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National Health Insurance in the U.S.

Updated on January 31, 2013

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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    • mackyi profile imageAUTHOR

      I.W. McFarlane 

      6 years ago from Philadelphia

      Ib radmasters, the government may not be the best choice to run the health industry, but at the same token interest groups will only try to further "milk the already meager cows"if you leave it all up to them. There has to be some form of overseeing and better accountability!

    • mackyi profile imageAUTHOR

      I.W. McFarlane 

      6 years ago from Philadelphia

      Hi Karien, Thanks for your comment. As an outsider, who have been currently living under a different health care system, and have experienced some of the positives and negatives of NHI, I think you are the ideal person to oppose or support NHI to an extent, based on your experience.

      I agree with you that when it comes to government, the Federal government has a very poor record of containing costs, as seen in the Department of Defense - there is a long history of cost overruns and mismanagement. Also, spending has skyrocketed under government's Medicare and Medicaid programs. However, with a better system of accountability and fraud reduction, more could be saved and all citizens could benefit.

    • ib radmasters profile image

      ib radmasters 

      6 years ago from Southern California


      As to your last paragraph, I don't think that the money, over one and a half trillion dollars, didn't help the economy. The government is the worst choice to run an industry.


    • mackyi profile imageAUTHOR

      I.W. McFarlane 

      6 years ago from Philadelphia

      Hi ib rabmasters, Thanks for your input on NHI. I do validate your comments. You and I know that when it comes to Politics, there are certainly a lot of slippery slopes, red herrings, and other fallacies that are usually used to decide what are the best solutions for some of the most urgent problems of the most needy American citizens.

      We are well aware of the fact, that in the U.S. there is a lot of politics involved in health reform. The sad thing about this, is that interest groups are always the individuals who seem to have the most to say, and their interest seems to be more of a concern as opposed to the need of common citizens.

      I do agree that it takes money to fund any health reform, just like it takes money to build infrastructures, expand the economy, develop the country etc. Usually, the bulk of this money comes from taxation! But the way I see it, if we can use millions of tax dollars to develop our nation, I don't think it's that bad to use a little to build a healthier U.S workforce and ultimately a healthier nation.

    • profile image

      Kieran Gracie 

      6 years ago

      As an interested outsider living within the UK National Health Service, I cannot understand how anybody would argue against the principle of free health service for all. I know there are many instances of poor management, cost overruns and so on but these can be overcome with determination from Government and health providers. In spite of these and other such problems, just try removing the NHS in the UK and see what a hornet's nest you would stir up! It can't be all that bad.

    • ib radmasters profile image

      ib radmasters 

      6 years ago from Southern California

      Basically it is tax revenue for the government.

      The government is going to steal from Medicare to fund part of it.

      Adding thirty two million people to a healthcare industry that is already operating at low quality won't improve the quality.

      To make this system not associated with work, it would be best to make it mandatory on government workers. The problem with Social Security was that it excluded government employees. The health care plan also excludes these employees.

      To get a health care system that is better for the country means that government employees should have the same insurance that is found in the private sector.

      Medicare has been plagued by fraud almost since it was created, and it hasn't stopped yet. So with the same government overseeing the Healthcare Law, what do you think about it being different than Medicare.

      The CBO just did a study that said it would cost $110 billion dollars over ten years if the healthcare law was repealed because of the loss of tax revenue from it.

      This Healthcare Law also greatly expands the size and scope of government and for that we need more taxes.

      It really doesn't make the quality of health care improve.

      As long as healthcare is an industry for profit, there won't be any quality healthcare.

      In the last fifty years there has been a dearth of medical cures for the major diseases, as Pharmaceutical companies provide long term expensive treatments. Treatments that are followed closely by the lawyers to sue them when these treatments are having side effects, and even deaths.

      The government by taxing people that don't want into the system are now going to focus on the tax revenue of its mandatory healthcare. So now even the government is more interested in the money as opposed to the health benefits.

      A better healthcare system would have used a scalpel instead of a chain saw.


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