Universal healthcare is a system intended to provide accessible, affordable healthcare services to all citizens in a given nation. What would otherwise be extremely costly services (surgery to repair a broken leg, for example) are substantially offset by a variety of funding sources. Most often, the primary funding source is taxation of the citizens, but this revenue is sometimes supplemented by other sources, such as levies on employers and employees, or payment plans for individuals seeking specific advanced healthcare services.
Traditionally, the United States has run a private-sector healthcare industry with costs borne mainly by the employer, but in recent years the burden of cost has shifted increasingly to the individual. The Affordable Care Act of 2010 was designed to correct this trend as well as to provide access to healthcare services to a larger portion of the population by mandating that businesses with over 50 full-time employees must provide their full-time workforce with employer-sponsored health insurance. This represents a significant step toward universal healthcare in terms of access, but funding remains an issue.
In countries with long-established socialized healthcare (e.g. Denmark, Sweden, Japan, and Australia), the legal basis for such a system is founded upon Article 25 of the Universal Declaration of Human Rights, signed in 1948 by many major nations. The U.S. failed to ratify the economic and social rights sections of this bill, however, or universal healthcare may have already come to fruition in the United States. Instead, large private insurance companies developed and merged with healthcare providers to determine market prices of healthcare services for consumers. This produced a for-profit bureaucracy that has raised baseline costs for healthcare providers and in turn, for consumers.
Perhaps the largest impediment to the passage of universal healthcare in the United States outside of the powerful insurance lobby is public opinion itself. Many people, frightened of longer wait times for surgeries or lower quality of services, don’t want to see a major shift, even if it means they have assistance to finance their healthcare completely out-of-pocket. A portion of the United States citizenry has, perhaps quite falsely, grown to associate quality of healthcare services with their corresponding out-of-pocket cost to the individual. With the passage of the Patient Protection and Affordable Care Act, it is possible that some of these associations will be tempered with hard evidence of what a system that relieves cost from the individual can do. The Small Business Health Options Program (SHOP) will allow small business owners across the United States to directly compare the costs of healthcare programs for their employees. Some small business owners have been adamant that mandatory health insurance for their full-time employees will cause them to shift toward an entirely part-time workforce (thus eliminating the financial penalty for employers who opt out of providing health insurance coverage to their full-time staff), though the long-term effects of the law remain to be seen.