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What is Universal Healthcare Coverage?

It's Not the Same as Single Payer Healthcare

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Updated January 24, 2013

"Universal healthcare" or "universal coverage" refers to a scenario where everyone is covered for basic healthcare services, and no one is denied care as long as they are legal residents in the geography covered, such as all the residents in the state of Massachusetts, or all the citizens in the country of Canada.

The concept of universal healthcare is often incorrectly equated to a single-payer, government healthcare system, where all healthcare is paid for by one entity, usually the government. However, "single payer" and "universal" are not the same.

In fact, throughout the world, many countries offer healthcare universally, to all their citizens, in public-private combinations, and not through single-payer systems. Examples of these countries are Germany. the Netherlands and Singapore. It is even suggested that Singapore has the most successful health system in the world, with long life expectancies, and low infant mortality rates.

According to the Institute of Medicine, one of the National Academies Sciences of the United States government, the United States is the only wealthy, industrialized nation that does not ensure all its citizens have access to health care as part of a universal system. It has recommended reforming the healthcare system by 2010, based on the facts that the per capita expenditures for health care are almost twice as much as any other industrialized nation, yet life expectancy and infant mortality rates lag behind those countries.

A bill was introduced to the United States House of Representatives in 2005 that proposes a universal system that is a combination of private and public coverage. Called HR 676, it provides for comprehensive health insurance coverage for all Americans.

When universal health care is discussed as a possible outcome of healthcare reform in the United States, it is often confused with the concept of a single payer system. Some even refer to it as socialized medicine, which is also incorrect.

If you find yourself in a conversation about healthcare reform, doublecheck with the other participants in the conversation to be sure you are using the term the same.

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