You Don't Need Your Friends to Hold Benefits for You When You Benefit from Universal Health Care
Aug 8, 2009
Last night we had dinner with our daughter Elin and her partner Emmanuel: she's just back from teaching at a week-long shindig in Chicago for viola da gamba players. One of the stories she told concerned a fellow gambist from Canada who was recently diagnosed with a leukemia-like disease and who underwent some cutting-edge treatment this spring in Ontario.
He was diagnosed and treated in his home city in a timely fashion and is doing well, it seems. But before his treament began, musician-friends in the US called him up and proposed doing a benefit concert for him to help defray his medical costs. It was a very nice gesture, and he thanked them warmly before explaining that it wouldn't be necessaray because he would have no-out-of-pocket medical expenses since he was covered by Ontario's version of Canada's universal health care.
The treament he got was top of the line, without a doubt. While being treated he meet another Ontarian who had a similar diagnosis but who decided to get a second opinion. That man paid his way to the Mayo Clinic for evaluation, only to be told that they would propose the same course of treatment which would run more than $1 million. The clinic's advice: go home, and get yourself taken care of there, where you won't go bankrupt with medical bills.
Universal health care is not free: Canadians pay for it through their taxes. But taxes are, as Justice Oliver Wendell Holmes said nearly a century ago, "what we pay for civilized society." The current campaign of disinformation in the US is a scandal: the babblings of that other Holmes, Shona, are a case in point. If you want some facts, not bluster, read André Picard's analysis in The Globe and Mail.
Conceptually, I'm in favor in providing health care to everyone, however I'm also concerned about the costs associated with such a universal benefit. As part of the cost benefit analysis i started thinking about some new social pressure it could create. Here's what i mean.
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Universal health care is health care coverage for all eligible residents of a political region and often covers medical, dental and mental health care. These programs vary in their structure and funding mechanisms. Typically, most costs are met via a single-payer health care system or national health insurance, or else by compulsory regulated pluralist insurance (public, private or mutual) meeting certain regulated standards. Universal health care is implemented in all but one of the wealthy, industrialized countries, with the exception being the United States. It is also provided in many developing countries and is the trend worldwide.
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. 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