In the chart below an in EVERY SINGLE HEALTHCARE INSURANCE PROGRAM on the globe the one constant is that it must carry a mandate for coverage. There is not and never has been an insurance program of any kind that didn’t require a mandate in order to be covered. Without a mandate, there are two choices: (1) You are not covered at all and all responsibility for costs are yours to bear or (2) Someone somewhere has to pick up the tab.
Most states require auto insurance in order to be a licensed driver. Very bad drivers are divvied up among the insurance carriers so that no one plan is forced to carry the majority of the bad drivers. There is usually some minimal plan to protect others on the road from even the poorest of drivers.
Life Insurance is simple. If you don’t have a policy and no relatives willing to pick up the tab, the state will dump you in a pauper’s grave without a marker, but that is about it.
Health Insurance. Some individual states such as Hawaii have mandatory requirements which have led to decreased costs and some states in full compliance with the ACA have been successful at decreasing costs to the taxpayer, but without universal coverage and a mandate costs in other states and for some people have increased dramatically.
There are any number of possible means of organizing healthcare, but in order to be successful, they must include one item: There must be a mandate.
Canada: A national health insurance program NHI (a government run health insurance system covering the entire population for a well defined medical benefits package). Health insurance coverage is universal. General taxes finance NHI through a single payer system (only one third-party payer is responsible for paying health care providers for medical services). Consumer co-payments are negligible and physician choice is unlimited. Production of health care services is private; physicians receive payments on a negotiated fee for service and hospitals receive global budget payments (Method used by third party payers to control medical care costs by establishing total expenditure limits for medical services over a specified period of time).
Germany: All individuals are required by law to have health insurance. Those earning less than $35,000 (1995) must join one of the sickness funds for their health care coverage (Henderson 495). Sickness funds are private, not – for – profit insurance companies that collect premiums from employees and employers. Those earning more than this limit may choose private health insurance instead. Approximately 74% of the population is compelled to join a sickness fund. Another 14% are members who join voluntarily even though their income exceeds the statutory cutoff. Of the remaining portion, 10% is covered by private insurance and 2% by police officers insurance, student insurance and public assistance. One of every 10 Germans covered by sickness fund insurance also purchases private supplementary insurance to cover co-payments and other amenities.
France: The entire population must pay compulsory health insurance. The insurers are non-profit agencies that annually participate in negotiations with the state regarding the overall funding of health care in France. There are three main funds, the largest of which covers 84% of the population and the other two a further 12%. A premium is deducted from all employees’ pay automatically. The 2001 Social Security Funding Act, set the rates for health insurance covering the statutory health care plan at 5.25% on earned income, capital and winnings from gambling and at 3.95% on benefits (pensions and allowances).
Japan: Mandatory insurance system which is comprised of an employment-based insurance for salaried employees, and an national health insurance for the uninsured, self-insured and low income, as well as a separate insurance program for the elderly. Employment-based insurance system is the primary insurance program in which employers play a significant role as sponsors and health plans have considerable flexibility in designing their benefit features.
Great Britain: Again Mandatory with England, Northern Ireland, Scotland and Wales each having their own systems of funded by and accountable to separate governments and parliaments, together with smaller private sector and voluntary provision. As a result of each country having different policies and priorities, a variety of differences now exist between these systems.