Most developed nations such as Japan, Canada, the United Kingdom, South Korea, and Switzerland
provide universal health care to their citizens, however, the United States has yet to adopt this
system (New York Department of Health, 2011). The question becomes why? There are pros and
cons to universal health care. The cons include large costs to implement the system and create the
processes needed while obtaining resources to run the new system (Zieff, Kerr, Moore, & Stoner,
2020). Another con includes the projected higher federal taxes for the population. Many people
may wonder why they are paying more in taxes to pay for someone else’s healthcare. Lastly, a big
argument many Americans make is that they do not want the government involved in more than
is necessary. This philosophy aligns with the laissez-faire system where there is a free system and
the government does not interfere.
After considering these cons, it is important to note all of the pros of universal healthcare. First,
while there may be large upfront costs for implementing this system, in the long-term, the
economic costs would decrease as the nation becomes healthier with free access to healthcare
(Zieff, Kerr, Moore, & Stoner, 2020). Aligned with the pro of lowering cost, the decrease in chronic
disease would likely be a benefit of universal healthcare as Americans are not worried about the
cost, insurance hassle, or access to healthcare and are more likely to seek out help. Additionally,
universal healthcare would work to eliminate some major disparities seen in access to healthcare
as well as quality of healthcare. There are many pros to universal healthcare that would benefit
everyone but the strong argument against government involvement prevents the implementation
of such a system.
The development of national health insurance presents logistical challenges and will require large
upfront costs related to changes in healthcare technology infrastructure, expanding the range of
healthcare services provided, and treatment of a large portion of the population that is healthy
and previously uninsured (Zieff, Kerr, Moore, & Stoner, 2020). The increased costs are just one
reason that Americans are against the idea of national healthcare coverage- because it will
increase their taxes. Another argument that Americans make against national health insurance is
because of the potential for an inefficient system including longer wait times and impeded medical
innovation. They compare wait times in Canada and UK for procedures and surgeries that range
anywhere from 3 weeks to a year. The disorganization and increased wait times could result in an
influx in people seeking care in the emergency room and subsequent increases in wait times for
emergency services (Zieff, Kerr, Moore, & Stoner, 2020).
Another reason that citizens do not want universal healthcare coverage is due to distrust of
government officials. Research has shown that Republicans are especially distrusting of the
government’s role in healthcare although most Americans are in Favor of programs such as
Medicare (Dalen, Waterbrook & Alpert, 2015). I think there is a lot of pushbacks for universal
healthcare coverage that stems from decades ago when universal healthcare coverage was initially
proposed. In the 1930s physicians campaigned to prevent federal officials from including national
health insurance in the social security act (Quadagno, 2004). Then in 1945 Truman proposed
national health insurance and the AMA lobbied against it with the message that national health
insurance was socialist and part of a Communist plot to destroy freedom (Quadagno, 2004).
Although many years has passed since then, there are still lingering subconscious thoughts and
opinions that national healthcare coverage is bad.
Why don’t American’s want universal health coverage? There are several reasons, but it boils
down to two key tenants: it is un-American, and they do not trust the government. That sounds
harsh, does not it! Let us look at the details more closely.
b b b b Americans in general, compared to other large industrial nations, embrace the idea that
government should have a more limited role in society. “As a nation that began on the back of
immigrants with an entrepreneurial spirit and without a feudal system to ingrain rigid social
structure, Americans tend to be more individualistic” Wilson (2012). Universal coverage clashes
with this belief. Universal coverage is equivalent to socialized medicine in the minds of many and
that is un-American (Callaghan, 2016).
Another compelling reason that we do not have universal coverage in America is because interest
groups do not want it. The health insurance industry has been a key player in influencing the
political process. The health insurance industry is big business and according to IBIS World in 2021
the health insurance industry was a $1.1T industry. They do not want things to change, and they
are spending $100M (2009 data) to keep private insurers as opposed to the government as the
key player in American healthcare (Callaghan, 2016).
Lastly, while most Americans support Medicare, they do not want to trade their patient centric
private insurance for a government plan. Private plans are accountable to the patient and the
“vast majority of our citizens do not trust their government” Dalen (2015). Americans have seen
the reality of universal coverage in countries such as Britain and Canada and seen millions of
patients facing frustrating delays and denials, experiencing long and often painful waits for care
(Moffit, 2022). Generally, most Americans are satisfied with their current coverage, despite the
cost and do not want to be forced to move to an “ill conceived, economically inefficient and
outdated government intervention” Moffit (2022).
Healthcare in the United States is governed by a complicated bureaucracy. "Over the last century,
American health care has thrived. Rather than impeding advancement, the complicated regulatory
framework, for all its failings, may have contributed to nourish and foster the broader industry"
(Field, 2008). Unlike the rest of the world, where medical facilities are generally controlled by
governments or private enterprises, most hospitals and clinics in the United States are owned by
public institutions or private organizations. However, the United States has the highest healthcare
prices in the world. Although these costs are borne mostly by public payers such as federal
organizations or state and municipal governments, they may also be privately insured and borne
by individuals. At the same time, unlike most developed countries, the United States' healthcare
system does not cover the entire population. Because there is no single national health insurance
system, the United States is mainly reliant on employers to offer health insurance for employees
and their dependents on a voluntary basis. Furthermore, the government offers programs that
tend to pay the expense of health care for disadvantaged groups in society, such as the old,
disabled, and destitute. These programs are all unique, and each one caters to a distinct
demographic.
The US government does not provide health insurance to everyone, and it is not essential for
those who live in the US to have health insurance. This is optional, but highly recommended and
necessary due to the exorbitant cost of health care in the United States, which is higher than in
any other country on the planet. "Health systems that fail to adapt to changes in fundamental
public health ideas face enormous inequities and consequences from preventable disease,
disability, and death" (Theodore, T and Elena, V., 2014). In the United States, there are two types
of health insurance: private and public. Most individuals use a mix of the two public health
insurance programs in the United States, which are Medicare, Medicaid, and the Children's Health
Insurance Program. Although insurance prices are reduced, this does not translate into decreased
medical costs. Obamacare's patient benefits will be repealed, resulting in the loss of coverage for
millions of Americans' medical treatment but still, incur high insurance costs.
I have heard many times over that Universal Healthcare is a big no-no for our Country, but I never
actually researched the reason why this is such a pushback. I came from a country who did have
Universal Healthcare; however, I have always heard that care was not as great as the care we
would receive in the US, and many times, I have heard that it is nearly impossible to find a
specialist in a timely fashion. I have also heard that it is very costly for the population, as taxes are
very high.
According to US News, (2016), there are 3 reasons why there is such a pushback over universal
healthcare. One reason is that our culture simply does not want it because they believe that the
government should have limited involvement in healthcare. Another reason is that interest groups
and lobbyist are not interested in having universal healthcare. Lastly, it would be very difficult and
expensive to enact. (Callaghan, 2016)
An article from the National Library of Medicine, claims that there are benefits to have a universal
healthcare system, such as a healthier population and less disparities, however, there are also
cons. Some of these cons that have given pushbacks against this matter include: 1. Increased
federal taxes, as high as 7.5% payroll, and 4% income tax; 2- system inefficiencies, such as length
wait times for patients seeing specialist and having elective procedures done; 3- unorganized
government systems. (Zieff, Kerr, Moore & Stoner, 2020)
It is safe to say that people seem to be very concerned with the cost this may imply on the
population, especially since may people already pay large a large amount of money for healthcare
insurance and out of pocket costs, as well as high taxes to provide government healthcare plans.
People also seem to have a push-back against the government being too involved in healthcare.
Worries of our healthcare quality decreasing may also be a concern.
The United States spends substantially more on health care than any other nation in the world,
spending more money on health care for those over the age of 65 than any other nation spends
for its entire population. Although the United States offers the most sophisticated and advanced
treatments that exist in the health care industry, we still suffer from worse health outcomes,
including lower life expectancy, higher infant mortality rate, and higher obesity than other
countries such as Australia, Canada, and the United Kingdom (Vladeck, 2003). Although President
Obama’s Affordable Care Act (ACA) moved toward the direction of expanding access to health care
to more people and ensuring that insurers cannot deny coverage because of an applicant’s
preexisting conditions, it was criticized for its flaws and President Trump pushed to repeal it. The
question remains as to why universal health care in America is not currently being considered,
although Medicare, Medicaid, and CHIP do currently serve to protect some of the nation’s most
vulnerable populations.
One reason there’s pushback regarding universal health care coverage in America is the unique
political culture. Americans, especially conservatives, hold a strong belief in classical liberalism and
feel that the government should have a limited role in society. The International Social Survey
Program discovered that a lower percentage of Americans believe health care is a government
responsibility when compared to individuals in other advanced countries, such as Germany or
Sweden (Callaghan, 2016). Furthermore, interest groups that influence political processes play a
strong role in universal health care opposition. For example, in 2009 the legislative battle over the
ACA generated $1.2 billion in lobbying. The insurance industry alone spent over $100 million
shaping the ACA and keeping private insurers (as opposed to the government) as the major power
holders in American health care. When discussions regarding universal health care are raised,
these lobbyists are quick to mobilize to prevent implementation. Additionally, America’s political
institutions make it difficult for entitlement programs to be implemented. Policy experts have
explicitly shared that the U.S. “doesn’t have a comprehensive national health insurance system
because American political institutions are structurally biased against this kind of comprehensive
reform.” Any major attempts at comprehensive reform must pass through congressional
committees, budget estimates, conference committees, amendments, and a potential veto while
opponents of reform publicly scrutinize the bill (Callaghan, 2016). This makes it extremely difficult
for any major reform to successfully pass through the obstacle course. Lastly, Americans are
worried that universal health care will create greater costs to them in the form of taxes. Many
Americans are against the idea of having to pay more out of pocket to keep the entire population
protected. Since Americans already must pay such high health care costs, the thought of having to
pay even higher costs is out of the question for them.
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