N
nancy_dalrymple
Guest
Universal health care is a broad concept that has been implemented in several ways. The common denominator for all such programs is some form of government action aimed at extending access to health care as widely as possible and setting minimum standards. Most implement universal health care through legislation, regulation and taxation. Legislation and regulation direct what care must be provided, to whom, and on what basis. Usually some costs are borne by the patient at the time of consumption but the bulk of costs come from a combination of compulsory insurance and tax revenues. Some programs are paid for entirely out of tax revenues.[3] In some cases, government involvement also includes directly managing the health care system, but many countries use mixed public-private systems to deliver universal health care.
[edit] Brazil
Main article: Health care in Brazil
The universal health care system was adopted in Brazil in 1988 after the end of the military regime’s rule.[citation needed]
[edit] Canada
Main article: Health care in Canada
In 1984, the Canada Health Act was passed, which prohibited extra billing by doctors on patients while at the same time billing the public insurance system. In 1999, the prime minister and most premiers reaffirmed in the Social Union Framework Agreement that they are committed to health care that has “comprehensiveness, universality, portability, public administration and accessibility.”[7]
The system is for the most part publicly funded, yet most of the services are provided by private enterprises or private corporations, although most hospitals are public. Most doctors do not receive an annual salary, but receive a fee per visit or service.[8] About 29% of Canadians’ health care is paid for by the private sector or individuals.[9] This mostly goes towards services not covered or only partially covered by Medicare such as prescription drugs, dentistry and vision care.[10] Many Canadians have private health insurance, often through their employers, that cover these expenses.[11]
The Canada Health Act of 1984 “does not directly bar private delivery or private insurance for publicly insured services,” but provides financial disincentives for doing so. “Although there are laws prohibiting or curtailing private health care in some provinces, they can be changed,” according to a report in the New England Journal of Medicine.[12][13] The legality of the ban was considered in a decision of the Supreme Court of Canada which ruled in Chaoulli v. Quebec that “the prohibition on obtaining private health insurance, while it might be constitutional in circumstances where health care services are reasonable as to both quality and timeliness, is not constitutional where the public system fails to deliver reasonable services.” The appellant contended that waiting times in Quebec violated a right to life and security in the Quebec Charter of Human Rights and Freedoms. The Court agreed, but acknowledged the importance and validity of the Canada Health Act, and at least four of the seven judges explicitly recognized the right of governments to enact laws and policies which favour the public over the private system and preserve the integrity of the public system. But not if the public system fails to deliver reasonable service as to quality or timeliness, as the court found in this case.[14]
[edit] Perú
On April 9, 2009 the Government of Peru published the Law on Health Insurance to enable all Peruvians to access quality health services, and contribute to regulate the financing and supervision of these services. The law enables all population to access diverse health services to prevent illnesses, and promote and rehabilitate people, under a Health Basic Plan (PEAS). [15][16]
[edit] United States
See also: Health care reform in the United States and Health care in the United States
The United States is the only wealthy, industrialized nation that does not have a universal health care system.[1][2] The government directly covers 27.8% of the population[17] through health care programs for the elderly, disabled, military service families and veterans, children, and some of the poor, through Medicare, Medicaid, SCHIP, and TRICARE.[18][19] Federal law ensures public access to emergency services regardless of ability to pay.[20] However, this unfunded mandate has contributed to a health care safety net that some analyses say is increasingly strained.[21] Certain types of medical spending and particularly health insurance benefit from significant tax subsidies; in particular, employer-sponsored health insurance is a non-taxable benefit. In all, government spending accounted for 45.1% of total health spending in the U.S. in 2005.[22] Current estimates put U.S. health care spending at more than 15% of GDP, a greater portion than in any other United Nations member state except for the Marshall Islands.[23]
Whether a government-mandated system of universal health care should be implemented in the US remains a hotly debated political topic, with Americans divided along party lines in their views of the US health system and what should be done to improve it. Those in favor of government-guaranteed universal health care argue that the large number of uninsured Americans creates direct and hidden costs shared by all, and that extending coverage to all would lower costs and improve quality.[24] Opponents of government mandates or programs for universal health care argue that people should be free to opt out of health insurance.[25] Both sides of the political spectrum have also looked to more philosophical arguments, debating whether people have a fundamental right to have health care provided to them by their government.
[edit] Brazil
Main article: Health care in Brazil
The universal health care system was adopted in Brazil in 1988 after the end of the military regime’s rule.[citation needed]
[edit] Canada
Main article: Health care in Canada
In 1984, the Canada Health Act was passed, which prohibited extra billing by doctors on patients while at the same time billing the public insurance system. In 1999, the prime minister and most premiers reaffirmed in the Social Union Framework Agreement that they are committed to health care that has “comprehensiveness, universality, portability, public administration and accessibility.”[7]
The system is for the most part publicly funded, yet most of the services are provided by private enterprises or private corporations, although most hospitals are public. Most doctors do not receive an annual salary, but receive a fee per visit or service.[8] About 29% of Canadians’ health care is paid for by the private sector or individuals.[9] This mostly goes towards services not covered or only partially covered by Medicare such as prescription drugs, dentistry and vision care.[10] Many Canadians have private health insurance, often through their employers, that cover these expenses.[11]
The Canada Health Act of 1984 “does not directly bar private delivery or private insurance for publicly insured services,” but provides financial disincentives for doing so. “Although there are laws prohibiting or curtailing private health care in some provinces, they can be changed,” according to a report in the New England Journal of Medicine.[12][13] The legality of the ban was considered in a decision of the Supreme Court of Canada which ruled in Chaoulli v. Quebec that “the prohibition on obtaining private health insurance, while it might be constitutional in circumstances where health care services are reasonable as to both quality and timeliness, is not constitutional where the public system fails to deliver reasonable services.” The appellant contended that waiting times in Quebec violated a right to life and security in the Quebec Charter of Human Rights and Freedoms. The Court agreed, but acknowledged the importance and validity of the Canada Health Act, and at least four of the seven judges explicitly recognized the right of governments to enact laws and policies which favour the public over the private system and preserve the integrity of the public system. But not if the public system fails to deliver reasonable service as to quality or timeliness, as the court found in this case.[14]
[edit] Perú
On April 9, 2009 the Government of Peru published the Law on Health Insurance to enable all Peruvians to access quality health services, and contribute to regulate the financing and supervision of these services. The law enables all population to access diverse health services to prevent illnesses, and promote and rehabilitate people, under a Health Basic Plan (PEAS). [15][16]
[edit] United States
See also: Health care reform in the United States and Health care in the United States
The United States is the only wealthy, industrialized nation that does not have a universal health care system.[1][2] The government directly covers 27.8% of the population[17] through health care programs for the elderly, disabled, military service families and veterans, children, and some of the poor, through Medicare, Medicaid, SCHIP, and TRICARE.[18][19] Federal law ensures public access to emergency services regardless of ability to pay.[20] However, this unfunded mandate has contributed to a health care safety net that some analyses say is increasingly strained.[21] Certain types of medical spending and particularly health insurance benefit from significant tax subsidies; in particular, employer-sponsored health insurance is a non-taxable benefit. In all, government spending accounted for 45.1% of total health spending in the U.S. in 2005.[22] Current estimates put U.S. health care spending at more than 15% of GDP, a greater portion than in any other United Nations member state except for the Marshall Islands.[23]
Whether a government-mandated system of universal health care should be implemented in the US remains a hotly debated political topic, with Americans divided along party lines in their views of the US health system and what should be done to improve it. Those in favor of government-guaranteed universal health care argue that the large number of uninsured Americans creates direct and hidden costs shared by all, and that extending coverage to all would lower costs and improve quality.[24] Opponents of government mandates or programs for universal health care argue that people should be free to opt out of health insurance.[25] Both sides of the political spectrum have also looked to more philosophical arguments, debating whether people have a fundamental right to have health care provided to them by their government.