National Health Insurance—Socialism or Realism?
There are three major health care
insurance systems in the United States.
Medicare covers people 65 and older.
The Department of Veterans Affairs
(VA) provides direct care to over 5 million disabled or low-income veterans.
The rest of the population in the U.S.
is covered (or not covered) by employ-er-sponsored or other types of private
Of these three health care systems,
only the VA is socialist in the true sense
of the word. As is the case with the national health system in the U.K., the U.S.
government employs all of the VA providers and the cost of the health care is
paid to the federal government through
taxes and other sources.
I don’t view Medicare as socialist
but as social insurance. Most of Medicare is funded through a single payer
(the U.S. government), but the majority
of its providers work in the private sector. Because the Medicare system works
much better than the private insurance
system (or lack thereof ) that’s available
to people under the age of 65, I believe
it offers a middle-ground health care
model for all Americans that is based in
realism, not socialism.
WHAT’S IN A NAME? In the case of socialism, enough to stop a
reasoned debate on the future of the u.S. health care system dead in
Medicare Advantage plans. For the 78
percent of those eligible who select traditional Medicare, there’s one uniform
national health insurance plan. Every
hospital and physician knows what is
covered and how much, if anything, the
physicians can afford to opt out of participation in Medicare. And Medicare
can, and does, enforce a rule that physicians can’t cherry-pick their Medicare
patients. Providers who take any Medicare patient must then take all Medicare
patients who come to them for help.
Under Medicare, providers face
two types of administrative expenses.
There’s the direct administrative cost
two national Health models
Medicare is similar to an insurer in that
it pays private providers for patient care.
But it covers almost all citizens and permanent residents of the U.S. who are
age 65 and older, leaving no pool of uninsured elderly and no fear among those
covered by Medicare that the program
will cease to exist or that they will lose
Medicare participants can choose
between the traditional Medicare
fee-for-service plan and a variety of
patient will have to pay for the benefits.
The providers all know what, if any,
preconditions must be met for a treatment to be covered. The providers deal
with one payer through a standard set of
claims-payment procedures. Approved
benefits are paid promptly and in full.
As the single payer, the federal government has the ability to adopt and
enforce effective cost controls on all
providers. No large hospital and few
to the insurer, and there’s the cost to
the provider of obtaining payment. The
direct administrative cost of Medicare
Parts A and B is only 1. 5 percent of health
care costs. Medicare does place substantial administrative burdens on providers,
but there’s only one system for standard
benefits and claims.
Medicare law allows private-sector
health plans to provide services under
its Medicare Advantage program. While