There are different systems of government and different beliefs worldwide. Some countries have governments that are highly involved in the healthcare of their populations, with national healthcare systems that offer universal coverage for all citizens. Other countries have governments that allow the private sector to control the majority of the healthcare industry. Considering that both options have positive and negative aspects, this chapter presents both pros and cons of government-controlled healthcare.
TopGovernment-Controlled Healthcare: Pros
In this section, the positive aspects to government-controlled healthcare will be discussed. Examples will be provided from countries that currently use a high level of intervention, or control, on the healthcare system and have positive outcomes for citizens as well as the healthcare system. Many countries with government-controlled healthcare believe that access to healthcare is a human right and that it is the responsibility of the society and government to assure this right. In 1948, the United States (US) and 47 other countries signed the United Nations Universal Declaration of Human Rights which stated that, “everyone has the right to a standard of living adequate for the health and well-being of oneself and one’s family including […] medical care” (WHO, 1978). The US and other members of the WHO met in 2005 to sign World Health Assembly resolution 58.33 stating that everyone should have access to healthcare services and should not have financial hardship (WHO, 2013). The US is currently the only one of 38 countries who belong to the Organization for Economic Cooperation and Development (OECD) that does not have government-controlled healthcare. The idea of government-controlled healthcare has been a politically divisive topic, especially since the passing of the Affordable Care Act in 2010. There have been attempts to extend Medicare and Medicaid, most recently during the 2016 election period –nicknamed, “Medicare for all.” The bill was sponsored by US Senator Bernie Sanders, who wrote:
Healthcare must be recognized as a right, not a privilege. Every man, woman, and child in our country should be able to access the healthcare they need regardless of their income…We need a system that works not just for millionaires and billionaires, but for all of us. Americans should not have to fear losing their health insurance if they lose their job or change employment…We need a system that prioritizes the health of working-class families over the profits of insurance companies.
Therefore, proponents of government-controlled healthcare see healthcare as an internationally recognized right (Fisher, 2022; Kelly, 2010; Sanders, 2017;WHO, 1978). They advocate to decrease the number of uninsured, lessen the financial burdens people face paying for healthcare, and expand or extend eligibility for existing coverage and shifting the costs to the federal government (Sanders, 2017; Thorpe, 2016). Some proponents focus on people who are currently uninsured or face particularly high healthcare spending burdens (Curtis et al., 2022; Dao & Mulligan, 2016; Friedman, 2021); others support a more inclusive program similar to Medicare and Medicaid that would provide healthcare to all Americans through a federal, government-controlled healthcare program (Fisher, 2016; Fox & Poirier, 2018; McGrath et al., 2022; Wang, 2021).