Universal health care describes any system whereby all residents of a given jurisdiction, often a country, are covered by plans to pay for their medical needs as they arise.
This can arise in several ways:
- The free market creates conditions under which, between employer-provided plans, individually purchased plans, and charity, everyone is covered (neo-con ideal).
- As above, except the gaps in the free market system are covered by government sponsored programs (current US system, except for the "universal" part — or the coverage of gaps part, or the level of "need" addressed, part...).
- A "single payer" system where one organization, whether private or public, pays for all care, theoretically at a regulated and affordable cost to the covered.
- A tax-supported government program is set in place to pay for medical care for all who partake of it, with medical professionals operating private businesses which make money by providing care to individuals, which is paid for by said government program at more-or-less set rates per service.
- A tax-supported government program is set in place to employ medical professionals to provide health care to the population.
The last two options are what people usually mean by "single payer".
The first two do not succeed in providing health coverage for all, in practice. The third example is provided just to acknowledge the concept that single payer universal health care could arise in the free market private sector somehow.
The fourth and fifth are what we see in many countries of the world, with varying results and popularity.
Advantages of tax supported single payer universal health care
- Health care for all!
- No direct health insurance costs for businesses or individuals.
- Efficiency of scale and simplicity.
- Health care continuity not affected by employment status changes.
- Money invested in healthcare is spent only on healthcare and related administration, rather than on profit-making insurance companies.
- Doctors' main goal is to get you healthy/save your life. The current system in the US can encourage unnecessary, expensive testing and extended care.
- Generally cheaper.
Disadvantages of tax supported single payer universal health care
- People cannot opt-out of the system if they do want to die from easily preventable diseases.
- Drug companies may pettily restrict access to newer drugs because they can't charge usury-style prices.
- The only motivating reason for quality and timely services is profit.
- It is often held that the government cannot do anything as efficiently as the private sector (although this is unproven and often the result of the private sector cutting corners to save on cost).
- Higher taxes, which may be levied "unfairly" (i.e. taxing the rich people more).
- "Creeping socialism."
- Lazy poor people deserve to suffer from easily preventable diseases.
- Adding millions of newly insured patients might overload the system, leading to health care rationing. This, of course, means that the poor will get fair treatment.
- If doctors are not compensated appropriately, there will be "shortages" in health care availability, like in Canada  and the UK .
The costs of maintaining universal healthcare, or financial limitations in its implementation, tend to increase substantially over time.
For example, the United Kingdom's National Health Service (NHS) was founded way back in the 1940s. There have been huge advances in pretty much every branch of medical treatment during the decades that followed, including, for example, the development of effective cancer treatments, intensive care and life support technology, and vastly improved pharmacology. With these improvements in medicine comes the ability to treat more conditions and keep people alive for longer, and with universal healthcare comes the obligation to do so. Many of these treatments are highly expensive, and some rely on corporations such as those of the pharmaceutical industry, resulting in NHS money being routed back into the private sector.
Hence the national cost of universal healthcare has gradually become more expensive (although the annual NHS budget amounts to slightly over $2000 per citizen, per year). This, along with measures taken in response to the rising costs, has resulted in restrictive budgeting and performance pressure at every level of the NHS, an unnecessarily competitive culture (including hospital league tables), marginalisation of some services, and lengthy waiting lists for some forms of elective surgery and other treatments. Regardless of the positive advances which have caused them, these negative effects have been a major target for criticism, with short-sighted commentators regarding them as a sign that the quality of service offered by the NHS has declined, often based on widely-reported but rare incidents.
This link between improved medical possibilities and rising healthcare costs also leads some to believe that universal healthcare has become — or will become — unsustainable. Arguably, it may also lead to increasing ethical (and financial) dilemmas of the "when do we pull the plug?" kind. Obviously, this problem never occurs without universal health care, because the complete lack of taxes under such a system implies all patients are breathtakingly wealthy.
Examples of systems in use today
Australia is perhaps unusual, in that it developed a universal health care system in the early '70s, then removed it, and then restored it again. The modern iteration, Medicare, is nominally funded by a 1.5% Medicare Levy on income, but in practice it is funded out of general revenue. Medicare covers 100% of in-hospital costs, 85% of specialist costs and 75% of general practitioners' costs. In addition, the Pharmaceutical Benefits Scheme (PBS) subsidises certain prescribed medications. Visitors from countries with reciprocal relationships with Australia (for instance, New Zealand) have limited access to Medicare (though all patients in Australia have access to free hospital care, regardless of whether they are Australian or not). The Australian health system is generally considered to be among the best, if not the best, in the world, providing reasonably timely treatment at a low cost to the country. Australia spends approximately 9.8% of its GDP on health care, making the Australian system among the cheapest in the world.
leeches back bacon for the asking, eh?
In practice, healthcare is generally funded by a combination of sales tax and federal transfer payments, although in the western provinces they've had good results in using casino revenues. While long wait times are often pointed at as a weakness of the system, they are more likely caused by the system's underfunding by a series of Liberal (centrist) and Conservative (right, recently hard right) governments, who didn't necessarily have a commitment to the system, and only hesitate due to the massive public supports for socialized medicine. Hard to win an election when you give the source of national pride a kick to the 'nads, eh?
There's some good background here on the history of Canada's healthcare system.
In fact, there has recently been a bit of controversy in Canada about the introduction of private health care; supporters claim that it will improve access; detractors claim it will create a two-tiered system that gives better service to the wealthy.
Since the dismantling of much of the communist healthcare system, access to healthcare in China has deteriorated substantially. Citizens now find they need to save substantial sums to cover potential medical bills, proving inarguably that privatized medicine is the perfect system.
Despite western propaganda claiming Fidel Castro regularly consumes infants and bathes in the blood of the innocent, Cuban healthcare is better than that of any other nation in the region.
After Moore's film Sicko, which depicted Cuba's healthcare system as incredibly good, the Republicans were quick to point to a hospital in Cuba with absolutely despicable conditions, that make 18th century medicine look like miracles. The Republicans pointed to this hospital to show that health care in Cuba is not as good as people present it to be. The hospital in question is actually a volunteer hospital providing care to people who are against the Communist Regime. It would honestly surprise us if a totalitarian government did provide adequate health care for dissidents. The USA (which arguably isn't totalitarian) certainly doesn't provide adequate healthcare for its poor or even all its freaking veterans!
Whether the system itself is really as good as claimed or not, Cuba is a major exporter of highly trained medical talent, with Cuban doctors involved in humanitarian efforts around the world. No, really. Oddly enough, America, which claims Cuba is evil and inhumane, has refused Cuban medical assistance during the aftermath of almost every major natural disaster, including Hurricane Katrina.
All Danish citizens have the right to free treatment from general practitioners, specialists and public hospitals. Depending on personal income, it may also be possible to get financial support from the municipality for other health-related costs.
About 1.8 million Danish citizens are also members of Sygeforsikringen danmark (Health Insurance Denmark), a private mutual insurance company, which offers refunds of up to 85% on expenses not generally covered by the public health insurance, such as certain types of medicine, eyeglasses and dental care.
Government expenses for the public health care system amounts to ca. 14 billion, or about 2500 USD per citizen, per year. The system as a whole generally functions well, but is however plagued by certain serious structural problems that lead to inefficiency and dissatisfaction in certain sectors. Many people also believe that the system does not receive enough funding to live up to expectations from the political level.
As a result of the 2001-2011 Liberal/Conservative government's not-so-subtle attempt at starving the beast, the private health-care sector in Denmark has expanded quite a bit in the later years, and the sale of private health insurance have been steadily rising. In 2010 it was forwarded that the then-prime minister, Lars Løkke Rasmussen, an avid admirer of the American health care system, had, in his period as minister of health, deliberately over payed the private hospitals in Denmark in order to help them out-compete the public hospitals.
Everyone in Japan is required to get a health insurance policy, either at work or through a community-based insurer. Eighty percent of Japan's hospitals are privately owned — more than in the United States — and almost every doctor's office is a private business (not exactly what you can call socialism). In Japan, waiting times are so short that most patients don't bother to make an appointment. The only problem is the prices are too cheap.
They pay less money for their healthcare, and get better treatment than most non-millionaire Americans. The disadvantage is that many hospitals need serious renovation, and getting extraordinary medical care, or routine care on weekends, is unlikely (despite the utopia presented in Michael Moore's film). However, "additional coverage" insurance, which provides for private doctors, more advanced technology (think "MRI" vs. "X-Ray" for a broken bone), and shorter wait times for routine care can be purchased at a fairly minimal cost.
Germany has a universal health care system made up of both mandatory public insurance and private plans (the self-employed and high-wage workers can opt out of the public plan and obtain a private one). The conditions and prices of the public plan are mandated by the government, but supplied by a range of contractors who may include additional benefits. Its costs are shared equally between employers and employees, who have to contribute a fixed share of their monthly payroll regardless of income. The premiums of low-income workers are subsidized by the state, which also supplies coverage for the unemployed.
Comparatively little tax money goes into the system, but the premiums have a noticeable effect on the cost of labor. High-wage earners and the self-employed can sign up for any of the nation's 200 private health insurance plans — a broader choice than any American has. If a German who uses the public plan doesn't like her insurance company, she can switch to another, with no increase in premium. And there's usually little or no wait to get elective surgery or diagnostic tests, such as MRIs. In Austria and Germany, if a doctor diagnoses a person as "stressed," medical insurance pays for weekends at a health spa.
None of the slaves have free health care. Thanks, Gandhi!
Citizens may choose between private and public health care, where public health care consists of special programs provided by the same companies that offer private health care.
The maximum fees of these public programs are restricted by the government, a typical public health insurance including dental care costs around 80 euros a month.
Health care for all minors (less than 18 years old) is free.
The Accident Compensation Corporation is an insurance fund paid into by all employed citizens, which then funds treatment for accidents and provides a percentage of salary lost due to accidents. Public hospitals provide care to a large portion of the population with means-tested fees and long waiting lists in some cases, while private hospitals cater to the wealthy and the privately insured.
National health system paid for by taxes. Quite centralized system but it works quite well. Hospital care covered but patients sometimes have to wait for non-urgent treatment. Standard charge for prescription medicines with reductions for pensioners. People have the option of taking out private health insurance if they don't want to wait for their non-urgent operations.
Apart from the central system there is also a system of General Practitioners (AKA Family Doctors) who provide localised care. The quality of this service varies from the really outstanding to the quite poor.
As far as dental treatment is concerned, urgent extractions are covered by the state system, but all other treatment is private.
In general Spanish people seem quite satisfied with their system, especially when compared with what they understand the American system to be.
Britain's National Health Service is similar in principle to Spain's, i.e. a centralized system paid for by taxes. Hospital care is covered but patients sometimes have to wait between consulting about an issue and beginning treatment; typically a maximum of 18 weeks for non-urgent treatment and 4 weeks for cancer care. People have the option of taking out private health insurance if they don't want to wait for their non-urgent operations.
There is a standard charge for prescription medicines but there are exemptions for the elderly, the very young, the poor, expectant mothers, and people living in Wales.
Until recently the British NHS was the envy of most other countries but there is a determined effort by the Government to edge it closer to the American model by privatisation in various guises. This effort is fiercely opposed by the majority of the British populace. There has also been a concerted effort by the American Right to portray the NHS as vastly worse than it actually is in order to derail US healthcare reform.
Michael Moore's 2007 film Sicko, made for the American market, paints a fairly realistic picture of the NHS and condemns US healthcare.
It is certainly true that the British in general have much better health care than Americans, except for millionaires.
Dental care is not fully covered by the NHS, but the repercussions of this are not obvious, particularly to Americans who would never base a stereotype on such a shortfall.
There is even a twitter page of real British people expressing support for the NHS. This led to twitter crashing when millions of Britons turned up to defend the NHS. The NHS supporters included Stephen Hawking, who said "I wouldn't be here today if it were not for the NHS." This was in response to an especially unresearched article claiming that Hawking, who has suffered from ALS for many years, would have been euthanised under the NHS.
United States of America
15% of U.S. residents have no health care plan, nearly two-thirds of bankruptcy filings in 2007 were linked to overwhelming medical bills, and 18,000 people die unnecessarily every year in the United States simply because they're uninsured. Despite campaigns by politicians on the center and left, no national health care service seems likely to be enacted any time soon, due to the perceived association of "socialized medicine" with Communism, among other reasons. The state of Massachusetts, as of July 2007, has a rudimentary universal health care system based on providing state-funded subsidies to commercial health insurance providers, but it's too early to decide how well it works.
In that same month in a speech in Cleveland, President Bush asserted that America already had universal health care when he said, "People have access to health care in America. After all, you just go to an emergency room." 
In 2000 a World Health Organisation report noted that the USA ranked 37th out of 191 member states for the quality of health care available to its citizens (France was top, the UK 18th, Colombia 22nd).  Life expectancy is lower in the United States than in many other developed countries and problems with health care are part of the reason. 
The Southern Baptists officially opposed expanding public child health insurance on the strawman that fetuses will not be covered. However, the Democrats were idiots for allowing this strawman to become an issue, considering that public health insurance for pregnant women would be a good thing. In 2009, the Democrats wised up and added a section for covering pregnant women; the godless Southern Baptists still found a way to oppose this under the motto of "Love the fetus, hate the child".
Michael Moore made a documentary, Sicko, in his inimitable style, about the current "system" in the United States, comparing people's experiences with it to those in Canada, France and Great Britain. He also pointed out that detainees at Guantanamo Bay receive free health services on par with, or better than, that which the average American must work or pay for. He then pulled an illegal stunt by bringing several ill first responders from the 9/11 cleanup to Cuba and obtaining free care for them (see above, Cuba). Which isn't so unusual since more than 5000 foreign patients traveled to Cuba in 2006 for a wide range of treatments including eye-surgery, neurological disorders such as multiple sclerosis and Parkinson's' disease, and orthopedics.
On September 9, 2009, a frustrated President Obama gave a speech before a joint assembly of both houses of Congress, outlining what he insists be included in such a bill and castigating people promoting what he termed "lies" about what such a bill might entail. Joe Wilson (R-SC) at one point heckled him, calling him a liar. Eventually Congress began debate on Obama's health care plan which garnered much of attention by the news media and extensive analysis by political pundits as it came toward a vote. Around this time the concept of "death panels" was first concocted by
psychopath former Republican VP candidate Sarah Palin as a way to smear the upcoming reform. Finally on March 23, 2010 the Affordable Care Act became law. The law had both a lot of support and criticism. In brief, the law lowers health care costs, holds insurance companies more accountable, provides more health care choices, and enhances the quality of health care for everyone. However, it is not a true universal health care system. The only state to have any form of universal health care is Vermont, which passed a single-payer health care system in 2011. 
Despite this, the United States does have certain forms of government-run health care: Medicare for the elderly, Americans over 65 have relatively good life expectancy, the main problems are with mortality among younger Americans.  There is also Medicaid for the poor, and health care through the veteran's administration for those that have served in the military. These systems very neatly separate the segments of the population that are likely to actually require a lot of expensive medical care and puts them on the public dole, while leaving the private sector to take care of the people for whom providing health insurance is likely to turn a profit.
Countries with universal health care
If that's not convincing, then we don't know what is.
- A Conservative Convert To Socialized Medicine.
- The Health of Nations, an interesting essay comparing several health care systems.
- Single Payer FAQ - Physicians for a National Health Program
- ↑ http://www.ooa.ca/files/economic%20costs%20of%20wait%20time.pdf
- ↑ http://news.bbc.co.uk/1/hi/health/7271772.stm
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- ↑ 
- ↑ http://borsen.dk/nyheder/foedevarer/artikel/1/119803/boom_i_salg_af_sundhedsforsikringer.html
- ↑ http://politiken.dk/politik/politikfakta/ECE1071850/derfor-er-sagen-vigtig/
- ↑ http://www.npr.org/templates/story/story.php?storyId=89626309
- ↑ http://www.denverpost.com/opinion/ci_13265319
- ↑ http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/@ps/documents/digitalasset/dh_122736.pdf
- ↑ http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/documents/digitalasset/dh_123394.pdf
- ↑ http://www.metro.co.uk/news/article.html?NHS_supporters_crash_Twitter&in_article_id=719001&in_page_id=34
- ↑ http://www.telegraph.co.uk/news/worldnews/northamerica/usa/6017878/Stephen-Hawking-I-would-not-be-alive-without-the-NHS.html
- ↑ http://latimesblogs.latimes.com/booster_shots/2009/06/medical-bills-led-to-twothirds-of-bankruptcies-in-2007-study-finds.html
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- ↑ http://www.bbc.co.uk/news/world-us-canada-14070090
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- ↑ http://www.motherjones.com/politics/2011/05/vermont-single-payer-health-care
- ↑ http://www.bbc.co.uk/news/world-us-canada-14070090