Universal Health Coverage

Universal Health Coverage in the USA: Viable or Not?
It is no secret that there is much controversy surrounding the health care system in the United States (US). The hybrid public-private nature of the system has resulted in many inequalities for users. These inequalities include access to primary and preventative health care, access to affordable health care and the uneven outcomes of health care interventions. Even more challenging is the lack of agreement of government and policy makers on how to address these difficulties. The Patient Protection and Affordable Care Act (PPACA) was enacted in 2010 with a key goal of expanding the accessibility of healthcare coverage to more people in the US. While the PPACA reshapes the landscape of
However, it is clear when reviewing the literature that this is also a big problem for the middle class. Contributing factors to this include increased deductibles and co-payments and cost shifting to the patient (Hayes, 2004). The US spends over 17% of its Gross Domestic Product (GDP) on health care expenses as compared to a mean of 10% in other high income peer nations like France and the United Kingdom (UK). Even though the US is the only one of the developed nations without a publicly funded healthcare program, an average of $9,086 is spent per capita. Public spending accounts for $419, $1074 from individual out of pocket cost and $3442 from other sources, such as employers. In contrast, the UK spends an average of $3364 per capita, $2802 comes from public spending, $321 from individual out of pocket cost and $240 from other sources. With number like these one would expect that healthcare outcomes in the US far exceed other countries, however this is not what the research shows. While the US is a major world power with economic strength and advanced technology readily available, it is important to note that its health metrics rank the lowest among like nations. For example, in the US maternal mortality is ranked at 12.2/100 000 compared with Canada at 4.8/100 000. Among 34 nations in the Organization for Economic Cooperation and Development (OECD), the US ranked 26
The PPACA has made strides to address many of the disparities, but does not include the idea of UHC. The US is currently the only industrialized nation without a publicly funded healthcare system and the ramifications can be felt in more expensive care, greater health disparity and poorer outcomes including a lower life expectance than like nations. It seems only reasonable after reading the literature that UHC be considered as a viable option in the US. Nurses and particularly DNP nurse leaders are well positioned to provide the education and guidance in making proposals that the people and government can