How universal healthcare can be implemented...

Both Canada and Germany successfully managed to do what the U.S. can only dream of. While the U.S. has 40 million individuals who have no form of healthcare available to them, these two nations managed to provide free healthcare to all their residents while spending a significantly lower percent of their GDP than the U.S does on healthcare. In fact, every industrial democracy offers some form of universal healthcare while spending significantly less of their GDP than the U.S does providing healthcare to only some of its citizens. And the U.S. ranks much lower than most of these nations including Germany and Canada in terms of average life expectancy. But the approaches taken by the two nations are quite different.

Whereas in Canada, the government holds a monopsomy on healthcare and don't allow their citizens to purchase private insurance in order to get higher quality healthcare and don't address critical areas of healthcare such as a drug plan and overall doesn't allow for market forces in the area of healthcare. Germany on the other hand takes a much less radical approach to healthcare when compared to the U.S. In Germany, healthcare is employer based similar to the U.S. The only difference is the employers as well individuals below a certain income level are required to contribute to sickness funds which negotiate directly with physician groups to provide all their individuals with high quality healthcare cheaply.

All the sickness funds are required to offer all the basic services including a drug plan but those seeking higher quality services with more choices can choose to enroll with more expensive sickness funds. Those above a certain income level can choose to opt out of sickness funds entirely and may buy private insurance if desired. And like in the US, most doctors and hospitals are privately employed/owned. Thus Germany's plan offers more choice and is more market driven and privately owned and thus has less waiting in lines for health services but provides good healthcare to all its citizens when compared to the U.S or Canada. It is also more in sync with the U.S way of thinking to rely upon market forces to keep prices down rather. Thus we have much to learn from Germany's healthcare system.

We can no longer believe managed care can deliver quality healthcare at low costs. Complaints have skyrocketed since the prevalence of managed care. Reports of cases in which people were denied reimbursement for failing to be preauthorized or for failing to go to an authorized hospital in the event of a life threatening emergency are not uncommon. Yet 90% of individuals in America are enrolled in a managed care plan. Yet costs continue to rise and healthcare in any form remains inaccessible to 40 million Americans. Healthcare shouldn't be though of strictly as a business. The primary concern in business is money, in healthcare, the primary concern should be life. Anyone who is personally afflicted by a curable illness or has a family member afflicted by such an illness would want the best treatments available even at slightly higher costs, this is not the case with other businesses. So how we continue to allow healthcare to sacrifice quality for higher profits, how can we allow HMOs to put patient's lives at risk needlessly.

It is a sad state of affairs that a lifetimes worth of savings can be swept away to bankruptcy by an illness. Even with insurance, families are destroyed not just emotionally but financially by sudden illnesses in the family and medical disasters continue to be the single largest cause of bankruptcy in the United States even amongst the insured by a hefty margin. No wonder more and more patients wish to practice euthanasia and terminate their lives. At the very least, the U.S should consider adopting some form of system where the government provides the costs of all necessary care and emergency care (when life or limb at threat).

This can be funded by taking away the heavy tax subsidies given to insurance companies or it can simply be funded by employers in an employer based system like Entovin advocates and by the government for the self-employed and unemployed. But treatments for minor ailments must be funded by individuals or private insurance companies that individuals choose to enroll into to control costs. Since private insurance companies don't have to pay for as many services, they can offer much lower and more accessible rates and individuals don't have to fear bankruptcy as a result of medical emergency.

But minor and unnecessary health expenditures will go down. Tort reform limiting medical liability awards for suffering should go far to discourage reckless lawsuits meant to get hefty settlements. And this would decrease unneccesary tests for fear of getting sued as well as decrease how much doctors would have to charge to be able to pay their insurance premiums without having to close down their practice. This reform may even reduce the government's expenditure on healthcare because many of the individuals who have no health insurance and thus don't receive necessary treatment until their conditions greatly worsen and they opt to go bankrupt and enroll in Medicaid and thus require far more expensive treatments that the government pays for. This spending unnecessarily accounts for a significant portion of health expenditures.