By Rohan Uppal
‘Healthcare’ is defined as the services provided by an organisation or a country that involve caring for people's health and treating people who are ill or sick (WHO., n.d.). It is a fundamental right of every human being regardless of factors such as age, sex, caste, creed, race, etc. This was first established in 1948 by the World Health Organisation Constitution and the Universal Declaration of Human Rights, which was subsequently incorporated into the International Covenant on Economic, Social and Cultural Rights in 1966, with emphasis on the right to the highest attainable standard of mental and physical health (WHO., n.d.).
The need for all people to have access to healthcare was emphasised in 2005 by the World Health Organization, which strongly supported financing for universal coverage of health (World Health Organisation., 2010). One method which has been widely discussed, which could be the solution to this, is making all forms of healthcare free of cost. ‘Free’ refers to
‘without payment or cost’. All countries bar 43 have ensured that at least 90% of their citizens have access to universal healthcare, with some examples being France, Germany, India, Singapore, and the United Kingdom (Skuad., n.d.). As for the countries that do not provide universal healthcare, there’s a variety of valid reasons as to why they haven’t been able to, or refuse to implement such a programme.
Supporters of free healthcare strongly believe that this is the best way to fulfil the idea of universal healthcare established by the WHO. In countries with costly healthcare services, unemployed people tend to have a hard time acquiring health insurance, such as the United States (Claxton et al., 2019). In some situations, people with health insurance may also struggle to pay off the over-the-top costs of healthcare services One argument that favours free healthcare is the lowered costs of healthcare – when it comes to free healthcare, the government is responsible for paying people’s medical bills, which is a huge benefit since this eliminates any financial barriers in the way of people receiving the necessary care they need. This also acts as a benefit for private companies who now don’t need to offer their services, which also removes costs of advertising, research and salaries. Healthcare costs could also be removed to address the issue of chronic disease infection. In the United States, 50% of the population is said to suffer from a chronic disease, with care for chronic diseases taking up 85% of healthcare costs (Holman, 2020). With these chronic diseases being treated as an epidemic-level crisis, removing healthcare costs could prevent a country’s economy from being strained (Zieff et al., 2020)
Another factor to consider is the fact that healthcare is a basic human right, which is strongly supported by the World Health Organisation. In the Universal Declaration of Human Rights, it is mentioned that every person, regardless of their status or livelihood, has the right to any form of healthcare. If healthcare is to be considered a basic human right, then it should be available to all regardless of their financial situation, otherwise, it could be considered as denying a simple human right. When it comes to health literacy, approximately 36% of adults in the United States have basic or below basic health literacy, and only 12% are proficient in this subject. This is due to the over-the-top costs of accessing healthcare facilities, which prevents them from being educated about their conditions and medications (Kutner et al., 2006). This can be countered by providing free healthcare, which has been shown to improve the health literacy rates of patients who do not possess insurance coverage by up to 30%. This allows people to gain knowledge about their conditions and the forms of treatment, which is essential for preventing future health problems and making smart healthcare choices.
The final factor to consider is the overall improvement of child health and a decrease in mortality rates. A study conducted in the United States which took data on 23 million child hospitalisations between 1988 and 2005, revealed that children without insurance were 60% more likely to die rather than those with a form of health insurance. Approximately 17,000 children’s deaths were due to a lack of insurance over those 18 years (Norton, 2009). Implementing free healthcare would counter this, especially when it comes to low-income countries such as Yemen and Nigeria. Such a policy was implemented in Kenya in 2018, which has allowed 3.2 million Kenyans to gain access to various health services in the country. Furthermore, there was a large decrease in children’s deaths and the disease burden of children in the country, which has led to a large spike in economic growth (Kiarie, no date). Such an example proves that free healthcare could benefit the health of children. Overall, free healthcare has various advantages that justify the reasons for the majority of countries in the world implement this into healthcare systems.
Each coin has two sides – free healthcare also does have its drawbacks. One of the main arguments against free healthcare is that it would be expensive for governments, especially ones struggling with budget. There would be an increase in taxes due to this, which would be a burden for low-income countries, which now raises the question as to whether the benefit of free healthcare outweighs increased tax costs. This is shown by the fact that the United States spends more than any other country on healthcare, but there’s still a large number of citizens who do not have access to any health insurance (Davis et al., 2014). Governments in low-income countries may even have to use money that was originally needed for other essential programs to keep the universal healthcare program going. This would have a concerning impact not only on the economy but also on society as a whole. This can come back to bite as patients may not be able to get the care they need due to a lack of funding when it comes to hiring specialists and medical personnel.
Another disadvantage of providing free healthcare is the long waiting times that patients will have to go through to receive treatment. When it comes to universal healthcare units, patients have been made to wait weeks, and sometimes even months to see their required doctor or specialist. A study between 2004 and 2007 revealed that for cancer patients, the waiting time for surgery increased from approximately 29.9 days to 56 days. For benign patients, the waiting time increased from approximately 33.4 days to 74 days (Kawakami et al., 2008). This would result in an increase of stress for the staff who work there, the hospital losing their patients and an increased risk of morbidity and mortality.
Combining long waiting times with the lack of funding for specialists, free healthcare could lead to poor quality of care. This is because specialists would be working under the intense pressure of long queues, where they will be more focused on getting the queue out of the way, so they may not end up properly examining the condition for which the patient has visited the doctor. This can lead to poor or incorrect diagnoses and prescriptions, which could affect patients in the long term. The final factor to consider is that free healthcare will make people irresponsible, due to the aspect that they don’t have to pay if they get any injury or fall ill. There will be a lack of preventive measures taken by people to make sure that they are healthy such as a balanced diet, or keeping fit, as they do not have to worry about the aspect of using the money for treatment, which could cause increased infection and injury rates. Overall, the arguments against the idea of free healthcare help establish a strong pillar for the reasons why some countries haven’t implemented such a system yet, and are also some things to be considered by countries who have such a system in place for healthcare facilities.
In conclusion, free healthcare has a convincing standpoint on why it should be implemented, as well as a rather well-framed argument against it which almost neutralises the benefits. So, to answer the question, should all healthcare be free? Before this is answered, we need to answer a different question - should any form of healthcare be free? The logical answer to this would be yes, however, this is not possible for all forms of healthcare, with funding or other priorities being the issue. Some forms of healthcare should be free, such as elderly healthcare, cesarean sections, antenatal care, etc. It can also be implemented as such that young children should get free healthcare, as they are the baseline of our future, and child health is a necessity to maintain no matter what. However, overall, the decision of whether all healthcare should be free must be made based on the availability of funds, the benefits towards the country and the conditions of the country itself.
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