| By Gale Staff |
The debate over healthcare reform in the United States is not new, but it remains one of the most divisive political topics today. Despite spending more than $4.5 trillion on healthcare in 2022—nearly double the per capita spending of other industrialized nations—the U.S. remains one of the only developed countries without universal healthcare care (UHC).
Approximately 25 million Americans lack insurance and countless others avoid medical services due to high out-of-pocket costs. According to a 2023 Gallup poll, 57% of American voters believe it is a governmental obligation to address the problem, but implementing such a system is complex and contentious.
As students prepare to become the next generation of leaders and decision-makers, they need the skills to research both sides of nationwide issues like healthcare legislation and form educated, independent opinions.
Gale In Context: Opposing Viewpoints is a reliable, media-diverse database that introduces learners to various perspectives. On the universal healthcare topic page, students can dig into a rich collection of resources, including the latest news from respected sources like CNN Wire and The New York Times, easy-to-read charts, videos, reference articles, and more.
The Pros and Cons of Different Healthcare Systems
Before students can take a stance on universal healthcare, they must have at least a general idea of how nations worldwide implement their systems. Each has nuances regarding cost management, access, and quality of care.
Gale In Context: Opposing Viewpoints is an excellent tool for introducing these healthcare systems in the classroom. The range of research materials available through Opposing Viewpoints is presented in an intuitive interface and through engaging multimedia content.
To inspire your classroom discussions, we will introduce the spectrum of UHC programs, starting with socialized medicine and ending with America’s hybrid multi-payer system. Along the way, we will link to a sample of Gale’s comprehensive collection of research materials.
Socialized Medicine
Often seen as the “purest” form of UHC, socialized (or nationalized) medicine involves the government managing healthcare as a public service—similar to schools and infrastructure—so that all citizens can access medical care. The United Kingdom’s National Health Service is a well-known example, which provides services at no direct cost to patients.
One of socialized medicine’s most decisive advantages is its ability to provide equity so that everyone, regardless of income or employment, receives the same quality of care. It’s also a simplified solution that reduces administrative overhead, eliminating private insurance bureaucracy and freeing up funds for direct patient care.
However, there are trade-offs. Citizens often face longer wait times for elective treatments or specialized care as governments prioritize the budget toward essential or emergency services. Another frequently cited drawback is that it can restrict innovation in the healthcare industry without competition between private providers.
Consider This: Critical Thinking Questions for Students
- How would nationalized healthcare affect populations with different health issues, such as chronic illnesses or disabilities? Would it encourage equity or cause certain needs to be overlooked?
- What benefits or challenges might arise for medical professionals employed directly by the government rather than working in privately-run systems?
Single-Payer Insurance Systems
Single-payer insurance is similar to socialized systems, with the government acting as the sole insurer, covering most or all of a citizen’s medical costs.
The critical distinction is the separation between financing and service delivery. While the government takes on financial responsibility, it does not directly manage or employ healthcare workers. This approach allows nations like Canada and Taiwan to retain some of the benefits of market-based medical care in that there can be competition regarding quality and patient choice.
One of the primary strengths of the single-payer model is that it creates a more streamlined system in which everyone is equitably covered, and no one needs to worry about their ability to afford essential medical services. Because it eliminates financial barriers, citizens are more likely to seek preventative care rather than avoid treatment due to cost. In the long run, it can reduce the strain on hospital resources and improve health outcomes as people can treat conditions before they escalate or become life-threatening.
With centralized funding comes bureaucratic inefficiencies, particularly in managing demand, which can result in long wait times for non-emergency procedures and limited budgets for innovative or specialized treatments. As governments attempt to negotiate strict price controls to keep costs low, certain specialties’ profitability may be limited.
Consider This: Critical Thinking Questions for Students
- Single-payer systems often involve higher taxes to fund the healthcare program. Do you think this is a fair trade-off if it guarantees healthcare for everyone? What factors should be considered when deciding how to finance a system like this?
- How could the U.S. ensure that healthcare innovations, like new treatments or technologies, continue to thrive under a single-payer system where the government sets most of the budgets and prices?
Multi-Payer Systems
Multi-payer or “two-tier” systems combine universal coverage with optional private insurance to address the competitive imbalance in single-payer systems. Therefore, citizens have the right to a government-funded safety net that provides a certain level of care for all citizens, and those who can afford to do so may opt to supplement their coverage with private insurance.
Such a structure alleviates the strain on public systems, as the individuals who choose private care reduce the demand for publicly-funded services. Thus, wait times in two-tier systems are typically more manageable, and patients who can afford private insurance have market choice.
Conversely, the multi-payer approach cultivates healthcare disparities, granting wealthier individuals access to faster, more comprehensive care, while those reliant exclusively on the public system have no such luxury.
Consider This: Critical Thinking Question for Students
- Under a multi-payer system, wealthier individuals can pay for private insurance that offers faster or more specialized care, while others rely on the public system. Some argue this system increases overall access to healthcare because it takes pressure off the public system. Others claim it only further increases medical inequities. Where do you stand and why?
America: A Multi-Payer System With Caveats
The United States is largely considered a multi-payer system, in which citizens are not given basic insurance. Rather, most health insurance is private and provided through employers, while programs like Medicaid, Medicare, and the Children’s Health Insurance Program provide a safety net for more vulnerable populations.
In terms of strengths, hybrid healthcare systems create an environment where innovation can flourish through industry competition. The U.S. is considered a global leader in medical research and technological advancements, much of which is driven by the private sector: pharmaceutical companies, medical device manufacturers, etc. Because patients have a choice in the care they seek, competitors within these industries strive to continually up the ante and collect more market share.
Like all systems, hybrid healthcare has weaknesses—like the fact that it leaves coverage gaps for those who earn too much to qualify for subsidized insurance but can’t afford the often staggering costs of deductibles and out-of-pocket fees.
Hybrid healthcare systems also lead to delayed care for many individuals, as nearly 40% say they avoid seeking medical treatment due to financial constraints. This, in turn, can exacerbate health problems and lead to more expensive interventions. People with chronic health conditions or those requiring regular medical attention are particularly vulnerable to these costs.
Consider This: Critical Thinking Questions for Students
- How does the U.S. hybrid system’s reliance on employer-based insurance affect job mobility? What about entrepreneurship? What changes might we see if we decoupled health insurance from employment?
- What types of regulations or oversight should be in place to keep private insurance companies from predatory pricing or denying coverage for necessary care?
Bringing Big Ideas Into the High School Classroom
Understanding healthcare reform demands a deep exploration of different systems, weighing their strengths and weaknesses, and considering their impact on human lives. Educators who encourage learners to grapple with these kinds of big ideas are helping to shape how their students engage with the world’s biggest challenges.
You can bring these conversations to your classroom with the help of Gale In Context: Opposing Viewpoints, where students can explore a collection of research materials and multimedia resources from varied perspectives.
We also offer our Open Access site, which is comprised of publicly available content organized into topical categories. You can review more articles on universal healthcare or browse through the available content on other social issues, like poverty or global warming.
If you would like to bring the full scope of Gale In Context: Opposing Viewpoints into your classroom, contact a local sales representative for more information.