National Health Insurance in the U.S.
Affordable Health Insurance For Americans
Over the years all the attempts that have been made to provide affordable health insurance for all Americans, have always been met with insurmountable pros and cons. National Health Insurance(NHI) for example, though favored by some advocates for health, has also been criticized by others. In this hub, I will be providing you with some of the arguments for and against National Health Insurance.
Arguments in Support of National Health Insurance
- It's believed to be the least complex and most direct way of providing universal access to health care.
- It allows freedom of choice simply because patients will be able to choose their own physicians.
- It would cut administrative costs far below that of the present system, which is believed to be administratively chaotic and expensive due to the fact that many private health care insurers are involved each with its own procedures and claim forms. In addition, it's also considered the best option as clearly seen when compared both the U.s. and the Canadian system for example. While administration costs in the Canadian system are less than 5 percent of total health care costs in the United States they are almost 17 percent.
- It disconnects health care availability from employment and therefore would prevent employers from using part-time and temporary workers as a way to avoid providing health care insurance.
- Finally, NHI would give government the power to use its single-in-insurers market power to mandate for a variety of medical procedure and thus curtail physicians' and hospital costs. Hospitals would operate on budgets set by the government.
Arguments Against National Insurance
- It's believed that's unlikely that Government-determined price ceilings on physicians' services will control costs, because doctors can insulate their incomes from fixed fees by manipulating the amount of care they provide a patient. For example, say the maximum fee for an office visit is $50. Physicians might spread a given number of diagnosis tests over two or more office visits, although the test could be done in one visit. It has been further argued that another way a doctor could collect more fees is by requiring further office visit to just to explain the results of certain tests, as opposed to giving the patient a simple phone call.
- Another argument is that when compared both the Canadian and the U.S. system, under the Canadian system, the waiting time for patients is often long for certain diagnostic procedures and surgeries. This is believed to be the result of the Canadian government's effort to control spending by restricting hospitals' capital expenditure and that NHI might strongly conflict with U.S. expectations of medical care "on demand."
- It's also believed that the federal government has a very poor record of controlling costs. As a result, spending has spiraled upward under the government's Medicare and Medicaid programs.
- Advocates against NHI also claimed that because insurance is a critical factor in the over consumption of health care, under NHI a completely "free" basis health care package would encourage consumers to "buy" health care as long as marginal benefits were positive, regardless of the real cost of society.
- Subtle and perhaps undesirable redistribution effects would result NHI, according to some critics.
- Others feel that under private health insurance, the cost of a particular health care insurance package is the same irrespective of the insured's income. This makes the cost of insurance appear as a regressive tax since low-income earners pay a larger percentage of their income for the insurance than do high-income workers.
- According to some, if NHI were funded out of personal income tax revenues, this funding would be progressive. Under NHI low income workers would receive health insurance at little or no cost.
- Some Opponents believe that while some Americans might consider this as desirable, other feel that redistribution in the United States has been overdone and that additional redistribution through NHI would not be fair.
- Another belief is that depending on the type of tax and its size, employers and employees in big establishments might receive windfalls in the form of higher profits and wages if NHI were to replace their health insurance programs. On the contrary, employees in small retail businesses and fast-food restaurants, where health insurance is typically absent, might not experience such gains.
Like all other health reform approach, National Health Insurance has its share of advantages and disadvantages. However, it's certainly not a totally bad approach to providing affordable health insurance for all Americans.
By: I. McFarlane 7/25/2012
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