Everything You Need to Know About Universal Healthcare Coverage

In order to understand universal healthcare correctly, some terminology needs to be adequately explained and set in place. Universal coverage or universal health care refers to resources that cover everyone’s basic healthcare needs – nobody is dismissed when it comes to this type of coverage as long as they are legal residents of a particular territory or country covered by the plan. 

The main idea behind universal healthcare is misunderstood and often mixed up with single-payer healthcare, where all medical coverage expenses are paid through one entity – typically the government. Nonetheless, even though it is considered a government healthcare system, single-payer is not equal to universal healthcare, and this article explains the main differences. 

Universal coverage

Universal healthcare coverage can mean two different things, and this is why confusion often might occur. Firstly, it can concern a system that implies that every citizen has access to public or private healthcare insurance. Secondly, it refers to a system where every citizen automatically obtains free or low-cost primary healthcare, including preventive care and emergency medicine. The government mandates these sets of standardized benefits, available to all. Universal healthcare coverage is achieved under a private health insurance system,  a government-run health coverage system, or a combination of the two. A great example of universal health care, where all legal residents of the state are covered, is Canada. 

Single-Payer Systems

A single-payer system, however, implies that no private insurance providers are participating in the healthcare plan. The government is the only entity controlling and issuing healthcare benefits. A great example of this type of healthcare is Great Britain, with its National Health Service (NHS). This institution authorizes access to these resources and even controls who gets employed as a healthcare provider. There are at least 17 countries that utilize the single-payer system worldwide; UK, Japan, Sweden, Norway, UAE, Italy, Spain, Portugal, Cyprus, etc.

Public-Private Plans – The Two-Tier System

The combination mentioned above of private and public healthcare plans is utilized throughout the world in various countries. All residents on these territories benefit from a system that provides healthcare resources from a public-private partnership. Exemplary countries that have these systems include the Netherlands, Germany, and Singapore. The title of one of the most successful healthcare systems in the world goes to Singapore, holding records for the low infant mortality rates and long life expectancy. 

Risk Management

Any system that contains a private insurer as a part of the healthcare system’s financing, individual healthcare providers must compensate through value-added services offered atop the government minimums. Balancing out the sick-to-healthy ratios and how the extras are priced in the open market are both things to consider by individual healthcare companies. Some countries’ governments have specific measures that protect insurers against considerable loss by punishing those whose risk profiles are over average. The process in which the government aids insurers and protects them from money loss is called risk adjustment.

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