The Good and Bad of Universal Healthcare

Healthcare professionals, as well as Monmouth University students and professors, analyzed the differences between healthcare in the United States compared to other countries.

Many college students feel led astray when it comes to health insurance in America. Estellsy Acuahuitl, a sophomore biology student with a concentration in molecular cell physiology, said, “All over social media I get videos about surprising facts…while living in whichever country, and most of the ones I’ve viewed have mentioned healthcare being free; which I think is great and would really wish for this to be accessible to everyone— not just in those certain countries.”

So, how does healthcare work in other countries? Massimiliano Lamberto, Ph.D., Associate Professor of Chemistry, recounted his experience with healthcare while living in Italy. He said, “In Italy, healthcare is nearly free because it is government-run and paid with taxes that are higher than in the U.S…you get treated regardless of who or where you are.”

Though, while universal healthcare seems like a good benefit, it’s not typically accessible right away in every country that offers it. Lamberto continued, “There are often long waitlists for specialized exams and visits. If urgent, people choose to go to private clinics and pay out of pocket.”

As reported by The Commonwealth Fund, Italy’s National Health Service uses collected government taxes to provide free care for citizens and legal foreign residents, including giving undocumented immigrants access to essential services and urgent care. According to the report, “Residents receive mostly free primary care, inpatient care, and health screenings. Other statutory benefits include maternity care, specialty care, home care, hospice care, preventive medicine, and pharmaceuticals.” Specialty visits and procedures have copayments, but these expenses are exempt for “pregnant women, patients with HIV or other chronic diseases, and young children and older adults in lower-income households.”

In the United States, none of these services are free unless a low-income individual has Medicaid or receives Charity Care. Moreover, with a private insurance plan, these services are typically associated with a copayment and can also have an additional deductible. Patients with HIV and chronic diseases are eligible to receive Medicare with another insurance plan (private or Medicaid) to cover costs. Pregnant women in America are not exempt from costs and face an average cost of $18,865 with insurance coverage for childbirth, according to the Kaiser Family Foundation.

“In America, the hospital costs for having a baby is a minimum of $10,000. In Canada, it’s free,” said Jonathan Ouellet, Ph.D., Associate Professor of Biochemistry who has experience with the healthcare system in Canada. He continued, “My sister had a liver transplant. The ambulatory transport and procedure—free. My mom who’s in charge of giving company to my sister is accommodated with a house to stay in during the procedure for free. My sister was diagnosed with a cytokinetic storm virus and… the immunosuppressant pills and care for her was all free. Her kidney was too damaged, and my mother gave my sister her kidney for free. When that kidney failed and she had to get another transplant, it was free. Now, she pays up to $500 in meds a year.”

In Canada, the country’s provinces and territories each have their own insurance plan and receive cash assistance from the federal government based on capita. “All citizens and permanent residents… receive medically necessary hospital and physician services free at the point of use,” reported the Commonwealth Fund.

The contrast between America and other countries is stark enough that “a high-income person in the U.S. was more likely to report financial barriers [in healthcare] than a low-income person in nearly all the other countries surveyed: Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland, and the U.K,” the Commonwealth Fund found in a recent study.

The study also found that “Half (50 percent) of lower-income U.S. adults reported that costs prevented them from getting needed health,” compared to only 12 percent of lower income individuals in the United Kingdom. “The U.S. spends less than other high-income countries on social services, such as child care, education, paid sick leave, and unemployment insurance, which could improve population health.”

“The United States is a very capitalist nation,” said Lauren Bevacqua, a junior English and secondary education student. “I feel that healthcare should be free because we are paying to be taken care of. Something about that doesn’t seem right.”

However, the reasons for America having no universal healthcare is rooted within the country’s structural and political history making the system inexorable and unlikely to change.

Despite the financial burden of healthcare in the United States, there are a few benefits to consider. According to a report by the Manhattan Institute, “Whereas Europeans may study medicine as undergraduates (usually with a 5- or 6-year course), in North America students must study for eight years before receiving a medical degree (4 years of medical school in addition to a 4-year undergraduate degree). This is then usually followed by a residency of 3 to 7 years, depending on the specialty.” American physicians are required to dedicate more time, cost, and resources than physicians in Europe, allowing for more opportunities to learn and gain expertise in the medical field. 

According to the Education Data Initiative, the average U.S. medical school debt is between $200,000 and $215,000. This expensive commitment leads to fewer physicians with the United States having “only 7.6 medical graduates per 100,000 citizens in 2017 and Canada 7.7, while France trained 9.5, Germany 12.0, and Australia 15.5,” the Manhattan Institute report continued. The dedication that must be given in the U.S. to become a physician contributes to the high salaries they receive with the lowest reported salary being $232,000 and the highest being $511,000 in 2020, as said by Dr. David Flick in his blog for the National Society Of High School Scholars. 

“Healthcare in the US is not free; however, here we have the best hospitals, medical technology, and quality doctors so I prefer this system to the Italian one,” said Dr. Lamberto. With this reality, experts argue that health insurance literacy is crucial for individuals in the United States to maximize their health care accessibility. Currently, many individuals, especially those from foreign countries, struggle with America’s system.

“I think it would be helpful to anybody to learn what their health insurance is about because I feel like a lot of people… spend a lot more [money] than they really should be,” said Keith Gosselin, a full-time insurance employee and Registered Nurse. Compared to other countries, individuals in America are already spending a lot more for their healthcare. With more focus on health insurance literacy, individuals might better understand how to make the most of their healthcare in the United States.