U.S. health care has long been known as the most expensive and least affordable system worldwide. Although more than 17% of the national GDP is spent on the healthcare system, many Americans still think it is in a disastrous state (Papanicolas et al., 2018, p. 1026). In fact, the United States spends more than any other developed country on medical care (Papanicolas et al., 2018). Despite various reforms, particularly the Affordable Care Act, also known as Obamacare, many citizens remain uninsured, which means they cannot access medical care (Tikkanen et al., 2020). Thus, many people are dissatisfied with the health system in the United States. According to recent data, only 30% of Americans are delighted with the country’s health care, 25% are neutral about it, and 43% do not like the system (Statista Research Department [SRD], 2022). In contrast, 60% of the citizens of Singapore are content with their healthcare system (SRD, 2022). Therefore, the new health care, which will be based on Singapore’s model, is proposed to provide universal and compulsory insurance.
The Prototype for the New System
Financing is the first thing that needs to be considered for the new system that will provide Americans with universal health coverage. The latter is defined as “ensuring that all people have access to needed health services,” and it “does not expose the user to financial hardship” (National Academies of Sciences, Engineering, and Medicine, 2018, p. 228). In the Singaporean model, the medical care budget is primarily formed from obligatory savings, MediSave (Tikkanen et al., 2020). Furthermore, Singapore’s citizens must usually pay deductibles, premiums, and co-payments in case of medication prescriptions or some outpatient services (Tikkanen et al., 2020). Similarly, the proposed system for the United States will need some legislative changes, requiring people to pay a separate medical tax and enroll in compulsory health insurance.
The Government’s Role
Money from the taxes will go to a specialized corporate fund that the U.S. Department of Health should regulate. The budget regulation will be made on the level of local, state, and federal governments to ensure enough money is allocated to cover all residents of a given city or state. Moreover, donations to this fund from private parties will be highly encouraged and widely promoted in the press and social media.
Insurance Companies’ Role
Notably, people should still be left with the option of choosing private insurers, but it will not exempt them from the medical tax. It is a risky step to diminish the role of insurance companies in the United States. However, if the federal government wants to reduce medical costs and wishes to eliminate medical bill-related bankruptcies, it should be prepared to limit the role of private insurers.
The Role Employers
The employers’ role in the new system will be similar to the old one. Particularly, they will serve as mediators in transferring employees’ required medical tax payments from their salaries. In contrast to the current health care, the proposed will be compulsory to ensure universal coverage. The law should be modified to require all companies to include this option as a required benefit they are obliged to provide to their workers.
Other critical points to discuss in the new system are the cost of care and providers’ income. The salaries of American physicians and nurses are significantly higher than the ones in other developed countries, like the United Kingdom and Germany (Papanicolas et al., 2018). It is enabled by the fact that medical services in the United States are more expensive than in any other state worldwide. Specifically, in the U.S., one must pay $896 and $1145 per computed tomography and magnetic resonance imaging scan, respectively, and these numbers are much lower in other developed nations (Papanicolas et al., 2018, p. 1036). Therefore, the federal government will need to reduce medical costs and constantly regulate them in the new system. Even if it diminishes health providers’ income, the salaries will remain sufficient for a comfortable living.
The Role of Consumers
Patients are the primary consumers in any healthcare system, and their role is essential. All clients will have their personal accounts where their medical savings and all the primary, secondary, and tertiary care services they are eligible for will be displayed in their electronic medical records. Notably, patients will be asked to give feedback on the provided services after every hospital visit or admission, which will be essential for the overall rating and bonuses for clinicians.
Individuals will pay 7% tax from their income to create a health savings account. This measure should ensure that all citizens have access to medical care. The citizens will still be required to pay co-payments for additional services, but most essential care will be covered by obligatory insurance. Another point to consider is unemployed people and vulnerable population groups who cannot pay the required amount to be insured. If an individual is unemployed, one can be covered by the corporate fund mentioned above. This particular cohort of people will receive coverage without the need for co-payments. However, they will be required to register and be associated with one specific healthcare provider.
In summary, the new healthcare system proposed for the United States is based on the Singaporean model because it provides universal health coverage. The financing will be done through required 7% tax payments and donations to a corporate medical fund regulated by local and federal governments. Furthermore, U.S. policymakers may need to introduce strict cost regulation of health services. Overall, the hope is that the new system will make American healthcare affordable and accessible to all citizens.
National Academies of Sciences, Engineering, and Medicine. (2018). Crossing the global quality chasm: Improving health care worldwide. The National Academies Press.
Papanicolas, I., Woskie, L. R., & Jha, A. K. (2018). Health care spending in the United States and other high-income countries. Jama, 319(10), 1024-1039.
Statista Research Department. (2022). Percentage of respondents worldwide who were satisfied with their country’s national health system as of 2019, by country. Statista.
Tikkanen, R., Osborn, R., Mossialos, E., Djordjevic, A., & Wharton, G. (2020). International profiles of health care systems. The Commonwealth Fund.