The United States has a world class healthcare system. Yet, during the pandemic, America’s largely private healthcare system has seriously struggled. Despite being on the frontline of the fight against COVID-19, many US hospitals are now losing millions of dollars a day as they cancel profitable surgeries to make room for the less-lucrative work of treating coronavirus patients. It seems absurd for healthcare professionals to lose their jobs during the worst public health crisis in a generation, but that is precisely what is happening.
In Europe, healthcare is largely provided free of charge. Of course, we can quibble about what “free” means (the taxpayer ultimately has to foot the bill). Yet there is clearly a difference between the approach taken by most European countries and the healthcare system in the US. Could the ongoing pandemic encourage the US to take a “more European” approach when it comes to healthcare (especially in an election year when healthcare is likely to be an important electoral issue)?
What do our readers think? We had an impassioned comment sent in to us by Muriel, who believes healthcare is as much a basic need as housing, food and water and should be guaranteed unconditionally. Is she right? Should healthcare should be free for everybody, particularly in the wake of the COVID-19 pandemic?
To get a response, we put Muriel’s comment to Francesca Colombo, Head of the Health Division at the Organisation for Economic Co-operation and Development. How would she respond?
Well, Muriel, you’re absolutely right in the sense that every human being on our planet has really the right to enjoy the highest level of attainment of health without really any distinction of gender, of race, of religion, of political belief and so forth. And I think in the context of the COVID-19 crisis this has really shown the importance of ensuring adequate funding of health services.
I would also like to highlight that, in September 2019, there was a universal health coverage declaration by the UN General Assembly that has really positioned universal health coverage as a landmark feature of our societies and economies.
Now, universal health coverage really means that everybody should be able to access healthcare and high quality healthcare without facing financial hardships. It means that individuals should have access to health services without being pushed into poverty or having impoverishing costs because of that.
And this is the fundamental element; there can be some countries where a share of the health spending is funded directly by individuals or through other means, but what is fundamental is that we don’t have impoverishing direct spending by households. And you will also understand that protecting the most vulnerable people, the most vulnerable groups, is particularly important, and I think the COVID-19 crisis has more than ever highlighted the fundamental importance of adequately-funded health systems.
Next up, we had a comment sent in from Hugo, who would disagree; he believes that the quality of healthcare is much higher in the US than most of Europe, and adds that taking care of healthcare is an individual responsibility and “only the lazy ones don’t have healthcare”.
To get a response, we put Hugo’s comment to Lee Ohanian, Professor of economics and director of the Ettinger Family Program in Macroeconomic Research at the University of California, Los Angeles (UCLA). What would he say?
In free societies – such as in the United States and in Europe, Australia, and many other countries – we all highly value that freedom comes with responsibility. We make our own choices, we have the opportunity and responsibility to make our own choices, and we do that wisely, because if we don’t then someone else will do it for us. So, that’s an important point that is in the background of any reasonable discussion about any good or service that we buy.
In terms of Europe, customers are not really incentivised to search for the best healthcare deals. In economics there are, broadly speaking, two ways to ration demand: through price or through waiting. And in Europe there’s a lot of waiting for some types of procedures. Some types of healthcare may not be offered. My understanding is that within the National Health Service [in the UK], operations such as cataracts surgery in some locations are not even offered because it’s termed of limited clinical value.
Now, 96-97% of cataracts surgery are very successful and can mean the difference between good eyesight and blindness. So, this is the longest-running publicly-provided single-payer healthcare service in the world and they are struggling with costs because the NHS, and a lot of Europe, just simply doesn’t obey the principles of economics.
So, yes, Europe can learn some things from the US, the US can learn some things from better principles of economics, and I think both locations can do a lot better in terms of satisfying consumers of healthcare and not wasting so many resources.
Should healthcare be free for everyone? Is healthcare as much a basic need as housing, food and water? Or should healthcare be treated as a marketplace, promoting efficiency and cost saving through competition between providers? Let us know your thoughts and comments in the form below and we’ll take them to policymakers and experts for their reactions!