Or something similar to ACA? (Or what it should be.)
I think a better way to phrase the question would be:
“can anybody name an industrialized country which does not provide government health care to all its citizens”?
As far as I know , the only country on that list would be the USA.
Yes, I think that better expresses what the OP seems to be asking.
Thanks, that sums it up beautifully. I suspected as much, but wasn’t sure.
My next question would be: How long have these other countries been on board with government health care?
The history section contains the information you’re after.
Note that some of that article is true only for some definitions of “universal”. For example, it indicates that Spain introduced UHC in 1986. The original designs for Seguridad Social (under other names) called for it to cover anybody who wasn’t covered under a system already in place, the mutuas. Mutuas are private insurance schemes/companies; in this context, they are sector-linked healthcare schemes. For example, the National Policemen Mutua still exists and provides additional coverage.
The 1986 change was a move from that mixed model to one where the single-payer system absorbed any coverage the mutuas provided which equaled that provided by Seguridad Social; this was prompted in part by several cases of double billing or inappropriate billing, even if it was announced as “finally, universal coverage!” In theory it also extended coverage to people who had never paid into any schemes (either personally or any first-degree relative), but I’ve never seen figures on how many people those were.
I love how government funded healthcare is nicknamed ‘socialized’ in the US to make it sound all ‘eek communism’.
Factually, though, isn’t it accurate to say government-funded healthcare is socialized? The same as public education?
The socialsm = communism thing is a different story, and one I’ve never understood.
Not quite. Socialism is state ownership of the means of production. In the case of health care, that would be government owning hospitals, directly employing doctors, etc. Under most “socialized medicine” schemes, the government pays for healthcare, but doesn’t own the health care infrastructure. This is just wealth redistribution, or welfare, not socialism. Of course, many American politicians have been failing to distinguish between the two for decades.
Thank you, Gorsnak.
Yes, all civilized countries provide government-paid health care.
There may be nominal taxes dedicated to support this; but I have not heard of any civilized, first world country where out-of-pocket medical expenses will bankrupt the patient. Unemployment during extended sickness may have a detrimental effect, but most civilized countries also have some form of unemployment/sickness coverage for the medium term. For the long term, there are disability pensions similar to the USA’s Social Security, but obviously not at the same level as a good middle-class income.
No. Again, you are confusing socialism with communism. The definition of socialism, as the word is used in practice in most of the world (as opposed to the USA, where it is mostly used just to scare people with some sort of vague association with Stalinism), is a good deal looser and broader than that. It may involve some degree of state ownership of some of the means of production (not that medicine is a means of production anyway), but it does not have to.
I would say that’s an overly simplified. A lot of countries have laws in place that oblige individuals to obtain health insurance, and the health insurance schemes have some sort of socialisation in place in the sense that the premiums paid by individuals do not fully and accurately represent the risk the insured individual represents from an actuarial point of view, so that cross-subsidisation among insured patients takes place. But this is not the same thing as “government-paid healthcare”, which, in the strict meaning of the word, is actually rather rare (the UK is an example). Germany, for instance, operates a two-tiered system where the majority of the population is insured in a statutory scheme where the contributions are calculated as a percentage of income. That’s as close to a “government-paid healthcare” system as it gets, but there is actually a variety of providers offering this insurance, with competition among them taking place. A smaller percentage of the population (e.g. self-employed people, those with an income above a certain threshold, or civil servants) are free to join that system, but most of them opt for private health insurance where the premium is calculated on actuarial principles rather than income. That is no “government-paid healthcare” at all.
In very general terms I would say the roots are in the first third of the 20th century but it was just after WWII when government healthcare really developed in all developed countries. It was not a single step but many small steps over the years.
In Spain there were earlier insurance systems but it was in 1942 that the government-run Seguro de Enfermedad was created and it coexisted with other insurance schemes (mutualidades). In the 1960s the system was expanded and unified. (link)
During and after WWII Spain was a third world country, extremely poor, uncapable of feeding its people. And with a fascist regime. And yet it started a social health care system which has improved and been proven over many decades. It’s not perfect but for the great majority of the population it is a lot better than anything America can offer.
In the UK there were several local government schemes for socialised healthcare before WWII. The sentiment arose, I think from the after affects of WWI which left an awful lot of widows and disable veterans. Then the depression of the 1930s when there were hunger marches from destitute communities in the industrial north petitioning the government to take responsibility for the welfare of the people.
There were a whole series of national reforms covering education, welfare, pensions much of it initiated by the dominant Liberal party at the time.
These reforms were regarded a matter of social justice for the terrible toll that this war had taken on ordinary working people. It is unsurprising given the dramatic number of men lost and the casualties.
The Great Depression and then WWII, similarly set off another huge range of social reforms in the years that followed. This time by the socialist Labour party which had a programme of nationalisation. The National Health Service was formed in 1948 and to this day state provided healthcare in the UK is regarded as the natural order of things and an incontestable right. It is a very foolhardy politician who tries question it.
The UK is a bit of an extreme example, where the concept of free healthcare is elevated so much it has been described as a peculiar ‘secular’ religion of the British. Nonetheless, after WWII, when many nations across Europe were starting from scratch in countries ruined by war and deciding which parts of the economy should be under state control and which should be left to the market, most countries decided healthcare should be financed by the state. The health of the nation was regarded as a clear national interest. It was a consensus shared by many developed countries, a no-brainer. Why the US went the other way is puzzling.
Every industrialized country has UHC except the US.
A better question is ‘what percentage of high middle income countries (4-12k per capita) have UHC’.
It depends on how you define UHC. Their systems may not be as good as what is in Europe, but a variety of middle income nations have UHC.
Mexico, Brazil, Chile, Thailand, Argentina, Peru, etc.
At least the latin and central american nations have UHC or rudimentary UHC systems. I don’t know if the middle income nations that are oil producing mideastern nations do (Iran, Iraq, Libya, etc).
I’ll steal a page from Justice Roberts, then - a “health care premium” which is a proportion of your income and mandatory and bears no resemblance to payout… is a tax, pure and simple. For a government paid service. If the only way out is special qualification and buying an equivalent service - still a tax.
(Side note - I’ll give a massive “Wow!” to Roberts, who though I disagree with his POV, was brilliant. Basically he managed to weasel out of a really nasty dilemma. He avoided being an activist judge, he stuck it to those Republicans who expected him to nullify the will of congress that they otherwise love to say should override the courts, he bounced the issue back to them to reinforce the message “stop sticking the courts with decisions politicians need the balls to make”, he managed to put a cap on the interstate commerce clause, but by meanwhile allowing ACA (mostly) he avoided tarring the SCOTUS with the “toady of ideologies” label… Basically Solomon split the baby and avoided being the bad guy. )
Take a note from the Canadian system - a doctor who is “outside” the system and private, gets zero reimbursement from the system. Neither do his patients. As a result, you can’t extra-bill, you can’t moonlight for higher fees on Tuesdays and Thursdays, you’re either all in or all out. If you’re out, good luck finding patients. Because all provinces cover pretty much any necessity, companies do NOT have USA type "Basic medical"insurance plans, nor do most insurance providers offer them (except for travel coverage). A doctor in the private side, unlike the private in the UK, must find patients rich enough to pay him out of pocket. Consequently, unlike the UK, we have no parallel private system to speak of. (Of course, if you’ve got that money, just go to the USA…)
This is the future the USA is being dragged into, kicking and screaming. All doctors can be in private practice, but they bill one provider and the fee schedule is set by that 800-pound gorilla (sorry, 800 kilos). Occasionally the doctors go on strike or otherwise make their point, but they don’t get as rich as in the USA. Charge more than that fee and good luck finding patients. I suspect the slippery slope will evolve by means of steadily increasing Medicare/Medicaid qualification levels…
No, he isn’t. You on the other hand, are definitely confusing the meaning of the word socialism with whatever other context/usage you may have seen it used in.
In Australia there is a standard Medicare charge for seeing a doctor but almost every doctor I know charges more. You pay the gap, doctors that bulk bill with no out of pockets tend to be pretty flat out and don’t offer the level of service most people desire.
We also have a levy (tax) as a percentage of salary, I also have private health care to cover me for private hospitals, dentist, chiro, elective surgery etc that are not covered by Medicare. Again most people have this on top of Medicare.
I don’t want to hijack the thread into a “What is socialism?” thread, njtt, but I would also agree with Gorsnak’s definition.
Bear in mind that Gorsnak is not an American. He’s a Canadian, posting from Saskatchewan, which in 1944 was the first jurisdiction in North America to elect a socialist government. That government and its successors did believe in state ownership of the means of production and nationalised many industries. Government intervention in the economy by means of government owned industries continues today in Saskatchewan, so he knows whereof he speaks.
As well, Saskatchewan was the first North American jurisdiction to introduce universal health care on a single payer model, which eventually was adopted by all of Canada. Hospitals in Saskatchewan are all publicly owned, albeit not directly by the provincial government. It strikes me as a form of socialism. Whether that’s good or bad is left as an exercise for the reader.