The Case for Universal Health Care

With the exception of the United States, all developed nations provide their citizens with quality, affordable health care. And, despite its having expanded access through such programs as Medicare, Medicaid, SCHIP, and the Affordable Care Act, nearly 20 million Americans still do not have health insurance. Worse, efforts by the Republican Party to dismantle the ACA and increases in premiums could leave millions more without the financial means to afford treatment when needed.

Countries that guarantee health coverage to all their citizens have done so recognizing the health of the nation is dependent on the health of their people. This has not occurred in the United States, not only because powerful forces have mounted a vast campaign against it, but also because no plan with clear solutions and guidelines has yet emerged.

Starting from the premise that health care is a societal responsibility, David Colton's The Case for Universal Health Care contends that universal health care should not only be guaranteed by the government, it should be organized and administered by a federal agency and funded through a new, health care transaction tax. This will ensure that the national health care program is focused on quality and is fiscally sustainable for current and future generations of Americans, ridding it from cost over-runs and service denials due to the search for profitability.

Colton provides a clear understanding of each facet of the present, flawed health care system: how it is structured and organized; how we pay for health care; what factors influence access, quality, and affordability; and contrasts it with approaches taken by countries providing universal coverage.

Thus prepared, the reader is taken through an in depth explanation of Colton's proposed alternative approach to universal health care, including a description of how an American national health care program would be organized, what treatments would be covered, and how it would be funded.The role of quality improvement, utilization review, and evidence-based medicine in controlling costs is examined as is the economic and moral case for universal coverage.

The cost of providing care in the United States will soon be unsustainable. It surely makes sense to consider an option that ensures health care is accessible to all its citizens and is fully funded regardless of vicissitudes in the national economy. This book is a must read for all concerned.

David Colton, Ph.D., M.P.A., M.Ed., is a retired health care administrator and retired adjunct professor of health care administration at Mary Baldwin University, Staunton, VA. Dr. Colton created the Checklist for Assessing Organizational Readiness to Reduce Seclusion and Restraint, which has been adopted by a number of organizations in the U.S., Canada, and Europe. He is co-author of the textbook Designing and Constructing Instruments for Social Research and Evaluation. His research interests, publications, and conference presentations have focused on quality improvement in health care