Can healthcare without charge and no fundraising exist?
Free healthcare is desirable by every patient provided there is no compromise in quality. To be precise, if all the five principles of healthcare can be assured, it is a no-brainer that any patient would prefer to be treated free of cost. But is this possible? How can a hospital or healthcare system sustain itself and provide the purported ideal healthcare when it cannot raise funds or charge patients?
The ultimate desire to increase access to healthcare can lead to a no-cost-to-patient model. But obvious laws of economics dictate that when the price is low (or zero), demand increases. Can existing infrastructure handle this influx of patients?
There are two observations to note. First, demand for healthcare is somewhat inelastic. That is to say, raising the price of healthcare to patients can decrease demand a bit but many people would still continue to go because they need relief from disease. One has heard of numerous anecdotes of people selling off their assets in order to obtain healthcare when the price is too high for them. Second, by assuring the first five principles, hospitals and healthcare systems may be able to look to the possibility of unsolicited funding for their services. This is a bet on human nature. One that has been taken by at least two healthcare institutions that will be discussed in future blog posts.
It is hard to talk about a middle ground
for something that is a fundamental right.
Rationale for Implementation
Nevertheless, one can achieve part of this principle by offering patients a single-payer universal health coverage. According to an OECD paper, all OECD countries have universal coverage except Mexico and the U.S.A. Providing universal coverage will undoubtedly face some infrastructure problems to deal with the marginally increased demand for health services. But the key is to keep following the other five principles. Good disease prevention strategies, compassionate and holistic healthcare, timely access and excellence in care can obviate patient visits to access the healthcare system and the infrastructure problem may then become moot. In the language of economists, lowering the price but following the other five principles will create a shifting demand resulting in possible excess capacity in the current healthcare system. In short, adhering or aiming for an ideal healthcare system will create an infrastructural self-sufficiency and a healthier population with decreased per capita healthcare expenditure.
For the purpose of our analysis, this variable may be measurable by looking for the percent uninsured in a country. As the Harvard study shows, this is a reasonable proxy variable to determine the impact on population health.