"President touts Obamacare as 'universal health care'" reads the Washington Times article, which goes on to say the following (bold mine):
"We were able to get it done in part because of grass-roots folks like you that fought so hard to make sure we were able to deliver on universal health care," the president told a group at Dallas' Temple Emanu-El, where volunteers are working to educate residents about the health care exchange programs established under Obamacare.
[...]
Although Mr. Obama's health care law requires all Americans to buy insurance or face fines, the system is built on private companies offering coverage to individuals or groups of consumers and thus is far from the kind of Canadian or European system the phrase "universal health care" connotes. Such systems — also called "single payer" — usually consist of one national government entity paying for and providing care for all citizens.
I wanted to verify the quote, so I turned to the Transcripts Editors
transcript (big thanks!) here at DKos (bold mine):
And there's a reason why it had never been done before. Starting with Harry Truman, people had talked about how we were going to make sure that everybody had affordable, quality health care. But through Democratic and Republican Presidents and Congresses, we couldn't get it done. And the reason is it's hard. It's a big chunk of the economy, and a lot of people, even if they don't like what is going on, are always nervous about change. So it was a challenge. But we were able to get it done, in part because of grassroots folks like you that fought so hard to make sure that we were able to deliver on universal health care.
No doubt like many others, I find it strange that Obama is calling the ACA universal health care, especially when the
CBO projections for the next ten years have the numbers bottoming out at 30-31 million uninsured Americans (down from 55-56 million):
Having 30-31 million uninsured Americans doesn't quite sound like universal health care to me, given that the figures for other OECD countries looked like
this in 2011:
But it turns out that researchers don't really have a universal definition of 'universal health care'. The WHO uses a
box model with the three dimensions corresponding to three criteria:
Should be simple enough to get an operational definition, right? Nope! The same source concedes:
In European countries with long-established social health protection, this "current pooled funds" box fills almost the entire space. But in none of the high-income countries that are commonly said to have achieved universal coverage is 100% of the population covered for 100% of the services that could be made available and for 100% of the cost, with no waiting lists. Each country fills the box in its own way, trading off services and the costs met from pooled funds.
We don't get any usable metrics for deciding whether a country has universal health care -- no cut-off points on the axes, nada. Even focusing on a single axis -- coverage -- gives us no widespread agreement. In a 2010
paper commissioned by the WHO, titled "The political economy of universal health coverage," researchers settled on a coverage of ">90% of the population having access to skilled birth attendance and insurance coverage" after finding problems in the literature:
One weakness in the literature is that while UHC is frequently invoked by health policy analysts, it is unclear what these analysts actually mean by the term. Definitions can vary widely. In general, authors writing about high-income countries refer to 'Universal Health Care', while low-income countries are referred to as having 'Universal Coverage'. Universal Health Care is currently studied in a non-systematic way, and we have been unable to find any systematic review has thus been conducted to assess the key dimensions, approaches, and classifications with which universal health care coverage is studied.
Further:
Another outstanding challenge is that the definition of UHC is nebulous (argued to be one reason why is it [sic] so widely shared), which makes it difficult to operationalise. There is, for example, no widely available and agreed upon list of countries which do or do not have UHC.
Wikipedia has also settled on the operational definition of ">90% health insurance coverage, and >90% skilled birth attendance," so expect to see an edit to this in the coming years (bold mine):
The United States does not have a universal health care system, however the Patient Protection and Affordable Care Act (PPACA) as amended by the Health Care and Education Reconciliation Act of 2010, seeks to have expanded insurance coverage to legal residents by 2014
So, yeah, Obama delivered on universal health care if the CBO projections pan out -- maybe not in the sense that many would like, maybe even disingenuously, but he's not demonstrably wrong in calling it universal health care.
Moral of the story: It's probably best to drop the term 'universal health care' altogether if what you want is a single-payer system.