Europeans Take Pride in Health Care for All

Health care systems that are public, of high quality and that give equal service to all citizens, unemployed or not, are best for society. That's what it's all about in Europe," said Bo Larsen of Denmark, head of Telecoms-Europe for Union Network International.

Of all the world's developed countries, the United States is the only one that fails to provide health care coverage for all its residents. While financing mechanisms vary, all 27 member states of the European Union, Japan and many other countries manage to provide universal coverage. None are perfect and — like the United States — all struggle with rising health care inflation. But overall there is pride and satisfaction in the service provided.

The national health system in France came in first in a recent quality ranking by the World Health Organization. (The United States came in 37th.) Surveys show that 78 percent of French citizens are happy with their health care system. France spends just 10.7 percent of its gross national product on health care; the U.S. spends 16 percent. The French system works much like Medicare in this country but covers the entire nation. 

Everyone in France has access to doctors of his or her own choosing through national insurance funds. Every employer and employee pays into these funds, and the state picks up the tab for the unemployed. Patients with chronic diseases and those requiring critical surgeries get no bills, the services are fully paid by the national plan. France's infant mortality rate is 3.9 per 1,000 live births, compared with 7 in the U.S. and life expectancy is 79.4 years — two years more than in the United States.

Great Britain's National Health Service (NHS), financed through taxes, provides free health care to all citizens. Though unions are free to bargain for supplemental health insurance, they have no need to bargain for basic health benefits.

Billy Hayes, general secretary of the Communication Workers Union, said the system "strengthens unions, because good health, without which all other gains are meaningless, is separated from the grasp of the employer to use as a stick to beat the union. That is why all trade unions in the UK rally to support the NHS when there is even the slightest suggestion of tinkering with it."

Great Britain in 2004 spent 8.1 percent of gross domestic product on health care, about half the U.S. expense, according to the World Health Organization.

"The NHS mission is to provide care from the cradle to the grave," explained Steph Marston, organizing director for Connect UK, a union for managers and professionals in telecommunications. "When I was born, my mother was attended by a NHS midwife. The NHS ensured that my brother and I were immunized against infectious diseases and treated promptly and expertly for childhood ailments. When my mother noticed I was peering at things, she could take me to the optician for free, and I got free glasses to correct my sight."

Marston also said that when she broke her finger, she went to the hospital, was scheduled for surgery the next day and had six months of physical therapy to regain strength in her hand — all free. When her father became chronically ill, he received treatment and medication for six years, including home visits by a physician.

"My family wasn't poor, but we didn't have money to spare, and they didn't work for union companies," Marston said. "It's more than likely that in America my family would not have had the means to access good health services."  

In Germany, "Compulsory health insurance and its joint financing have been dependable here for more than a century," said Lothar Schröder, head of the Telecommunications and IT Sector of Ver.di, Germany's largest union. "The public health system guarantees a high level of medical care in Germany — regardless of people's social status and income."

Workers in Germany are required to join one of almost 300 statutory sickness funds, which must accept all applicants.  The sickness funds are required to be self-sufficient and premiums are set as a percentage of income — currently about 14 percent — with employers and employees each paying half.  Unemployed residents who have previously worked are still covered through one of the sickness funds, as are retirees, who pay lower premiums. Local governments provide additional funds to cover the unemployed who have never worked.

"Unions play a major role in the design of the German health system," Schröder pointed out. "The health insurance funds are administered by the employers and the trade unions on equal terms."

He pointed out that Germany's health system pays all costs for inpatient and outpatient treatment, hospital stays and dentistry and, "If an employee is sick for more than six weeks, the health insurance additionally pays part of the wages."

Great Britain's Hayes said unions around the globe are waiting to see what priority voters in the U.S. will give to health care in the coming election. "It would be an inspiration to workers all over the world if labor's interest were delivered through free universal health care for the American people."

How Does the United States Stack Up?