Universal HealthcareBy NextBestFit

Faces political, industry, or legal opposition

Affected groups may oppose the path, and it may invite legal disputes over authority or obligations. This matters when opposition blocks or weakens the policy, and less when there is durable agreement.

Under your mix of paths

Paths that create or worsen it
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Caused or worsened by these paths

A cost these paths share. Each path's page says how it applies there.

Replace premiums with progressive taxesPremiums are a large, flat, hidden tax on wagesChosen

Tax financing is politically harder to increase than premiums.

One public price list for every servicePatients can't know prices in advanceChosen

Setting a public fee schedule creates a target for lobbying.

Make consolidation irrelevant to priceHospital and physician consolidation raises pricesChosen

Large systems retain political influence over the rate commission.

Use government march-in and compulsory licensingPatent thickets and evergreening delay genericsRejected

Government licensing of drug patents can lead to trade disputes with partners.

Shorter training: combined undergrad/medical programsMedical education debt shapes specialty choiceRejected

Shorter medical programs beginning after high school require changes to accreditation.

Standardize across many payersAbout $1 trillion a year in administrative costChosen

Insurers may resist requirements to give up their own forms, codes, and rules.

Easy access to medication treatmentOverdose crisis and gaps in addiction treatmentChosen

Some clinicians are reluctant to prescribe medication for addiction despite broader prescribing access.

Harm reduction servicesOverdose crisis and gaps in addiction treatmentChosen

Supervised consumption sites and other harm reduction services face community opposition and legal uncertainty.

Ban duplicate private insuranceTwo-tier care: a private fast lane for those who can payRejected

A ban on private insurance for publicly covered services can face legal challenges, as in Canada.

Cover new treatments at launch, then reassessSlower access to new drugs and technologyChosen

Once new drugs or devices receive immediate coverage, withdrawing that coverage later is difficult.

Cover from day oneCovering all residents raises cost and migration concernsRejected

Immediate coverage for all residents raises political concerns.