Argument for a National Health Care System

EXECUTIVE SUMMARY

The U.S. Department of Health and Human Services (HHS) stated that “The health of the individual is almost inseparable from the health of the larger community and that the health of every community in every state and territory determines the overall health status of the nation.” It has now become clear that our economy in terms of healthcare insurance is not healthy; the healthcare system in the United States spends 1 cent of every healthcare dollar in the prevention of diseases and 99 cents on the cure. Our healthcare system is the most expensive and yet arguably among the least cost effective in the developed world. Despite the highest per person health care spending among the Organization for Economic Cooperation and Development (OECD) nations, the United States still ranks below many along a variety of health indicators (Aguirre, 55). In a complicated health care system where the rules are many and economic forces drive both structure and function, the needs of vulnerable populations in terms of quality and access to care inevitably suffer due to economic incentive and rationalized care.

The U.S. health care financing system is based on the premise that most workingage Americans (and their dependents) receive health insurance through their employment. A large proportion of citizens who are not covered through their employment are only partially covered by charity care, municipal health care facilities, or governmentsponsored programs such as Medicaid and Medicare. Both of these assumptions break down in the case of the uninsured or the “working poor”, approximately 45 million Americans or 15.6 % of the population that tends to be clustered in jobs that are low paying, less stable, more hazardous, and less likely to have fringe benefits such as health care coverage. This lack of coverage is a serious problem for all, resulting in reduced access to medical services, restricted access to primary and preventive care, and increased reliance in the emergency rooms and hospitals for treatment. In turn, this phenomenon (cost shifting) is responsible for increased hospital rates, inflated insurance premiums and astronomical medical bills that have driven over 2.5 million Americans to bankruptcy (annually).

Therefore there should be a national healthcare system in place of employer-provided healthcare that would guarantee every American basic health insurance without regard to income; second, it would control costs by introducing a scheme of large insurance purchasing cooperatives which would compete to provide insurance for the highest quality care at the lowest possible cost. The consumer, whether employer or individual, would have a choice among plans offering alternately greater choice and services at greater cost, or fewer choice and services at less cost. All plans would be required to offer at least a minimum package of benefits. Our government is already doing that anyways through

Medicare, Medicaid and Health Departments. Technically the fight is over roughly 1/3 of the healthcare industry; the government is already responsible for the other 2/3’s.

Purpose of the Report

This report explores (1) the consequences of these market (economic) forces on vulnerable populations (2) Benefits of a national health care system of the healthcare industry (3) The role of government with or without a national healthcare system.

INTRODUCTION

"The issue of universal coverage is not a matter of economics. Little more than 1% of GDP assigned to health could cover all. It is a matter of soul." - Uwe Reinhardt

The current American health care system is not composed of a single system, but rather a series of separate subsystems that serve different populations in different ways. Sometimes these subsystems overlap; sometimes they are entirely separate. They are supported with private or public funds, or with a mixture of both. Different subsystems may use the same facilities, or they may use facilities and personnel that are entirely separate and distinct.

Financing the health care services in the United States reflects the fragmentation of health care as a whole. It is a patchwork of loosely connected financing mechanisms varying in terms of sponsorship and provider type. It also reflects the age, health and economic status of the specific patient groups that are being served. Considering the growing number of Americans who are uninsured for health care and the low ranking of the United States among a variety of health indicators, one may say that it is a disappointing financing system. These observations provide a basis for supporting our position for a national health care system. Where possible, comparisons will be drawn between the United States and