In the wake of the COVID-19 pandemic, the weak U.S healthcare system has been exposed, signaling the need to implement better health reforms than the existing ones to safeguard its citizens’ lives and health. While the U.S healthcare system is largely privatized, most countries in Europe have a universal healthcare system termed ‘free.’ Depending on one's interpretation of the term ‘free, ’ these countries ensure that all their citizens have access to healthcare services. The right to health is a fundamental obligation of every government, and the high healthcare expenditure by the U.S government should be justified by a robust healthcare system (DeGenova, 2020). With the ongoing debate on healthcare systems still raging on, one question remains, should healthcare systems be free? This paper argues that healthcare systems should not be free, and all individuals pay for health services.
A free healthcare system translates to a deteriorating quality of service. Arguably, it is impossible to implement a publicly-funded healthcare system and still expect high-quality healthcare services (DeGenova, 2020). Such a healthcare system depends on the government’s expenditure and cannot guarantee efficiency and quality services. While the idea of providing free healthcare services is beneficial to all citizens, the responsible governments will be unable to raise the needed funds to support the healthcare system. As such, quality and access to healthcare services are compromised. Countries that support a free healthcare system end up rationing healthcare services requested by the patients. For instance, finding the most expensive treatments and medication can prove a challenge as the government's expenditure on these items outweighs the potential benefits in the long run.
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Free healthcare systems lead to irresponsible lifestyles and choices. Human beings like taking risks, and with a free healthcare system, they will adopt an erratic lifestyle. When access to healthcare is free, people will no longer take care of their wellbeing. As depicted by de Boer et al. (2020), population demographics indicate that high-risk behaviors and lifestyles result in high healthcare costs. Those who engage in healthy behaviors often do not visit hospitals for medical assistance; hence spend less on health services. As such, a free healthcare system does not offer individuals the right incentive to make healthy choices. These individuals will be skeptical about managing their health and instead substitute curative care rather than preventive care. With complimentary health services being available at any given time, sedentary and risky behaviors will increase. However, people will live a healthy and safe lifestyle if mandated to pay for health services. Apart from providing quality healthcare services, a healthcare system should encourage healthy lifestyles. Through privatizing the healthcare system, people will remain cautious and be more vigilant in living a healthy lifestyle.
A free healthcare system is more inclined to produce wastage. One can conclude that when a given service is free, people tend to take it for granted or abuse it. The same mentality will also apply to a free healthcare system. While providing free healthcare services to all citizens will reduce the health burden, most people will abuse the free services without realizing the implications. For instance, a country that has implemented a free healthcare system will have patients visit the doctor with trivial issues that could be solved through over-the-counter medication or a change in behavior or lifestyle. This issue’s implication involves overburdening the healthcare system by wasting resources that could have otherwise been used elsewhere (Chalkidou & Appleby, 2017). Waste associated with a free healthcare system, ultimately, takes a toll on the public coffers.
While free healthcare systems encourage irresponsible lifestyles and encourage waste of public resources, they are cheaper than privatized healthcare systems. As earlier noted, the U.S spends a large portion of its GDP on healthcare. The U.K and U.S have different healthcare expenditure costs per capita as they have varying healthcare systems (Papanicolas et al., 2019). The variations can further be observed through mortality rates among these two nations. Countries like the U.K encourage a preventive care system geared towards mitigating emergency health services (Papanicolas et al., 2019). Since more people have access to health services, healthcare inequalities are reduced, impacting the overall healthcare expenditure. Indeed, universal healthcare systems are not after colossal profit margins, but rather provide quality healthcare services over a single-payer system that does not overburden ordinary citizens. Simultaneously, governments who implemented the free healthcare system can control this system’s cost growth compared to those with privatized healthcare systems.
The healthiest individuals are disadvantaged in a free healthcare system. In a free healthcare system, the healthiest people are at a disadvantage as they foot the bill for the unhealthy. Some people are cautious about the food they consume in every society, undertake regular exercise, and observe a healthy lifestyle. This group of individuals does not seek medical services regularly despite paying for the publicly-funded healthcare system through their taxes (de Boer et al., 2020). While unhealthy people still contribute to their medical services, a private healthcare system would not tolerate such disparity. Everyone would be forced to pay for their medical services. In the long run, unhealthy people will adopt healthy living standards due to private healthcare services.
Free healthcare systems take up a considerable chunk of the government budget expenditure. Countries with a universal healthcare system, such as the U.K, spend a vast portion of their total GDP on healthcare (Papanicolas et al., 2019). If the U.S government, for instance, adopted the same healthcare system, they would have to spend additional funds to finance the system entirely. As such, the country's budget would be strained, forcing policymakers to enforce budget cuts in other vital sectors to support the healthcare system. Such a high expenditure might not justify the quality of services provided, including more prolonged waiting times. Moreover, chronic illnesses receive the highest amounts from a healthcare budget, and not everyone benefits from the same. A free healthcare system means one's contribution goes directly to treat someone else rather than help one receive the right medical assistance.
On the contrary, a free healthcare system positively impacts workplace productivity and boosts economic growth. From an economic viewpoint, a free healthcare system makes a financial sense, especially when putting workers' performances into perspective. According to Dizioli & Pinheiro (2012), the U.S economy alone losses over $65 billion in sick days due to the private healthcare system. In essence, insured workers miss more workdays than their uninsured colleagues. Moreover, workers under a free healthcare system are likely to seek medical services and return to work as quickly as possible. With preventive care as part of a free healthcare system, more workers will increase their productivity. However, Dizioli & Pinheiro (2012) also note that a free healthcare service will overwhelm hospitals as more people will seek medical assistance. Regardless, fewer days of work missed translates to more workplace productivity and overall economic growth.
An overlooked aspect of this debate is the significance of free healthcare to children, emergencies, and healthcare inequalities. Undoubtedly, adequate health care is critical to children's development. According to Martin et al. (2018), most marginalized communities either do not have access to quality health services or cannot pay for necessary health procedures. As such, children from these families do not receive the required medical assistance vital to their growth and development. A free healthcare system will give these children access to health care and facilities, allowing them to live a healthy lifestyle. Sadly, many patients die as they could not afford emergency health services. A free healthcare system will enable people to get emergency services, saving lives from critical situations. Moreover, people can seek early medical interventions, assisting doctors and nurses in making a diagnosis and preventing future complications, such as in early cancer screening.
In conclusion, while a free healthcare system is vital for all citizens, increasing economic productivity, mitigating health inequalities, and accessing critical emergency services, its cons outweigh its pros. Indeed, a free healthcare system does not guarantee the quality of service. Free healthcare systems are strained, and the quality of medical services provided is often compromised. Simultaneously, a free healthcare system does not promote responsible behavior, good health choices, and is a disadvantage to healthy people. In essence, people stay healthy to avoid unnecessary health costs, and with no incentive to adopt a healthy lifestyle, most people will ignore the state of their wellbeing. Further, a free healthcare system is a burden to health facilities, health professionals, and the country's GDP. Financing a free healthcare system will elevate the government's healthcare expenditure, leading to budget cuts in other areas, such as education. Ultimately, a free healthcare system will lead to unforeseen consequences, such as longer wait times, increased health disparities, and a waste of healthcare resources.
References
Chalkidou, K., & Appleby, J. (2017). Eliminating waste in healthcare spending. DOI: 10.1136/bmj.j570
de Boer, W. I., Dekker, L. H., Koning, R. H., Navis, G. J., & Mierau, J. O. (2020). How are lifestyle factors associated with socioeconomic differences in health care costs? Evidence from full population data in the Netherlands. Preventive Medicine , 130 , 105929. DOI: 10.2139/ssrn.1689750
DeGenova, E. (2020). Healthcare: Public or Private. DU Quark , 4 (2), 38-49. https://dsc.duq.edu/cgi/viewcontent.cgi?article=1071&context=duquark
Dizioli, A., & Pinheiro, R. B. (2012). Health insurance as a productive factor. https://mpra.ub.uni-muenchen.de/39743/1/MPRA_paper_39743.pdf
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. DOI: 10.1016/S0140-6736(18)30181-8
Papanicolas, I., Mossialos, E., Gundersen, A., Woskie, L., & Jha, A. K. (2019). Performance of UK National Health Service compared with other high-income countries: observational study. bmj , 367 . DOI: 10.1136/bmj.l6326
