For more than a century, America has argued about how to share the costs of health care. Drawing from new government-sponsored insurance programs in Germany and England, Progressive reformers made the America’s first serious push for compulsory national health insurance in 1915, on the grounds that it was the responsibility of an enlightened society: Illness was a major driver of poverty, so spreading the cost of sickness would benefit everyone by diminishing disease and dependency, right?
Not everyone agreed, of course. Government-sponsored health insurance would encourage freeloading, or at least result in a ton of bureaucracy, opponents contended. Why offer more power to the federal or state governments when most insurance could be handled privately?
Today, the debate rages on. While the 111th Congress passed the Affordable Care Act, which, among many changes, mandates that all Americans possess health insurance and requires private insurance companies to offer certain kinds of coverage, subsequent Congresses have voted to repeal the act. Even as Donald Trump has hinted at the value of national health care coverage, a spokesman has tried to clarify that he’s against “socialized medicine.” No one thinks that America’s health care system is perfect, but what really is the best way to for a country to treat its sick and pay for this treatment? Should nations try to partner with neighbors to create international systems, perhaps continent-wide, to ensure equal coverage for all? Or, conversely, should care be focused at the most local level, to be most nimble and creative?
In advance of a Zócalo/Arizona State University event on the best ways for countries to approach health care, we asked a variety of health-policy experts: Should health care systems be national? What are the advantages and disadvantages?
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