Introduction
Free medical care in a country means that the government can provide quality health care services to all its citizens irrespective of their social or economic status. Therefore, the government will be responsible for funding health care programs and relieving citizens of the financial burden. Universal health care breaks the barriers that prevent millions of Americans from accessing high quality and equal medical services and also increases financial stability among health care providers. Despite the benefits of free medical care, it also has significant disadvantages on a country. While free medical care is beneficial in ensuring access of care for all, it can increase the burden of taxes on people, make people be less serious about their health, have negative financial implications while also eliminating competition in the sector thus reducing quality and innovation.
The Government’s Role in Funding Health Care Services
In a bid to fund complete universal health care services, the government is expected to reimburse health care providers similar to the ways that insurance companies compensate them for their services. A study conducted by Stabile and Thomson (2014) suggest that it is the role of the government to ensure that citizens of a country can access quality and affordable health care services. The World Health Organization affirms that the government must establish an efficient and people-centered integrated care that fulfills the health needs of the citizens. On the other hand, critiques argue that countries with universal health care coverage struggle to finance the rising health costs while at the same time attempt to avoid the possible risks in the insurance sectors and advocate for quality and efficiency when procuring health services. Developed countries that have implemented universal health care policies and reforms perform four financing activities. These activities include increasing revenue, making insurance coverage decisions, procuring services and pooling risks. The financing functions that governments perform concerning the provision of universal health care services affect the decisions on efficiency, quality and affordability. According to Stabile and Thomson (2014), most developed nations are investigating new approaches they can generate revenue income through the health care industry, which will enable them in addressing the increasing costs incurred. Similarly, universal health care increases government revenue. Blomberg and Holahan (2019) assert that a single-payer system can raise the money spent on federal health care by approximately 50%. The authors identify that with such increased revenues, households and employers would not be able to save on the tax payments significantly.
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Free medical care can make people be less serious about their health and health conditions. According to a report by Evans-Lacko and Knapp (2017), people may abuse the health services provided through free medical care as opposed to when they are incurring the direct costs of medical services. In the report, the authors affirm that most individuals prefer to self-medicate unless they are diagnosed with chronic illnesses. Remarks made by Blomberg and Holahan (2019), support this claim as they affirm that people may misuse the universal health care system by failing to care for themselves or observe a healthy lifestyle properly. Findings in the respective publications suggest that people tend to abuse the health care services due to lack of direct financial costs. Universal health care system does not guarantee quality care and services. Evans-Lacko and Knapp (2017) explain that although services at public health institutions are free, the quality may not be excellent; thus, patients opt to pay to receive quality care. The authors assert that health care services are expected to be of high quality, cost-efficient and accessible; therefore, health providers cannot compromise the quality of services at the expense of providing affordable services.
Impact of Free Medical Care on Health Services
Free medical care makes it difficult for the government to balance between quality and accessibility for all. According to Martin et al., (2018), there is a gap between the requirement to pay for a health care service and one's ability to afford the services. The authors cite that the social and economic differences that exist between citizens make it possible for some people to benefit from the health care services provided while others struggle to access the same services at an affordable cost. As a result, the Government of Canada has introduced universal healthcare coverage as a strategy to promote equality in the provision and accessibility of health care services. Martin et al. (2018) affirm that through universal health care coverage, the Canadian government aims at providing quality and affordable health care services in both private and public health institutions. These sentiments are similar to those expressed by Stabile and Thomson (2014) in their study as the authors identify universal health care coverage as a strategy that aims at eliminating the social and economic discrimination that citizens of a country face. The financial implications of free medical care impacts governments and citizens annually. Due to the increased health care costs, taxpayers are expected to pay more taxes to enable the government to continue funding the health care services. According to an article written by Blomberg and Holahan (2019), the universal health care system forces some taxpayers to cater for services that they do not use. For instance, individuals that are healthy and wealthy are required to pay for the sick and needy. This places a financial burden to individuals that are committed to maintaining a healthy lifestyle.
Impact on Quality and Innovation
Free medical care tends to eliminate competition and this may reduce the quality and incentive to innovate. Competition is required in any market to realize increased quality and innovation. However, Moore (2018) argues that free medical care eliminates competition from healthcare facilities and the industry as a whole. Because the patients do not directly pay for their medical care, healthcare providers both in private and public healthcare facilities are more likely to reduce the quality due to lack of incentive to compete. As a result, there could be no motive for healthcare providers to work toward quality improvement. At the same time, free medical care is more likely to lead to a large number of patients visiting healthcare facilities. This rise in the number of patients comes at a time when the sector is already struggling with nurse shortages ( Sinaiko, Mehrotra & Sood , 2016). The impact of this would be a single nurse handling a large number of patients leading to fatigue thus increased chances of medical error.
Eliminating competition through free medical care can lead to reduced motive to innovate. Due to lack of incentive to innovate, many healthcare organizations would remain to operate in inefficiencies that leads to increased costs on the government, but low quality and patients satisfaction on the patients ( Ebinger et al., 2018 ). Competition in the healthcare sector provides an inspiration for firms within these sectors to innovate and create improved methods of customer care and service delivery. Free medical care thus tend to lower the incentive to innovate and thus leads to reduced quality. Paid healthcare services has been found to play a key role in increasing competitor within the sector and enhances innovation amongst the healthcare providers.
Conclusion
The pros of universal health care services are attributed to the ability of the government to shift the financial costs from its citizens. Governments that provide universal health care strive to ensure that its citizens have access to quality care and services at no financial expense. On the other hand, the disadvantages of free medical care arise from the increased financial costs as citizens are expected to pay more taxes to assist the government in providing quality and affordable health services. The pros and cons of free medical care reveal the existing gaps in medical care policies related to universal health services, which the federal government must address.
References
Blumberg, L. and Holahan, J. (2019). The Pros and Cons of Single-Payer Health Plans. Urban Institute. Retrieved from: https://www.urban.org/sites/default/files/publication/99918/pros_and_cons_of_a_single-payer_plan.pdf
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Evans-Lacko, S., & Knapp, M. (2017). 15. Healthcare–evaluating the overall system. Handbook of Social Policy Evaluation , 279
Martin, D., Miller, A. P., Quesnel-Vallée, A., Caron, N. R., Vissandjée, B., & Marchildon, G. P. (2018). Canada's universal healthcare system: achieving its potential. The Lancet, 391(10131), 1718-1735.
Moore, G. T. (2018). Let’s Provide Primary Care to All Uninsured Americans—Now!. Jama , 319 (21), 2240-2240.
Sinaiko, A. D., Mehrotra, A., & Sood, N. (2016). Cost-sharing obligations, high-deductible health plan growth, and shopping for health care: enrollees with skin in the game. JAMA internal medicine , 176 (3), 395-397.
Stabile, M., & Thomson, S. (2014). The changing role of government in financing health care: an international perspective. Journal of Economic Literature , 52(2), 480-518.
