Harmonies of the World by Johannes Kepler
Our United States health system is dysfunctional. It leaves many without coverage, is the most expensive of the world, and drives many others into bankruptcy and poor health outcomes. Our two-tiered system of care maintains access for Americans with comfortable incomes but restricts access for everyone else, noted by Anthony Kovner, PhD as a particularly brutal form of rationing. Majority of us agree that things must change, but we hardly make much progress because we can’t seem to find something that unites us all in our great healthcare debate. I contend that there actually is common ground. Our current President once noted, “Nobody knew healthcare could be so complicated.” However, at its core it really isn’t.
An interesting analysis done by the Office for Economic Cooperation and Development (OECD) showed that there seems to be a connection between life expectancy and how much we spend on healthcare. However, that’s not the case for the United States.
This may explain why we spend the most over any other comparable country in the world yet our health outcomes are poor and we have a higher level of disease burden than they do. What is it that we are doing differently from these other countries other than leading the world with the highest obesity rates? The most important difference is that we don’t have Universal Health Coverage for our citizens and instead treat healthcare as a commodity. We are the only developed country in the world that does this.
Universal Health Coverage is one of the most widely shared goals in public health around the globe. While countries do implement different funding mechanisms, they all focus more on who has access to the care. There are two specific instances where the United Nations unanimously declared Universal Health Coverage as a public priority for our world. The first was in 1948 when fifty-three-member countries signed the Universal Declaration of Human Rights agreeing that all member countries would ensure their citizens have the right to adequate health as a public good and not a commodity. Then again with the Sustainable Development Goals of 2015 stating that all UN Member States agree to try and achieve Universal Health Coverage by 2030 urging governments to move towards providing all people with access to affordable, quality health care services as a part of sustaining our human race and planet.
Only the developed, industrialized countries (thirty to forty of the world’s two-hundred countries) have established health care systems. These developed countries achieve Universal Health Coverage in several ways, each with its own set of arrangements. None of them trust the free market completely and instead impose regulations like these: insurance companies must accept everyone and cannot make a profit on basic care, everyone is mandated to buy coverage or pay taxes to cover it, the government pays for the poor who cannot, and doctors and hospitals have to accept a standard set of fixed prices. Additionally, not all of the countries do what’s considered socialized medicine, instead many have private doctors and hospitals as a part of the equation. Let me repeat that—single-payer healthcare does not automatically mean socialized medicine.
World Health Organization had its 1st Global Symposium on Health System Research in 2010 and had this summary: Out of the countries in their analysis, seventy-five had legislation that provided a mandate for Universal Health Coverage independent of income. The United States was still not one of them. I reached out to a woman who works for the World Health Organization to get some information about accountability towards Universal Health Coverage …