) attempted to improve the overall population’s
health by increasing the number of people covered by health insurance, but it kept the general
structure of the system intact. Though the legislation imposed additional restrictions on
insurance companies, to protect consumers, it did nothing to address the rising cost of healthcare
and implemented a mandate for employer-based insurance coverage including minimum covered
benefits, and that every adult acquire health insurance somehow. The expansion of public
insurance to include people who would not previously qualify, allowing parents to keep their
adult children on their insurance policies, and the facilitation of health insurance exchanges in
the states were some strategies included in the ACA to increase access to health insurance.
Though the federal government is the largest payer of healthcare costs annually for seniors and
disabled-persons, people in the general workforce generally do not have a deep trust in the
federal government and do not trust the federal government to make healthcare decisions on
their behalf (Dalen, Waterbrook, & Alpert, 2015).
References
Dalen, J., Waterbrook, K., & Alpert, J. (2015, August). Why do so many Americans oppose the
Affordable Care Act. The American Journal of Medicine, 128(8), 807-810.
doi:10.1016/j.amjmed.2015.01.032
Zieff, G., Kerr, Z., Moore, J., & Stoner, L. (2020, November). Universal healthcare in the U.S.: A
healthy debate. Medicina, 580. doi:10.3390/medicina56110580
