The Centers for Medicare and Medicaid Services, or CMS, administer the federal health care programs, Medicare and Medicaid, as well as other health insurance programs. States are responsible for administering Medicaid programs to their citizens. The concept of universal healthcare goes back to 1912, when Theodore Roosevelt, running on the progressive ticket, advocated for a centralized national health service. However, he lost the election and the concept did not become a reality.
The benefits of universal health care are numerous. The idea is to ensure that every citizen has access to quality medical care, without discriminating based on ability to pay. However, governments are faced with a significant cost: implementing this program requires them to spend vast amounts of taxpayer money on it. The benefits of universal coverage are clear. But how does it work in practice? This case study will discuss the practical realities of universal coverage for patients in Norway.
While universal coverage is a great tool in public health, there are many challenges associated with its implementation. In the United States, waiting times are an important issue. In some cases, patients may not receive the care they need due to lack of insurance or a high deductible. For these patients, the only solution is to have a high deductible or to have higher co-pays. Moreover, if the patient does not have a high income, they may be denied the treatment they need.
In Germany, universal coverage is tied to employment, and the funding of the system comes from taxes and social contributions. Companies and employees’ representatives administer these programs, but the state decides whether it should intervene in the health insurance funds. When a financial imbalance arises, the state must intervene to correct the imbalance. The model was adopted in Austria and other European countries. It is a viable option for countries that want universal coverage.
In Germany, universal coverage in real practice poses different challenges. The system is funded largely through social contributions and taxes. In other countries, it is managed by the companies and employees. In Austria, the system is a national model for universal health care. Its APRNs have increased autonomy and authority, and the government can work towards expanding access to care. In addition, adjusting primary care payment rates can help mitigate the negative effects of the plan in the short-term.
Germany has a national health insurance system, which was first rolled out in 1941. In this country, 63 percent of the population was covered by public health insurance. Private health insurance was an option for the affluent and the uninsured. Concerns over long waiting lists and inefficiencies led to market-oriented reforms. Enthoven proposed the managed competition model. The 2006 Health Insurance Act combined the public and private sectors into one universal social insurance program.