Imagine working from paycheck to paycheck providing for you and your family. You seem to be in good health until one day you have a stroke, waking up in the hospital with a $20,000 medical bill and are unable to pay. Skyrocketing healthcare costs in the United States, rising health insurance premiums double the rate of inflation, and working families being unable to afford health insurance are a common theme involving U.S. healthcare in the past decades but is finally coming to a peak. According to Journal of Health Politics, because of these issues, there are currently "more than 50 million Americans that lack any form of health insurance, and millions more are "underinsured", meaning that they have insurance but if they encounter a medical emergency they won't be able to pay, causing them to go bankrupt (Sonfield). When 50 million out of the 318 million citizens of a first world country cannot afford medical care, there is something severely wrong with the system in place. One solution to this problem is currently being practiced in various forms in other countries already and is known as universal healthcare. While Universal healthcare is working in other countries, the implementation of the various versions has arisen to new problems in each country. Complications and issues in the United States healthcare system need to be resolved before the change to Universal healthcare can be made to avoid simply creating a new set of problems. In order to understand the issues at hand, one must first understand what exactly Universal healthcare does for the population.

Background: Universal healthcare put simply is defined as "a basic guarantee of health care to all of its citizens" (Chua).  This means that everyone in the given population has access to "appropriate promotive, preventive, curative and rehabilitative health care when they need it and at an affordable cost" (WHO). By charging a fair premium for health insurance or paying through taxes, the money collected is then pooled together, being used to pay for anyone in need of medical care. This works better when there are a significantly higher number of healthy people supplying the cost to treat the sick.  Pooling of resources also enables people to "fill prescriptions", to "report problems that may need medical care" at an earlier stage, allows for citizens to "have a regular source of health care", makes people more likely to receive preventive care, convinces people to see their doctor more frequently in order to catch disease at an earlier stage, and finally receive quality care for chronic diseases (Chua 2-3). By having these resources available to everyone, it brings the total cost down by keeping more people healthy for longer periods of time. When an individual visits the doctor more frequently due to the burden of a medical bill no longer an issue, doctors will be able to catch diseases in early, easily treatable stages. Take cancer for example, an "$88.7 billion" (CDC) for direct medical costs in 2007. If frequent visits to the doctor can spot cancer before it progresses, the cost of treatment would be significantly less. Universal coverage requires different components in order to work financially, including collecting revenue through taxes/other means, pooling resources in order to pay for individuals who are more of a burden on the system than healthy people, and using available funds to provide appropriate and effective health interventions that are necessary. Being the only first world country without Universal healthcare, the United States sees healthcare as a privilege rather than a human right, only treating those who can afford to pay. The flaws in the United States healthcare system today prevent a smooth implementation of Universal healthcare and need to be addressed before causing more issues.  

Examining the foundation of our medicine shows the ugly truth of how flawed the US healthcare system is.The U.S. healthcare system has changed from a healthcare system to a "disease care system" (Heinman). A healthcare system is about providing people with information and the means to live a healthy lifestyle to avoid illness and chronic disease and treating patients when this fails. When Heinman coins "disease care system", he is speaking about how the doctors do not spend enough time with the patients. They are not helping people change lifestyle choices that caused the issues in the first place, but simply giving them a pill or another temporary fix until they return weeks later. From a business standpoint, this is a great idea, imagine that instead of having a customer show up once and pay a single time, the patient can be given a solution that helps only just enough to satisfy their instant needs, until the return after a short few weeks for additional treatment. Our "disease care system" also works as a fee-for-service style of business. Imagine that you break your leg when hiking a more dangerous trail, and friends take you to the hospital. The lady behind the desk, and then the nurse that you see, and then finally the doctor that sees you,, and then there are multiple scans that are done to check the damage, and on and on until you have solved your issue and there are a multitude of people who need to be payed and the bill is sky high because of course you have to pay each individual who laid hands on you. When did healthcare become a business? When the healthcare system is focused on making profits over the health of their patients, there is a serious issue. When trying to solve an issue as large as the one at hand, it often is helpful to look to others who have had similar experiences and learn from their decisions, such as other foreign countries with their own versions of Universal healthcare that entail their own complications that arose from a hasty change to UHC.

In the film Sick around the World, a man named T.R. Reid travels to different countries to learn about their healthcare systems and how they differ from the United States. The first place visited is the United Kingdom, which uses a healthcare system called NHS. Citizens in the UK receive no medical bills and therefore not a single person experiences medical bankruptcy. When it comes to primary care, family doctors, and emergency medicine, the care is "pretty good" according to a man named Nigel Hawkes. He then speaks of elective medicine, which includes "hip replacements, heart operations" and other procedures on the topic of waiting lists and time it takes to actually have the operation (Palfreman). In the UK, the government has set up healthcare with business like competition without the focus on profits. Simply, hospitals must compete with each other to even stay afloat. UK citizens are allowed to go to any hospital of their choosing, which makes hospitals strive to attract as many people as they can. By working hard to lower waiting times, they can attract more patients in order to stay in business. While this may be accepted in the UK, the United States is a heavily capitalist society, and medical workers would most likely become angered at the suggestion of a similar system. The way the British pay for their universal healthcare is through extremely higher taxes on the populous. A country that uses medical scans such as x-rays, MRIs, and others around 8 times more than the U.S. and 20 times more than the UK while spending less than both on health care is none other than Japan.

In Japan, healthcare is extremely cheap, also covering every citizen no matter their occupational status. Everyone is required to purchase health insurance, with the wealthy helping support the poor. Prices that doctors can charge for every single possible procedure are set by the government, keeping prices the same anywhere in Japan. The government also makes it where if a doctor or hospital tries to increase profits by performing more procedures / operations, they lower the cost of treatment in the following year to balance it out. (Palfreman). Additionally, if a citizen loses his or her job in Japan, they will not go without insurance, but simply switch to a community insurance that provides general care until they are working again. With businesses forced to pay half of this premium, it is extremely affordable compared to the premiums seen in the United States. This prevents doctors and insurance companies from getting rich. Implementing this kind of healthcare in the United States could discourage those set on a medical career, deeming it not worth the time and money they would have to pour into the process. While from the patients and businesses point of view, this is an excellent system, but if they were to take a step back from their own situation, they would see the dilemma they are in. According to Professor Saito Hidero, in Japan "over 50% of hospitals are in financial deficit now" (Palfreman). With how popular the healthcare system is with everyone except medical professionals, they are finding it difficult to convince the officials to raise prices in order to save the hospitals. This will eventually lead to hospitals shutting down due to bankruptcy, placing additional strain on the remaining hospitals to treat all the citizens. Overall this system would work excellently if they simply raised the prices just enough to help the hospitals stay in a small surplus. From these two countries and others who have made the switch to Universal Healthcare, America can decide what system would work best for the states. Before the decision to Universal Healthcare is made, the U.S. needs to figure out how healthcare is going to be paid for, and an overhaul on our healthcare system needs to be made towards a focus on preventative care instead of the "disease care system" currently in place.

While taking time to thoroughly plan and research a course of action is generally the best way to go, some believe that any form of universal healthcare needs to be implemented as soon as possible. According to some individuals, health care should be treated as a human right, not as a luxury. When people believe that something is a right, they will want it yesterday instead of being patient to implement a new, working system instead. With health insurance premiums rising "on average by double-digit percentage points over the past five years, a rate of increase that is 2-3 times the rate of inflation" (WHO), an increasing number of uninsured Americans, and "over 20% of nonelderly adults having problems paying medical bills in the past twelve months" (Shartzer), everyone can agree that the United States healthcare system is flawed and needs to change. If a change isn't made, Americans will see the collapse of their healthcare system and the situation will only become worse in the near future. In any case, a change to universal healthcare will take years to implement, and will put the "poorest at risk, due to having citizens pay out of pocket for healthcare during the transition". If we don't fix the way we charge for health care today before attempting the move to universal health care, only additional problems will appear that cause deeper scars that will be harder to fix in the future.

Overall, America has its hands full of issues that need to be resolved. 50 million Americans with no healthcare, and countless others struggling to pay. There are many options laid out in front of all of us and we need to decide as a whole what we think will be best for this amazing country. Should stay steadfast in the way our health care system works now? Or copy something that another country did before us? It's no individual's choice to make, and the decision relies on whether you believe that what I have brought to the light is even a problem at all. Solutions that could end a nationwide cause of over half of personal bankruptcies. No matter the path we take, our system is failing, and we need to decide as a whole before it is too late to make any decision at all. 

