Universal health care is a term that refers to a governmental system meant to ensure that every citizen or resident of a region has access to the required medical services. The methods through which payment is achieved, and through which doctors and other medical professionals practice medicine, vary widely depending on the country or municipality.
Health coverage was first achieved on a national level in Germany in the 1880s as part of a widespread system of reforms instituted by Otto von Bismarck. Germany’s early system had both employees and employers pay into a health care system, which was administered by local health bureaus. In the modern world, every wealthy industrialized nation, aside from the United States, offers some form of universal health care to its citizens.
One of the most socialized systems is the National Health Service (NHS) of the United Kingdom, which was established in the wake of World War II, in 1948. Every facet of medical care is covered entirely from tax revenues, so that patients need not pay at all, either into a general insurance fund or in direct fees to a medical provider. Medicines, meals, lodging, and services are all provided, as are incidental costs such as outpatient care and equipment. In the past, the NHS was criticized for offering a fairly low quality of health care, and for extended wait times for service. Since the late 1990s, the government has invested substantially more money in the NHS, modernizing it drastically and bringing it up to a par with the rest of Europe. The NHS has also begun to interact more heavily with the private sector, often outsourcing entire segments of health care to non-governmentally controlled interests.
Other systems of universal health care may have mandatory insurance for citizens as a way of providing medical services. Under a system like this, insurance rates are kept low through subsidies, but all people are required to buy into a system. This sort of flat fee helps reduce the funding tax burden, and in most cases, assistance is provided by the government for those who are not able to afford an insurance payment. Some systems may require employers to carry the bulk of the burden of paying for insurance, rather than the individual.
While universal health care is not an issue of much debate in many nations, in the last few years it has begun to face attacks in countries where it has long been an institution. Aging populations have in many cases placed a high burden on existing systems, and increased privatization throughout the world has led to factions pushing against system of public health care. Opponents often argue that, by keeping health care out of the free market, quality of service is reduced, wait times are increased, and freedom of choice is stifled.
In the United States, the issue of universal health care is highly politicized. As the only wealthy industrial nation without such a system of any sort, a number of political candidates and elected officials have made the institution of such a system a high priority. Proposals range from tax-funded systems along the lines of the UK model, to single-payer, mandatory insurance systems. As the issue becomes more mainstream, and the public becomes more informed, it will likely continue to become a hot button political issue, and to play a major role in future elections.