Sunday, March 21, 2010

List of Countries with Universal Healthcare � True Cost – Analyzing our economy, government policy, and society through the lens of cost-benefit

List of Countries with Universal Healthcare � True Cost – Analyzing our economy, government policy, and society through the lens of cost-benefit

Thirty-two of the thirty-three developed nations have universal health care, with the United States being the lone exception [1]. The following list, compiled fromWHO sources where possible, shows the start date and type of system used to implement universal health care in each developed country [2]. Note that universal health care does not imply government-only health care, as many countries implementing a universal health care plan continue to have both public and private insurance and medical providers.

CountryStart Date of Universal Health CareSystem Type
Click links for more source material on each country’s health care system.
Norway1912Single Payer
New Zealand1938Two Tier
Japan1938Single Payer
Germany1941Insurance Mandate
Belgium1945Insurance Mandate
United Kingdom1948Single Payer
Kuwait1950Single Payer
Sweden1955Single Payer
Bahrain1957Single Payer
Brunei1958Single Payer
Canada1966Single Payer
Netherlands1966Two-Tier
Austria1967Insurance Mandate
United Arab Emirates1971Single Payer
Finland1972Single Payer
Slovenia1972Single Payer
Denmark1973Two-Tier
Luxembourg1973Insurance Mandate
France1974Two-Tier
Australia1975Two Tier
Ireland1977Two-Tier
Italy1978Single Payer
Portugal1979Single Payer
Cyprus1980Single Payer
Greece1983Insurance Mandate
Spain1986Single Payer
South Korea1988Insurance Mandate
Iceland1990Single Payer
Hong Kong1993Two-Tier
Singapore1993Two-Tier
Switzerland1994Insurance Mandate
Israel1995Two-Tier
United States2014Insurance Mandate

Will the United States join this list in 2009?

[1] Roughly 15% of Americans lack insurance coverage, so the US clearly has not yet achieved universal health care. There is no universal definition of developed or industrialized nations. For this list, those countries with UN Human Development Index scores above 0.9 on a 0 to 1 scale are considered developed.

[2] The dates given are estimates, since universal health care arrived gradually in many countries. In Germany for instance, government insurance programs began in 1883, but did not reach universality until 1941. Typically the date provided is the date of passage or enactment for a national health care Act mandating insurance or establishing universal health insurance.

System Types:

Single Payer: The government provides insurance for all residents (or citizens) and pays all health care expenses except for copays and coinsurance. Providers may be public, private, or a combination of both.

Two-Tier: The government provides or mandates catrastrophic or minimum insurance coverage for all residents (or citizens), while allowing the purchase of additional voluntary insurance or fee-for service care when desired. In Singapore all residents receive a catastrophic policy from the government coupled with a health savings account that they use to pay for routine care. In other countries like Ireland and Israel, the government provides a core policy which the majority of the population supplement with private insurance.

Insurance Mandate: The government mandates that all citizens purchase insurance, whether from private, public, or non-profit insurers. In some cases the insurer list is quite restrictive, while in others a healthy private market for insurance is simply regulated and standardized by the government. In this kind of system insurers are barred from rejecting sick individuals, and individuals are required to purchase insurance, in order to prevent typical health care market failures from arising.

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