Government-Financed National Health Insurance
The American Association for Labor Legislation Plan
1915 plan to insure all poor from an income contribution to a state run pool
THe Wagner-Murray-Dingell Bill
1934--pay physicians and hospitals as part of social security
Medicare & Medicaid
1965--you have to pay into the system to get anythign out when you are older
1970 Kennedy Bill & the Single-payer Plan of the 1990s
universal care package--defeated by the AMA
Employment-Based National Health Insurance
1980s number of uninsured rose dramatically
government purchased/subsidiesd
Individually Purchased National Health Insurance
Secondary Features of National Health Insurance Plans
Insurance Reform
secondary features add to the complexity
Benefit Package
mostly cover accute inpatinet care, with some preventetive in HMOs
Patient Cost Sharing
usually some sort of deductable or limited coverage
Insurance Reform
currently high-risk patients are experience rated
national coverage woudl illiminate rating
insurance cooperatives could spread out the risk amoung small businesses and amoung individuals too small to negotiate for better rates
Effects on Medicare, Medicaid, & Private Insurance
single-payer models would dramatically change the current system
employer mandates would do much less because most insurance is already employee financed
Cost Containment
national health insurance have the potential to dramatically increase utilization--however, caps and incentives to prevent this would be utilized
not really possible to establish a global cap with multiple insureres
Which National Health Insurance Plan is Best?
single-payer--reduce administrative costs, universal coverage, universal access to basic services, more preventetive, reduced overall costs through caps--against: no freedom of choice, limited facitlities, waiting in line, government control over what care they can recieve, higher taxes
employer mandate--hidden taxes, current system, less drastic change-- against: very hard on small employers, people changing jobs have to go through lots of administrative work, your boss chooses your physician
individual mandate--relive the employers of the burden, put it on the individuals, tax credits would help the poor
the future of reform is controled by the very powerful and rich health care industry lobbyists