The Many Paths to Universal Coverage

This good article from Harold Pollack contains a highly valuable resource:

Virtually every other wealthy democracy provides universal coverage, achieves good population health, and spends much less on health care than the United States does. These are embarrassing realities, familiar to nearly everyone who follows health policy. Less familiar is another reality: Wealthy democracies have pursued surprisingly diverse paths to accomplish these goals.

In May, the Commonwealth Fund released its encyclopedic compendium: International Profiles of Health Care Systems, which summarizes the main health system features in 19 major economies. These case studies make clear that there’s no single route to universal coverage. Each society follows its own path, reflecting its own unique history, institutions, and political and economic constraints. A true single-payer system provides one approach. But that is not the only or even the most common path. The United States can, and should, learn from these histories, as we make our own decisions about how to build on our existing systems of care.

We’ve been through this before, but to summarize:

• There are many different universal health care programs. They are all better than the status quo in the United States.
• These systems generally evolve based on internal political dynamics. Nobody just takes another country’s system to Kinko’s — that not how policy of this magnitude gets made.
• As Pollack points out, “Medicare for all” (at least if it used the current actually existing Medicare) would actually be much more like a hybrid model than the Canadian one.