The Case for National Health Insurance

More than ten years have passed since President Bill Clinton proposed a national health insurance plan, which was dead on arrival in Congress. Health costs today are a greater burden on both business and local government than they were then, and even more Americans are uninsured. What should be done about it?

Q1. What is wrong with the current system?
1. About fifty million Americans (about 18%) have no health insurance.
2. The cost of providing health insurance to employees is driving up the cost of American products, which compete in world markets with those produced in countries where government, not business, provides this insurance.
3. Too much of our medical-insurance cost goes toward the profits and overhead of insurance companies, rather than toward payment of claims. This overhead includes the costs of advertizing, marketing, underwriting and lavish executive salaries, none of which benefit the insured person.

Q2. Why not let the free market deal with health insurance?
Insurance companies prefer to insure young and healthy people, many of whom would prefer to spend what money they have on other things. On the other hand, the people most interested in buying health insurance are the middle-aged (but under 65) and those with long-term illnesses, whom the insurance companies do not want. The result is the fifty million uninsured.
When the uninsured get sick or injured, they often turn to hospital emergency rooms, which are required to treat them. The cost of their care is often uncollectible, and hospitals lose millions of dollars each year for treating the uninsured.
Businesses that provide medical insurance to employees are in competition with others (both domestic and foreign) that do not, so the incentive is to limit or eliminate coverage, or move production jobs outside the US. This is occurring right now, so the number of working people with no health insurance is growing and jobs are leaving the country.

Q3. What is the best alternative to the present system?
President Clinton called his plan Americare, so I will too.
Americare would be a program administered by the US Department of Health and Human Services (DHSS) that would pay for:
1. Emergency medical care for everyone who needs it.
2.For all American citizens and documented resident aliens:
a. Hospital costs, including surgery, for those that have a medical need for such treatment, as determined by a panel of doctors, none of whom would perform the required services. (Elective and cosmetic surgery would not be covered).
b. Outpatient and doctor-office care, subject to use-limitations and co-pay requirements.
c. Prescriptions.

Q4. How would this program be financed?
The direct costs of Medicare and Medicaid are already borne by government, both federal and state, as are the cost of tax deductions for businesses that provide medical insurance.
The additional costs of Americare should be financed by a federal sales tax on both retail and wholesale transactions.

Q5. What about reproductive medicine?
The cost of birth-control and child-birth should be covered. Abortion should be covered only if it is medically necessary. Infertility treatment should be covered only for married couples, since it is contrary to the public good to bring children into the world without a stable, two-parent home.

Q6. What political problems would this idea encounter?
Although most Americans would benefit from Americare, the health-insurance industry would be devastated. The industry would spend billions to prevent the adoption of this plan.
Unless we had a Democratic President and a Democratic majority in both houses of Congress, no form of national health insurance has a chance of passage.