Introduction to Access to Healthcare

This chapter demonstrates how the comparison between Europe and the United States reveals two very different approaches to dealing with the fundamental question of access to healthcare. Here, ‘access to care’ consists of both availability and affordability. Affordability is determined by how a country helps people to pay for care, including by means of healthcare coverage that entitles or enables a patient to access affordable care. Coverage is commonly provided by some type of insurance that pays for the costs of treatment. But care can be arranged and paid for more directly, without insurance, through a program that simply operates facilities or clinics serving an eligible population, as in the United Kingdom. Typically, these direct-access programs are run by government, but they may also be privately operated, as for instance the free clinics and ‘safety net’ hospitals that serve the uninsured in the United States.