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    Should the US have universal healthcare?

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    Business Spotlight Audio 3/2021
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    Transcript: Should the US have universal healthcare?

    Ian McMaster: Should the US have a system of universal healthcareGesundheitswesen, -versorgunghealthcare? This question has been debated more or less non-stop in the US for decades, it seems, and the positions of the various protagonists are still as far apart as ever.

    It’s often hard for Europeans — who are typically used to the state running some form of universal health scheme, in which everyone has health coverage (US)Krankenversicherungsschutzhealth coverage — to understand the US system, with its mainly employer-based health coverage. It’s also hard to comprehend how millions of people can be left either without health insuranceKrankenversicherunghealth insurance at all or with inadequate health insurance — that is, although they have some insurance, it doesn’t cover the full cost of their health treatment, leaving individuals to pay often huge sums of money out of their own pockets.

    Those who support a universal health scheme in the US to argue that...argumentieren, dass...argue not only that this is an issue of equityGleichheitequity — that everybody should have adequate coverage — but also that it’s a matter of efficiency. In other words, they argue that universal state schemehier: gesetzliche Versicherungstate schemes — such as those in the UK or Canada — are more efficient to administer than privately based health insurance. 

    The counterargument — one that is very strong in the US and also sometimes difficult for Europeans to understand — is that by having a universal and uniformeinheitlichuniform health scheme, the state would be to impinge on sth.etw. beeinflussenimpinging on the freedom and individual rights of US citizens to decide on exactly the kind of health insurance they would like and believe is needed for them and their families. Indeed, I have experienced debates in the US at which any kind of public health provisionGesundheitsvorsorgehealth provision was to be denounced as sth.als etw. gebrandmarkt werdendenounced as “socialism”.

    Anyway, in the US, this is a heated debate, but I have a very clear view on this topic. On grounds of both equity and efficiency, universal health systems are superior. As in Germany and other countries, one can also allow people to to take out insuranceeine Versicherung abschließentake out additional private health insurance if they wish — for example, for dentalZahn-dental treatment — so that they can adapt their coverage to their personal wishes. That’s my view. But what do you think?

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