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Perspective

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Which Path to Universal Health Coverage? Perspectives on the World Health Report 2010

  • Sara Bennett mail,

    sbennett@jhsph.edu

    Affiliation: Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America

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  • Sachiko Ozawa,

    Affiliation: Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America

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  • Krishna D. Rao

    Affiliation: Public Health Foundation of India, New Delhi, India

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  • Published: November 22, 2010
  • DOI: 10.1371/journal.pmed.1001001

Reader Comments (1)

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Universal Health Coverage Is Not A Good Idea

Posted by cfisher on 20 Nov 2010 at 18:33 GMT

I do not agree with the underlying assumption of your article: universal health coverage is the solution to the healthcare dilemma.

Healthcare insurance, despite its best intentions, does nothing to control healthcare costs. Healthcare costs have escalated dramatically the more we have moved away from a doctor-patient relationship based on a fee for service. The same is true for government intervention in healthcare. Healthcare costs escalate as government participation increases in healthcare. I challenge anyone to prove that healthcare costs have gone down over the last 20 or 30 years since the move from a cash-based system with more and more government intervention. Why then is the solution more government and more health insurance?

At the heart of the matter is that people, quite frankly, will not ration healthcare when they do not have to pay (or even see) the bill. Moreover, people are not motivated to maintain healthily lifestyles when there is no immediate and significant financial impact for poor lifestyle choices.

I think an immediate return to a fee-for-service combined with catastrophic healthcare insurance coverage would solve this dilemma over night. Healthcare providers must provide a valued service for a fee that their customers (patients) can afford or go out of business. The same is true for pharmaceutical companies, and this would almost immediately end crazy medication prices. Catastrophic healthcare insurance would cover those with severe injuries or life threatening/chronic disease. Moreover, the doctor, not the government or insurance bureaucrat, would make treatment decisions based on the individual patient. This plan is simple, elegant, and self-correcting.

No competing interests declared.