• Background: US system gives tax breaks to employers for providing insurance
• Debate: Markets are more efficient v. The US system is clearly not working
• Country Comparison: WHO assessment of world health systems
• Recent Legislation: State initiatives for universal health coverage

Background

• While the US government provides health insurance for veterans, the elderly, poor and disabled, there has yet to be a system that ensures coverage for every citizen. In the U.S., health insurance is typically provided to workers and their families by their employers. The U.S. government offers a tax reduction to employers offering health benefits in what is referred to as a 'tax expenditure'. The exclusion of employer contributions for medical care amount to the nation's top tax expenditure at $102.3 billion in 2004, which is nearly twice as much as the next highest tax expenditure- mortgage interests.
• According to the OECD 2003 Health Data report, the United States tops the OECD ranking for overall health care spending at $4900 per capita in 2001, more than twice the OECD average of $2100. Though more than half of the cost is private funding, the U.S. government spends the most out of all OECD countries (except Norway, Luxembourg and Iceland) per capita even though only about 25 percent of the population is insured through public programs compared with 90 per cent in other OECD countries (Source: OECD).
• There are many different ways to organize universal health systems. A single-payer health care system is typically a government-run organization that collects and pays out all health care costs. Germany has a universal multi-payer system with two main types of health insurance: "Compulsory health insurance" and "Private." The French health care system, rated the best in the world by the World Health Organization, has private and public health care providers and universal access funded by taxes and co-fees.The United States is the only developed nation without a universal health care system.

Debate

• Proponents of a universal health care system point to the global trend of industrialized countries with providing health care. Administrative costs would be drastically decreased. The U.S. government spends more than all other countries per capita without receiving proportional health benefits and more than 47 million people are uninsured.
• Opponents cite that income taxes would increase and private insurance companies may be put out of the health care administrative business, a result that would fly in the face of laissez-faire capitalism the US was founded upon.

Country Comparison

• See the World Health Organization's assessment of world health systems.

Recent Legislation

• A few states and cities have taken steps to provide health coverage for citizens, such as Minnesota and Massachusetts.The Massachusetts 2006 Health Reform Statute is a law that requires nearly all residents of Massachusetts to purchase health insurance or obtain coverage through State sponsored insurance for those with low incomes. San Francisco is currently phasing in a universal health care program.