But a Dream: Why Doesn’t The United States Have Universal Health Care?

Most industrialized, even developing countries have at least some measure of health care coverage that is paid for by the state. The EU, UK, Canada and Australia are Western(ized), liberal democracies much like the U.S.; so why not them too?

(Image via Wikipedia)

In most liberal democracies – such as the majority of the nations in the European Union, the United Kingdom, Canada, Australia, significant parts of South America, China and Japan – there is some level of universal or comprehensive health care system. I define “universal” or “comprehensive” health care as a system in which hospitals and/or General Practices are administered by the government paid for from a public fund via taxation or levies; a mixture of the latter alongside privately owned health care providers that are subsidized partly or fully by the government; or a government-run health insurance corporation that provides affordable premiums to all of its citizens; a system that does not burden an individual or his/her family with the majority of the cost of using basic health services.

In the US, if one wishes to be treated for any ailment, be it acute or severe, irritating or debilitating, fatal or frivolous, they must take out a health insurance premium provided by one of many health insurance providers; incorporated entities that are run for profit, just like any other company that sells a product or service. With the exception of elected officials, Veterans of the Armed Services and seniors that qualify for the public health fund known as Medicare or Medicaid and/or children covered under Children’s Health Insurance Program Reauthorization Act of 2009, most US citizens must pay for their own health insurance either individually or in conjunction with their employer.

Many conservative commentators in the United States have branded universal health care as “socialized medicine” invoking connotations of socialism. To those outside of the US, the debate seems almost ludicrous. So why is there a debate, and what differentiates the US from other nations? A lot has to do with their individual political economic and historical development.

The supreme law of the United States is codified in the Constitution which outlines the powers of the Executive, Judiciary and Legislature. The philosophy of these laws are rooted in the Enlightenment writings of the French philosophe Montesquieu, social contract theory of Rousseau and the liberalism of John Locke.  The federalist papers written primarily by John Madison and Alexander Hamilton advocated a limit on federal power, so as to prevent a tyranny of the majority and as such, minimal interference in the economy by the state. A welfare state, or the concept thereof had no real historical antecedent until President Theodore Roosevelt’s 1912 proposal for extending health insurance to industry. A congressional Committee on the Costs of Medical Care was formed in the 1920s, however strident opposition to their reform plans as it was deemed too “socialist”, a major concern due to the recent fall of Russia to the Bolshevik Revolution in 1917 and the fact the US had no overarching labor movement like the UK or Australia.

Chris Watson, Australia’s First Labor Prime Minister. (Image via Wikipedia)

In the UK, the first instance that prepared the country for universal health care was what was known as the liberal welfare reforms. This set of laws were enacted by the Liberal government that was returned to power in coalition with the Labour Party. The Labour Party primarily represented the workers and as such held a democratic socialist platform. Among the reforms were compulsory health insurance for low-income earners. In Australia, labor movements were prominent in colonial life, federating under one banner as a political party entitled the Australian Labor Party (originally the “Labour” party, changed in 1912.) In 1903, the Labor Party was the first democratically elected socialist government in the world with Chris Watson as Prime Minister. With the Labor Party’s official stance being “the socialisation of industry, production, distribution and exchange”, universal health care seemed almost like an inevitability.

Although for both countries, universal health care didn’t become law until much later (1948 for the UK; 1975 for Australia.) however, the history of government intervention in the UK and Australia was entrenched in popular consciousness; in the US it was viewed with suspicion. Built on the principles of life, liberty and the pursuit of happiness, the US free market ideology was one that consistently prevailed. The conception of freedom in all three countries all differ wildly and hence we get the debate in the US today.

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  1. very good article

  2. Interesting article, its good to read about the origins of US healthcare, its a viewpoint that is never really discussed, especially with the current debate! Unfortunately though, the US will never switch to a ‘universal’ scheme, the current healthcare debate is highly political and any dramatic change would create public outrage. These countries have made their healthcare choices and will most probably stick by them forever.

  3. I agree; I think once a system is entrenched as much as it has in all these nations its hard to get rid of or modify. Reform, if it heads towards a universal system in function may come in the form of piecemeal initiatives for decades.

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