Universal health coverage (UHC) has been defined as the extent to which inhabitants of a country have access to effective and affordable health services without facing financial hardship, and United Healthcare is one of the largest providers of medical insurance in the United States. When you buy an insurance plan from United Healthcare, you gain access to these benefits and more, including wellness programs and discounts on prescriptions, dental care, vision care, and other services. But how does UHC work? How do you know what kind of health plan will work best for your budget?
Why does UHC exist?
UHC exists to provide everyone with access to medical care without experiencing financial hardship. The goal of UHC is to ensure that everyone has access to the necessary medical care without experiencing financial hardship. One example of how UHC works in America is Tricare, which provides members with health coverage for a monthly fee.
An individual would need to enroll in Tricare before they could receive any benefits, but once they’re enrolled, they can use any facility that accepts Tricare. For example, if an individual goes to see their doctor at National Health Care Corporation, their co-pay is only $20 for each visit as opposed to paying hundreds of dollars out-of-pocket. Another way that UHC provides all individuals with equal access is by ensuring no one pays more than 20% of their income on healthcare costs. A humane Tricare member’s premium does not exceed 8% of their income and their out-of-pocket expenses are capped at $1,500 per year.
United Concordia Tricare Dental offers discounts on orthodontics and dental implants based on the patient’s age and there is no waiting period or exclusions for preexisting conditions. More than 20 million people have signed up for Tricare since 2002. The Centers for Medicare & Medicaid Services (CMS) manages the contracts between providers and insurers through what is called a fee-for-service model. Under this system, private insurance companies negotiate fees with hospitals, doctors, drug manufacturers, and other providers.
CMS also sets a target price that these private insurers must meet when negotiating rates with doctors and other service providers. In order for private companies to negotiate rates successfully with providers, there needs to be sufficient competition among them so that private companies are not setting exorbitant prices just because they know the government will cover them through Medicare.
If a company negotiates too high of a rate from one provider, another company can step in and offer lower rates. Patients are expected to share responsibility for reducing costs by seeking less expensive alternatives such as generic drugs instead of brand-name ones.
UHC progress over time
Universal health coverage has been in existence since 2000. It was created to provide affordable medical care to everyone, regardless of their economic status. The first step was getting all Americans enrolled in some form of insurance so they are eligible for healthcare benefits.
Today, there are many different options for people who need health coverage including Tricare for Life which provides supplemental coverage to the military families of retired service members and their dependents. For those without insurance coverage or who are underinsured, there are other options such as a high-deductible plan with a health savings account.
However, the Affordable Care Act (ACA) guarantees no lifetime limits on your mental health care plan so that you can get help when you need it most. UHC Vision helps cover eye-care costs that may not be covered by another provider’s plans like a vision care policy from United Healthcare Vision.
One way you can know if you’re uninsured is if your out-of-pocket annual expenses for health care exceed 10% of your income. If this happens, we recommend enrolling in an Obamacare exchange marketplace plan to reduce monthly premiums and out-of-pocket costs. There are five categories of essential benefits included in ACA health policies: hospitalization; emergency services; maternity/newborn care; pediatric services; prescription drugs. All providers must follow these standards whether they work at public hospitals or private clinics. In addition, state Medicaid programs must adhere to federal guidelines and also offer comprehensive health benefits. Depending on your job status and household size, you might qualify for subsidized rates through a variety of state-based exchanges. Enrolling in Medicaid will lower the financial burden of hospital visits because they only charge low co-pays instead of charging copays that can cost thousands per year.
Countries with UHC
- The United States provides health insurance through the U.S. Department of Veterans Affairs and a system of social security that offers public health insurance programs like Medicare, Medicaid, Tricare Dental, Tricare Select, or VA loans to purchase homes.
- Sweden has national healthcare for all citizens with taxes funding about 85% of the costs. Healthcare services in Sweden are divided into three categories: primary care (general practitioner), secondary care (specialist), and tertiary care (emergency room, intensive care unit). Hospitals are run by county councils while doctors can be either self-employed or salaried employees. Private health insurance is available but less than 3% of Swedes have it. There is also a patchwork of private supplemental coverage companies called försäkringskassor. These companies offer additional benefits for things like dental and optical care not covered by Swedish universal healthcare. You don’t need to pay anything out-of-pocket when visiting your general practitioner or hospital because most Swedish residents live under some form of national health coverage. In Sweden’s system, you may be charged a fee if you visit the emergency room at your local hospital more than once within six months. Certain medical treatments, such as IVF treatment, fertility drugs, cancer treatment, and mental health treatment are free from cost.
- If you want an elective surgery done privately, you would need to find this service on your own and pay for it upfront before being reimbursed later by Sweden’s National Board of Health and Welfare. The Board pays 70% of approved treatments so long as they’re done in licensed clinics or hospitals. Another 10% comes from the patient themselves, who receives 30% back from their company’s employer. Private providers can charge patients 90%. Countries with UHC include Canada, Cuba, Denmark, France, Germany, Italy, Japan, South Korea and Taiwan among others.
Pros and cons of UHC
While there are many benefits to UHC, the system has a few drawbacks that may be worth considering. For one, if people have to pay for their own health care, they will likely only go to the doctor when they are sick. The lack of preventative care can lead to higher costs in the long run as illnesses grow more severe or chronic.
UHC also requires a government bureaucracy that may not be able to maintain itself financially in difficult times. In some countries with UHC, high taxes are necessary to fund medical care, which means less money for individuals to spend on things like education or food. Additionally, because everyone pays into the system and then receives services depending on need rather than the ability to pay, some argue this leads to rationing of care. These groups often cite waiting lists for surgeries or treatments as evidence that UHC leads to waiting death.
On the other hand, proponents of universal health coverage point out that it protects all citizens from financial risks associated with serious illness.
Those who feel they cannot afford private insurance may find relief from public insurance programs such as Medicaid. Another benefit is reduced over-utilization of medical resources through effective cost-sharing mechanisms such as deductibles and copayments. Preventative care remains accessible to those who don’t get sick very often, while those with chronic conditions can receive treatment regardless of their income level.
Finally, supporters say universal health coverage provides better overall quality of life by ensuring access to all aspects of human dignity including healthcare, nutrition, housing, and social security. With better access to health care, people can focus on taking care of themselves and their families instead of struggling just to survive. Universal healthcare empowers society’s most vulnerable members – children, women, the elderly, and persons living with disabilities – to live full lives as contributing members of society.
They will no longer face arbitrary discrimination based on gender, age, disability status, or sexual orientation. It ensures equal opportunity for economic growth and improves the productivity of our workforce by investing in good health for all.
Challenges with UHC
Universal health coverage can be challenging for the individual to navigate. The sheer number of providers and options can be overwhelming. A solution that has emerged to this problem is the UHC link, a website that provides information about the many different types of healthcare plans available in your area. It also helps you find a provider nearby and provides reviews from people who have used them before.
However, as with any new technology, there are some limitations. The site does not provide prices or coverage details until you input personal information like income and location which can put some individuals at risk for identity theft or fraud. In addition, there is no way to compare providers so it’s hard to know if one plan will be more affordable than another.
There is also no way to compare plans side-by-side which make it difficult when trying to decide between two similar ones. Despite these challenges, the UHC link can help make navigating healthcare more manageable. They use data science to surface relevant content without the user having to search extensively. The team behind the project was motivated by their experience of dealing with medical bills while they were in college.
At times they had trouble making payments but they wanted to avoid using credit cards because of high interest rates on top of other financial costs. UHC link aims to help consumers get on top of their bills early by providing upfront cost estimates for procedures and informing them what subsidies may apply based on their income level. They then collect feedback about quality, pricing, and effectiveness after the procedure is complete so that future users can benefit from what others found helpful or detrimental during their time navigating healthcare options.
Final thoughts on UHC
The universal health coverage goal would be to ensure that all people have the opportunity for good care, mental health care, and advanced care planning. This would require a comprehensive plan to provide the proper amount of funding, as well as cooperation between the government and different organizations. A key component of UHC would be a national or international public insurance program to insure against catastrophic health costs. Additional plans should include broadened public investment in prevention and treatment, with an emphasis on strengthening primary care services.
Investments could also come from out-of-pocket payments and private insurers to increase competition.
A complete list of policy recommendations by the WHO includes:
Universal health coverage would require partnerships across various sectors, including government agencies and NGOs. The WHO has identified six important objectives:
(1) sustainable financing;
(2) universal access to essential services;
(3) quality healthcare;
(4) better patient outcomes;
(5) responsiveness to patient’s needs; and
(6) social protection.
These objectives are aligned with four proposed interventions that the WHO recommends governments adopt in order to achieve UHC:
(1) guaranteeing basic health coverage for everyone through legislation;
(2) making additional financial commitments towards improving the accessibility and quality of healthcare delivery;
(3) increasing investments in preventive measures and treatments; and
(4) empowering patients by enhancing their knowledge about their rights and expectations when seeking medical attention.
Finally, the WHO identifies three other means of achieving UHC:
(1) investing in educational programs for high-quality maternal and child health care;
(2) decreasing out-of-pocket expenditures for family planning services; and
(3) promoting innovation among policymakers and healthcare professionals.