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).” a 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
