Universal Coverage

The most basic measure of any nation’s health care system is whether it provides universal coverage, guaranteeing health care to all citizens and legal residents of a country. The United States is the only more developed nation that neither provides health care to all citizens nor recognizes a right to health care (a topic discussed in Ethical Debate: Is There a Right to Health Care?). Instead, the U.S. gov- ernment provides insurance to only a small percentage of the population, and even under the Affordable Care Act (ACA) allows private insurers considerable leeway in deciding who to insure and how much to charge for that insurance. In contrast, all legal residents of Great Britain or Canada, regardless of income, place of residence, employment status, age, or any other demographic characteristic, can obtain state-supported health care—although they are guaranteed neither imme- diate service nor every service they want.