Discussion of Universal Health Care System

Introduction

Universal healthcare is one of the most sensitive topics that governments around the world have to address despite the growing economic inequality. While the rich can afford to pay for the best medical care services available, the poor struggle to get basic health care. In this comparative analysis, the researcher has chosen Denmark, a global north nation, and Myanmar, a global south nation. Denmark has one of the best healthcare in the world. The Danish universal healthcare system offers free or significantly discounted specialized treatment for all the Danes that is financed through income tax (Tikkanen et al. para. 6). The report shows that all permanent residents of the country are entitled to a national health insurance card that covers a wide range of services, including examinations and treatment.

Myanmar on the other hand has one of the worst healthcare. With “a score of 0.138/1 on the WHO health systems performance index,” the country has one of the worst medical services in the world (Tandon et al. 6). The government has failed to provide universal healthcare for its citizens and accessing quality care is unaffordable to the majority of the residents. The infant mortality rate in this country is significantly high while life expectancy is low. In this paper, the researcher seeks to provide facts in support of a comprehensive universal healthcare system.

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Comparative Analysis of Healthcare Systems in Denmark and Myanmar

Healthcare System in Denmark

Denmark is considered to have one of the best healthcare systems in the world. The healthcare system in the country has evolved over the years to reach the current state. Christiansen et al. explain that in the 1880s, Denmark was one of the first European countries to start non-governmental universal care, which at that time was known as a sickness fund (9). It evolved and soon after the Second World War, the government got actively involved in offering universal healthcare for its citizens. In 1973, the government established the current universal public coverage system through legislative reform (Nøhr et al. 5). The goal of this new policy was to ensure that every citizen and permanent resident of the country has healthcare coverage.

When enacting the law, the challenge that the government had to address was how to fund the cover. The cost of implementing the new system was high and the government had to find a way of meeting it. After several months of debate, a decision was made to increase income tax slightly (Christiansen et al. 7). The additional tax was meant to cover the cost of healthcare in the country. Implementation faced some resistance at the beginning. The majority of the employees were not comfortable with the additional tax, arguing that they will be paying for services that are then used by others, especially the retired and the unemployed who cannot pay income tax.

However, the government was able to explain the relevance of the policy and the majority of these workers agreed to embrace it. They were convinced that healthcare is a basic need and there is no harm in helping those who not afford the high cost of healthcare. The government is also spending about 84.4% of its GDP on healthcare. It is a demonstration of how committed the government is to offering universal care for its citizens.

The universal healthcare system in Denmark has been massively successful. Christiansen et al. report that “the healthcare system in the country runs more effectively than other developed countries, such as the U.S. and other European countries,” (6).

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The success of the system is demonstrated in the low mortality rates in the country. People have access to quality healthcare services every time that they need it. As such, the country has one of the lowest infant mortality rates in the global north countries. Christiansen et al. report that “The overall life expectancy of Danish citizens is 81.3 years, which slightly exceeds the average of the E.U.” (9). Although it took long for the country to have a universal healthcare system, the current cover has been effective in offering protection to all permanent residents irrespective of their financial capacity.

The universal public coverage system in Denmark had a positive impact on the overall wellbeing of people in the country. The residents no longer have to worry about the cost of healthcare because it is met by the government. The strategy has helped in bridging the gap between the rich and the poor as services are offered to all who are in need irrespective of one’s financial capacity. The quality of services offered in public healthcare facilities is just as good as those found in private hospitals. Nøhr, Christian, et al. explains that despite the obvious benefits of this system, some challenges still exist that hurt its implementation (8). The rising cost of healthcare means that the government has to spend more on this sector at the expense of other sectors. A section of society also believes that people should directly pay for these services.

Healthcare System in Myanmar

Myanmar has one of the worst healthcare systems in the world. WHO health systems performance index gives the country a score of 0.138/1, which is the second-worst rank after Sierra Leone in Africa (Han et al. 990). The country’s political instability that has persisted for decades is partly to blame for the country’s disintegrating healthcare system. When the National League for Democracy came to power in 2015, one of its major healthcare initiatives was the development of a Roadmap towards Universal Health Coverage in Myanmar (2016-2030) (Schödwell et al. 45). The goal was to ensure that by 2030, the country will have a universal healthcare system for all its citizens.

The government launched the National Health Plan (2017-2021) to help provide basic medical cover for citizens of the country (Schödwell et al. 44). It was one of the first major attempts by the government to offer some form of healthcare coverage for its citizens. However, the hopes of developing a comprehensive universal healthcare plan in line with the manifesto of NLD were lost when the military overthrew the civilian rulers in 2021. Currently, there is no universal coverage for citizens of the country.

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The National Health Plan (2017-2021) was put in place in 2017 and the government was expected to meet part of the cost while individual citizens had to pay for specialized treatment. However, the system has since collapsed and the majority currently rely on private insurance companies. The country’s history of political instability is largely to blame for the weak policies regarding healthcare services. The healthcare plan 2017-2021 was partially successful, especially in the early days when it was introduced. There was a genuine attempt by the government to fund this program and to facilitate its success. However, it has become a failure as the current regime is not keen on financing programs that had been initiated by the previous government. The country spends only 0.5%-3% of its GDP on the healthcare sector at a time when other countries are spending more than 17% (Han et al. 994). With its small GDP, it means that the expenditure is negligible.

The ineffective system has had a massive negative impact on the overall well-being of the people of this country. Life expectancy in the country is 66.87 years, which is significantly lower than the global average that the United Nations estimates to be 72.6 years (Schödwell et al. 44). It is important to note that the estimates were provided in 2018 when the country was still under civilian governance.

The statistics at the moment are likely worse than they were at that time. The infant mortality rate is higher than the global average as well. The main problem is the lack of political goodwill in the country. Those who are in power are not keen on creating a functional healthcare system. It may take some time for the country to have universal healthcare coverage. The majority of employed citizens have to rely on private insurance cover. The rest have to pay for these services in both public and private hospitals.

Theoretical Perspective

Conflict Perspective

When arguing about the relevance of a universal healthcare system, the conflict perspective is one of the macro theories that can be used as a persuasion tool. The theory holds the view that society is characterized by inequality based on gender, social class, and education among other factors (Rusu 19). The problem with the inequality is that it often breeds conflicts between the haves and have not. The poor believe that the rich are the source of their suffering. As such, it is necessary to have major social changes that can help reduce inequality to create an egalitarian society (Rusu 35). It is important to ensure that basic needs can easily be met by everyone irrespective of their financial capabilities.

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This theory views healthcare as a universal system that should be available for everyone. However, proponents of the theory argue that in many countries around the world, healthcare is taking a capitalist system where the rich often have access to the best medical care while the poor struggle to have access to these basic needs (Han et al. 995). Even in most countries in the global north, healthcare is still a challenge to the poor (Han et al. 995). They have to get such services in public hospitals, which are often overstretched because of the high number of patients they have to handle daily. Lack of a universal healthcare system may escalate the conflict between the rich and the poor in society unless the far-reaching social change is introduced.

Functionalism

Functionalism is another macro theory that can help in explaining the need to have a universal healthcare system. This perspective holds the view that social stability, social integration, and socialization are essential in creating a strong society (Ormerod 1888). Social institutions play an essential role in enhancing the social stability of a country. Institutions such as schools, hospitals, and law enforcement agencies have the primary role of promoting peace and stability. Although change is critical to achieving advancement, it should be implemented gradually because rapid change threatens social order (Ormerod 1890). Government institutions have to understand their role in enhancing a stable society.

This theory, just like conflict theory, views healthcare as a universal system that should be accessible to all. It argues that the stability of a given society depends on the strength and functionality of public institutions, one of which is the healthcare sector (Schödwell et al. 45).

People will be comfortable when they are assured of affordable quality healthcare services whenever they need them. Such quality services define the level of trust they have in their government and their willingness to support it. It means that it is not enough to have effective policies. The government must ensure that they are effectively implemented. Although the theory does not entirely reject the capitalistic system of healthcare, especially the services provided by private institutions, it emphasizes the need to ensure that a section of the society is not ignored. The existence of these private institutions should not compromise the quality of services that people receive in the public sector.

Symbolic Interactionism

The third perspective that was considered in this paper is symbolic interaction. It holds the view that people tend to define their societal roles based on their interaction with others as opposed to rigid definitions and expectations of society (Low and Bowden 585). The roles may change as one interacts with more people and in different settings. The theory emphasizes the significance of communication in reaching a shared understanding. Differences may emerge, but when there is effective and unbiased communication, such conflicts can easily be resolved. The theory challenges strict roles that society may define based on one’s gender or age. Instead, it holds a flexible view that one’s role should be defined by prevailing realities.

This theory is flexible when viewing universal healthcare as one that should be universally acceptable or capitalistic. The role of various stakeholders in society continues to evolve. At the moment, the government is expected to provide universal healthcare to citizens in most parts of the world. It explains why several governments in the global north have enacted laws meant to promote universal healthcare. However, that does not mean the healthcare system cannot embrace the capitalistic system (Low and Bowden 586). It is wrong to castigate the private healthcare sector while they also play a critical role in promoting healthcare in the country. As the roles continue to evolve, the approach that a country takes to offer healthcare to its citizens may also change.

The argument for a Universal Healthcare System in the United States

Universal healthcare remains one of the most sensitive topics in the United States. According to Sun et al., every administration often promises to address the issue when coming to power, but most of them fail to develop comprehensive solutions (175). Unlike most of the developed countries in Europe and North America, the United States does not have universal healthcare. There have been attempts to introduce a law that would create a free and universal healthcare service to all permanent residents but intense opposition from a section of the society has frustrated such attempts.

The Affordable Care Act (ACA) of 2010 came close to achieving this goal, and many people still wrongly believe that it offers free and universal healthcare (Yabroff et al. 181). However, it only focused on making medical services affordable for all the residents of the United States. Chaudhary et al. explain that the Affordable Care Act’s “aim was to make health care more affordable for everyone by lowering costs for those who can’t afford them” (653). It means that although the government has significantly subsidized the cost of healthcare both in the public and private sector, Americans still have to make some form of payment to access these services.

A comparative analysis of the healthcare system in Denmark and Myanmar demonstrates the significance of having universal healthcare. The analysis shows that having a comprehensive universal healthcare system increases life expectancy. In Denmark where the government offers free and universal healthcare, life expectancy is 81.3 years while that of Myanmar is 66.87, which is below the global average. Currently, life expectancy in the United States is 78.54 years, which is lower than that of Denmark and many other developed countries around the world with universal healthcare (Wang et al. 704). One of the ways through which the quality of the healthcare system is determined is life expectancy. It means that the United States is performing poorly compared to other developed nations in this index.

The strongest argument that opponents of universal healthcare often put forth is that it is not fair to make a section of society bear the burden of paying for the healthcare services of others. However, this approach to viewing universal healthcare is misleading. Health, just like security, access to clean water, and border protection are essential for a stable and successful country (Bloom et al. 13). However, the government is using a universal tax form to get resources to fund these initiatives. It would not be wrong to have a comprehensive healthcare plan to cover every American. The plan will cover everyone without any discrimination.

The United States has been at the forefront in spreading capitalism around the world, especially after the Second World War. This form of the socio-economic and political system has proven to be the most effective as most of the communist nations around the world have embraced it (Tonelli et al. 20). The problem is that it creates a society where a section is rich while the other is poor. The gap between the poor and the rich should be minimized as much as possible to ensure that there is political stability in the country.

The government cannot achieve such a goal by using communist strategies of taking wealth from the rich and redistributing it to the poor. Instead, it can be achieved through a fair taxation system that will empower the government to provide basic needs to all its citizens. Healthcare is one of the most important basic needs in the country. When every permanent American citizen has access to free healthcare services, the gap between the rich and the poor cannot be of any significance. The strategy has worked in many other global north countries, and it did not deny citizens of these countries the opportunity to achieve economic prosperity. Moreover, the rich need a healthy workforce to help them to generate more wealth.

Conclusion

The United States deserves a comprehensive universal healthcare plan that will cover every permanent resident of the country. As the world’s leading economy that has been keen on pacesetting in different fields, it is shameful that many citizens and legal residents cannot afford basic healthcare services. A healthy nation will be more economically prosperous, which means that the cost that will be incurred shall yield returns. Most importantly, universal healthcare is one of the ways of reducing the gap between the rich and the poor at a time when the country is witnessing increasing cases of extremism. The main limitation of the policy is the cost, but the country is rich in resources and can afford it.

Works Cited

Bloom, David, et al. “The Promise and Peril of Universal Health Care.” Science, vol. 361, no. 6404, 2018, pp. 4-19.

Chaudhary, Muhammad, et al. “Universal Insurance and an Equal Access Healthcare System Eliminate Disparities for Black Patients after Traumatic Injury.” Surgery, vol. 163, no. 4, 2018, pp. 651-656.

Christiansen, Mia, et al. “Age-Specific Trends in Incidence, Mortality, and Comorbidities of Heart Failure in Denmark, 1995 to 2012.” Circulation, vol. 135, no. 13, 2017, pp. 3-14.

Han, Su, et al. “Progress towards Universal Health Coverage in Myanmar: A National and Subnational Assessment.” Global Health, vol. 6, no. 9, 2018, pp. 989-997.

Low, Jacqueline, and Gary Bowden. “An Embattled Yet Enduring Influence: Introduction to a Special Issue on Blumerian Symbolic Interactionism.” Symbolic Interaction, vol. 43, no. 4, 2020, 575-596.

Nøhr, Christian, et al. “Nationwide Citizen Access to Their Health Data: Analyzing And Comparing Experiences in Denmark, Estonia and Australia.” BMC Health Services Research, vol. 17, no. 534, 2017, pp. 1-11.

Ormerod, Richard. “The History and Ideas of Sociological Functionalism: Talcott Parsons, Modern Sociological Theory, and the Relevance for OR.” Journal of the Operational Research Society, vol. 71, no. 12, 2020, pp. 1873-1899.

Rusu, Mihai. “Street Names through Sociological Lenses: Functionalism and Conflict Theory.” Social Change Review, vol. 18, no. 1, 2020, pp. 1-43.

Schödwell, Steffen, et al. “Genetic Loading or Evil Mind: Current Conceptions of Depression in Myanmar from the Perspective of Healthcare Professionals.” The British Journal of Psychiatry International, vol. 16, no. 2, 2019, pp. 43-46.

Sun, Yuelian, et al. “Chinese health care system and clinical epidemiology.” Clinical Epidemiology, vol. no. 1, 9, 2017, pp. 167–178.

Tandon, Ajay, et al. “Measuring Overall Health System Performance for 191 Countries.” World Health Organization. 2019, pp. 1-23.

Tikkanen, Roosa, et al. “International Health Care System Profiles: Denmark.The Commonwealth Fund. Web.

Tonelli, Marcello, et al. “Comparison of the Complexity of Patients Seen by Different Medical Subspecialists in a Universal Health Care System.” JAMA Network Open, vol. 1, no. 7, 2018, 18-48.

Wang, Xiaowen, et al. “Association between Universal Masking in a Health Care System and SARS-CoV-2 Positivity among Health Care Workers.” JAMA, vol. 324, no. 7, 2020, pp. 703-704.

Yabroff, Robin, et al. “Minimizing the Burden of Cancer in the United States: Goals for a High‐Performing Health Care System.” A Cancer Journal for Clinicians, vol. 69, no. 3, 2019, pp. 166-183.

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