I could see it going either way.
With free access, people would be more inclined to go to the doctor for simple and small things, but in return would probably catch more serious issues early and have better access to treatment, therefor reducing the need for intensive and specialized healthcare.
Without, people avoid going to the doctor for small stuff, but end up having to go in with more complicated issues later on.
Heres some studies if you want to do some reading:
Impact of Universal Health Care Coverage on patient demand for health care services in Thailand
Think about all the people involved in health care that aren’t involved in actually providing healthcare. Billing, debt collection, assessing insurance claims, denying claims, legal fighting over denied claims, advertising etc.
All that money is better spent providing healthcare.
You bring up a counter point that I’ve heard often, and my usual response is that most could probably find admin positions in the government’s system, and the rest can figure it out like the rest of us.
The last part doesn’t make for a great sales pitch, so what about those people who don’t have a job anymore?
staffing issues aside, generally, “free” healthcare (or rather, government provided healthcare) generally reduces the over all costs- in part, as you noted, by allowing far more prevention and efficiency. Also remember, in places with health insurance like the US, you also have staffing for the insurance agency, and the half-dozen agencies providing support to them, as well.
I think it would be complicated.
The demand for GPs and family doctors would increase.
The demand for hospital beds would decrease.In the long term, things would stabilize into a new ratio of services.
“Free healthcare” doesn’t exist. You can spread the cost differently. Either you pay what you need - which could be a lot - or you pay less but consistently into a big pool along with other people and then that pool money gets distributed to health care providers. That smaller but regular contribution will go up if everybody goes to see their family doctor unnecessarily so there is a bit of a feedback gauge. It isn’t all milk and honey in socialized health care.
No matter what system your country uses, you will have heard about the same problems. Not enough staff, lacking qualifications, people being overworked and underpaid - in particular on the lower rungs of the ladder. That leads me to think that the staffing levels are about the same. Maybe one system has more work hours invested in preventative care while the other needs more in mop-up crews for those who fall through the cracks.
I believe short term there is an increase, give that a lot of people are braving stuff they can’t afford to fix. But it stabilizes and reduces in the long term cause as society becomes healthy, and with other health initiatives like healthy eating, exercise and preemptive healthcare, it normalizes with a general reduction in staff numbers.
When doing comparisons of the nature posed by the title, it is all-important to establish the baseline criteria. That is, what does the landscape look like just prior to implementing the titular policy?
If starting from the position of the present-day USA, then it is almost certain that free-at-time-of-service universal health care would cause the Bureau of Labor Statistics (BLS) to rewrite their projections for medical personnel jobs, in very much an upward trajectory. After all, middle- and upper-class people that already had decent won’t somehow need more healthcare just because it’s free, but people who have never seen a doctor in their adult life would suddenly have access to a physician. More total patients means more medical staff needed, both short-term and long-term. The latter is because the barrier to annual checkups is all but eliminated, which should also yield better outcomes through early detection of problems and development of working rapports with one’s physician.
If, however, the baseline situation is a functional but private-payer healthcare system in a place with a low Gini coefficient – meaning income is not concentrated in a few people – then it’s more likely that healthcare is already accessible to most people. Thus, the jump in patients caused by free healthcare may be minimal or even non-existent. It may, however, also be that free healthcare would benefit different segments of this population through access to a higher standard of quality care, if removing the private-payer system results in dismantling of legacies caused by racism, colonialism, or whatever else.
After all, that’s one of the tenants of a universal healthcare system: people get the treatment they need, with no regard for who they are or what wealth they have (or not).
