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At least 109 records · Page 6Linked to original sources
PubMed1978

NHI in crisis: politics, predictions, proposals.

Marked by intense feeling, the NHI debate has produced a crisis rhetoric that clouds the issues and misrepresents the state of medical care. Generated in response to the rhetoric, current NHI proposals fail to combat the central problem of rising health care costs. A promising approach combines a comprehensive insurance plan for preschool children with protection against financial catostrophe.

American Medical Association↗
PubMed1978

A cash-equivalent option under "major-risk" national health insurance.

A central purpose of proposed "major-risk" ("catastrophic") national health insurance would be to provide an incentive to economize by requiring most households to pay, out of pocket, at least a fraction of the cost of all medical care they use. To help ensure the success of this cost-conscious strategy, the author asserts, a cash-equivalent option for workplace supplementary private health insurance should be legally required.

Deductibles and Coinsurance↗
PubMed1980

Catastrophic health insurance and cost containment: restructuring the current health insurance system.

Catastrophic health insurance may be necessary to curb rising health care costs in the United States. A major factor in this rise has been the current structure of the nation's health insurance system, which inadequately protects individuals with expensive illnesses, but encourages over-insurance for less expensive illnesses. This Note examines the current health insurance system, and analyzes its impact on health care costs for individuals and society. It evaluates several proposals to modify the structure of the current health insurance system, and recommends the adoption of a catastrophic health insurance plan based on an economic definition of catastrophe. Such a plan would decrease shallow coverage, and would use coinsurance and deductible rates keyed to the individual's income as means of increasing consumer cost consciousness without making necessary care unreasonably expensive. This Note also recommends that a catastrophic plan only cover treatment that has been determined medically necessary by utilization review, and that this review encourage outpatient rather than costly inpatient treatment.

Cost Control↗
PubMed1991

The simplest, best cure for our health-care crisis.

Could national health insurance (NHI) cap the explosive rise in medical costs and at the same time give everyone access to health care? More and more people believe so, and for the first time in 20 years NHI proposals are being taken seriously in Washington. But the author contends NHI proponents have misread the causes for America's health-care crisis, and have been misled in their search for a solution by the example of the Canadian health system. All we really need she says, is a home-grown reform that's surprisingly simple and remarkably inexpensive.

Canada↗
PubMed2003

Proposal of the Physicians' Working Group for Single-Payer National Health Insurance.

The United States spends more than twice as much on health care as the average of other developed nations, all of which boast universal coverage. Yet more than 41 million Americans have no health insurance. Many more are underinsured. Confronted by the rising costs and capabilities of modern medicine, other nations have chosen national health insurance (NHI). The United States alone treats health care as a commodity distributed according to the ability to pay, rather than as a social service to be distributed according to medical need. In this market-driven system, insurers and providers compete not so much by increasing quality or lowering costs, but by avoiding unprofitable patients and shifting costs back to patients or to other payers. This creates the paradox of a health care system based on avoiding the sick. It generates huge administrative costs that, along with profits, divert resources from clinical care to the demands of business. In addition, burgeoning satellite businesses, such as consulting firms and marketing companies, consume an increasing fraction of the health care dollar. We endorse a fundamental change in US health care--the creation of an NHI program. Such a program, which in essence would be an expanded and improved version of traditional Medicare, would cover every American for all necessary medical care. An NHI program would save at least 200 billion dollars annually (more than enough to cover all of the uninsured) by eliminating the high overhead and profits of the private, investor-owned insurance industry and reducing spending for marketing and other satellite services. Physicians and hospitals would be freed from the concomitant burdens and expenses of paperwork created by having to deal with multiple insurers with different rules, often designed to avoid payment. National health insurance would make it possible to set and enforce overall spending limits for the health care system, slowing cost growth over the long run. An NHI program is the only affordable option for universal, comprehensive coverage.

Cost Control↗