In the past, this blog has made the case that universal health coverage means not only a healthier nation but one that is far more prosperous and growth-oriented. The Economist magazine, this blogger’s favorite magazine for almost 40 years now, has again made an extremely compelling case for coverage for all. Included here are the links to their Leaders opinion piece entitled, “Universal healthcare, worldwide, is within reach,” as well as an abbreviated web version of their 10-page Special Report. Here are some salient points:
- The Economist actually refers to it as “universal basic health care,” but does not, in fact, advocate a one-size-fits-all socialist medicine solution. It says that care should be provided to one and all without necessarily being prescriptive about how that would occur in a given nation or in the world. “It does not have to mean big government,” it notes. “Private insurers and providers can still play an important role.”
- The Economist notes that there is a clear correlation between the wealth of a nation and life expectancy, but by no means is wealth the only predictor of good health. Indeed, worldwide, those with relatively low income can receive increasingly good health via affordable coverage. At the same time, nations, such as the United States, can spend massive amounts toward healthcare with little or no dividends.
- The Economist points to a few universal care use cases in the world. Chile and Costa Rica each spend about an eighth of what the U.S. does per person, yet life expectancies are similar. A third example, Thailand, spends a pittance per person, yet has health outcomes almost as good as the richest nations. Rwanda, too, has introduced a form of such coverage and seen its infant mortality rate dive significantly. Finally, Mexico introduced a coverage scheme for about half of its citizens and experienced a drop in its infant mortality and catastrophic bills for citizens.
- While infectious disease eradication is important in developing countries, it is equally true that nations are seeing the burden of the costs of chronic conditions. Universal coverage and properly funded primary care are the likely answer to dealing with this ever-growing problem worldwide.
- The Economist advocates that the richest coverage schemes are not necessarily the right approach. The better one is to cover as many people as possible even if services are more basic. Small amounts targeted at the right places, including primary care, can go a long way and have major benefits.
- The Special Report carefully chronicles the fact that America is a huge outlier for developed countries. The U.S. uses 18% of its GDP on healthcare while similar nations spend between 10% and 12%. It speaks about the fractured nature of America’s system, its over-reliance on employer-sponsored coverage to provide for the majority of Americans, gaps in insurance as well as high drug and hospital costs.
Universal access for all Americans to primary care and other services would do wonders to improve efficiency and outcomes. Over time, universal access to primary care and other services might reduce significantly the over-reliance on gross domestic product to cover Americans who are, far too often, cared for in the most expensive, crisis-oriented places. Such access is also a necessity for this nation’s long-term economic health. It is about time Congress figured this out.
Mind you, this author never looks through rose-colored glasses. Universal access and coverage is not the panacea for what ills America’s healthcare system. A future blog will explore how and why social determinants, as well as, poor behaviors create huge obstacles to a more rational system.