Universal Health Care Coverage

Universal health care coverage refers to systems in which all legal residents of a given jurisdiction have health insurance coverage; most industrialized nations enjoy universal health care coverage, though the U.S. does not.

Universal health care coverage refers to the state of a society's health sector, rather than the system of laws and regulations that leads to it: everyone in a given country can have health insurance, whether the country has a single-payer system, socialized medicine or an insurance mandate, or simply relies on a set of subsidies and and other incentives.

The earliest example of universal health care coverage is 19th-century Germany, where Chancellor Otto von Bismarck introduced a series of bills guaranteeing access to health care in the 1880s.

Under single-payer systems, all health costs are paid by the government using tax revenue. While health insurance is universal and offered by a single entity, however, care itself is generally still provided by private-sector doctors and hospitals. Examples of this model include Canada and France. In both of these countries private-sector insurers also exist, though they play a minor role as providers of supplemental coverage.

In socialized systems both insurance and care are provided by the government. These systems are less common than single-payer ones, and include the UK's National Health Service. Sweden's publicly funded system mostly provides care through government providers, though private companies play a limited role.

Achieving universal health care coverage does not require the government to be the single or even largest provider of health insurance. Germany's system includes for-profit and not-for-profit insurers. In the Netherlands and Switzerland most insurance is provided by private companies; the government requires that all residents purchase insurance and subsidizes premiums.

This system is similar to the one established by the 2010 Affordable Care Act, more commonly known as Obamacare, but the U.S. has not achieved universal health care coverage, and many people who do have insurance can barely afford it. One reason is that the individual mandate – the requirement that everyone have health insurance – does not provide steep enough penalties to make obtaining insurance the most economical decision for everyone, in light of how high premiums are in many areas.