Expanding Universal Health Coverage Globally

¶ … Universal Health Coverage in the U.S. From the World Health Organization's and United Nation's perspectives, universal health coverage (UHC) is essential to continued international development (WHO, 2015). These organizations believe this issue transcends multiple policies designed to promote sustainable development, because it is a precondition of sustainable development, as well as an outcome and indicator.

The three dimensions of sustainable development are social, environmental, and economic and all three must be addressed through health reform policies to promote sustainable development, in order to make high quality health care available to everyone regardless of their social and economic status. The philosophical foundation for the belief that UHC is essential for sustainable development is based on the proposition that citizens of a country should not have to choose between healthcare services and feeding their families (Dye et al., 2013, p. xi).

In other words, UHC is viewed by many policymakers around the world as a fundamental human rights issue (Dye et al., 2013, p. 6). An example of a multi-dimensional policy issue related to UHC is the timely provision of treatment for tuberculosis (TB) (Dye et al., 2013, p. 10). UHC, if free or heavily subsidized, would encourage all patients to seek treatment for what some may experience as mild respiratory symptoms. Arriving at a diagnosis can take weeks or months and UHC would make this process affordable.

A TB diagnosis can be socially stigmatizing and social protections should be in place, which allow TB patients to return to work shortly after treatment has commenced. Sick days would also be essential for preventing income loss during the diagnosis and initial treatment period. The WHO also recommends strengthening or adding discrimination protections for groups who may be more susceptible to acquiring TB. Such an approach requires UHC policymakers to consider multiple policy dimensions of a successful universal healthcare system.

In the United States, opponents of UHC have made the claim that this type of healthcare system would undermine economic freedom (Roy, 2015). The blame for this ideology has been attributed by many to be the product of conservatism, but the conservative think tank Heritage Foundation begs to differ. According to their research, UHC is provided in countries with greater economic freedom than the United States. In addition, two of these economies, Switzerland and Singapore, have a healthcare system that costs four to five times less than the U.S.

system and if the U.S. had either system the budget deficit would be eliminated. From a historical perspective, the failure to enact UHC legislation in the U.S. can be blamed on a laundry list of special interest groups, including the American Medical Association (AMA) and the private insurance industry (Palmer, 1999). Policy concerns, such as economic freedom and the fight against communism, have represented the main reasons why the U.S.

has failed to pass UHC legislation, but each interest group will define their policy concerns in their own way. Ultimately, however, passage of UHC legislation will depend on the willingness of politicians and special interest groups to weaken the U.S. class system in order to render a more egalitarian society (Palmer, 1999). As Palmer (1999) notes, the AMA has historically resisted UHC legislation because of its belief that it represented a form of socialized medicine and a slippery slope to communism.

Later, as Congress debated Medicare and Medicaid legislation in the early 60s the AMA argued that doctor-patient relationships were at risk, but a massive grassroots effort succeeded in overcoming this and other objections. Providers would have.