What is Universal Healthcare Coverage?

Universal healthcare coverage refers to systems in which all legal residents of a given jurisdiction have health insurance coverage. Many industrialized nations enjoy universal healthcare coverage, though the United States does not.

Understanding Universal Healthcare Coverage

Universal healthcare coverage refers to the state of a society's health sector, rather than the system of laws and regulations that leads to it. Universal healthcare coverage usually means everyone in a given country can enjoy the protection of health insurance, whether the country has a single-payer system, socialized medicine, an insurance mandate, or simply relies on a set of subsidies and and other incentives.

The earliest example of universal healthcare coverage is 19th-century Germany, where Chancellor Otto von Bismarck introduced a series of bills guaranteeing access to healthcare in the 1880s.

Single-Payer Systems of Universal Healthcare Coverage

Under single-payer systems, all health costs are paid by the government using tax revenue. While health insurance is universal and offered by a single entity, however, care itself is still provided by private-sector doctors and hospitals.

Examples of this model include Canada and France. In both of these countries, private-sector insurers also exist, though they play a minor role as providers of supplemental coverage.

Universal Healthcare Coverage as Socialized Medicine

In socialized systems both insurance and care are provided by the government. These systems are less common than single-payer ones, and include the UK's National Health Service. Sweden's publicly funded system mostly provides care through government providers, though private companies play a limited role.

Other Models of Universal Healthcare Coverage

Achieving universal healthcare coverage does not require the government to be the single or even largest provider of health insurance. Germany's system includes for-profit and not-for-profit insurers. In the Netherlands and Switzerland most insurance is provided by private companies; the government requires that all residents purchase insurance and subsidizes premiums.

This system is similar to the one established by the 2010 Affordable Care Act, more commonly known as Obamacare, but the U.S. has not achieved universal healthcare coverage and many people who do have insurance can barely afford it. One reason had been that the individual mandate—the requirement that everyone have health insurance—did not provide steep enough penalties to make obtaining insurance the most economical decision for everyone in light of how high premiums were in many areas. Starting in 2019, the individual mandate was reduced to zero dollars as part of the Tax Cuts and Jobs Act.