Let us be clear: This is an informational editorial.
One of the most highly debated issues among the large number of candidates in the 2020 presidential campaign is the future of America’s healthcare.
We are not advocating or denigrating any of the healthcare plans being discussed, but in the interest of helping voters learn more, we thought it might be instructive to examine the benefits and flaws in universal healthcare in some other countries:
• Australia: Using a two-tiered system, the government pays two-thirds and the private sector pays one-third. “Medicare Everyone” provides benefits to all. People must pay deductibles before the government payments kick in. Half of the residents have paid for private health insurance to receive a higher quality of care. Those who buy private insurance before they reach 30 receive a lifetime discount.
• Canada: Using a single-payer system, the government pays 70% of care for services provided by a private delivery system. Private supplemental insurance pays for vision, dental care and prescription drugs. They provide free care for all residents regardless of the ability to pay. In 2016, healthcare cost 10.6% of Canada’s Gross Domestic Product. The cost per person was $4,752 in U.S. dollars. There were 10.5% of patients who skipped prescriptions because of cost. A whopping 56.3% waited more than four weeks to see a specialist.
• France: Its mandatory health insurance covers 75% of healthcare spending, including hospitals, doctors, drugs and mental health. The French government pays for homeopathy, house calls and child care. Payroll taxes fund 40%, income taxes cover 30%, and the rest is from tobacco and alcohol taxes.
• Germany: Mandatory health insurance is sold by 130 private nonprofits. It covers hospitalization, outpatient, prescription drugs, mental health, eye care and hospice. There are co-pays for hospitalization, prescriptions and medical aids.
• Singapore: Has a two-tier system that is rated the best in the world. Two-thirds is private and one-third public spending. It provides five classes of hospital care. The government manages hospitals that provide low-cost or free care. Workers can pay 20% of their salary to three mandated savings accounts. The employer pays another 16% into the account. One account is for housing, insurance or education investment; another for retirement savings and a third is for healthcare. In 2009, Singapore spent 4.9% of its GDP on healthcare — $2,000 per person in U.S. dollars. In 2015, life expectancy was 83.1 years.
• Switzerland: Has mandatory health insurance that covers all residents. Quality of care is rated one of the best in the world. Coverage is provided by competing private insurance companies. The government pays for 60% of the country’s healthcare. Dental is not covered. Vision is only for children. The government subsidizes premiums for low-income families, about 30% of the total. In 2016, healthcare spending was 12.4% of GDP. It was $7,919 per person in U.S. dollars. In 2015, life expectancy was 83.4 years.
• United Kingdom: Features a single-payer medicine program. The National Health Service runs hospitals and pays doctors as employees. The government pays 80% of costs through general taxes. It pays for all medical care, including dental, hospice care and some long-term care and eye care. There are some co-pays for drugs. All residents receive free care. In 2016, healthcare costs were 9.7% of GDP. The cost was $4,193 per person in U.S. dollars. Hospitals can be crowded with long wait times. In 2015, life expectancy was 81.2 years.
• United States: There are 28 million Americans who have no coverage. In 2015, life expectancy was 79.3 years. In 2016, healthcare cost 18% of GDP. That was a staggering cost of $9,892 per person. There are 60% who want Medicare for all. The quality of care is low and the United Nations ranks the U.S. 28th in the world. That’s a low score for our country and improvements are desperately needed.