Health Insurance For Everyone

Health Insurance for Everyone

The first suggestion of a national health insurance policy began in 1912 with Theodore Roosevelt during his presidential campaign. The year 1915 saw the defeat of the model bill for a national health insurance policy. The people fear of socialized medicine was the driving force behind the defeat. President Truman during his speech to Congress in 1945 and President Clinton in 1993 also proposed a national health insurance policy. In both cases, special interest groups such as the insurance companies and some medical advocacy groups joined ranks to oppose the plans (CHA, 2006). The challenge to insure all citizens is a daunting task, but a challenge that is possible.

The United States health care system is failing many Americans, yet the cost of health care is rising higher each year. Some estimates have the number of uninsured and underinsured adult population at 61 million people in the United States. The cost of our current health care system is roughly 15.3% of our gross domestic product in 2003 (Hodges, 2006). Healthy People 2010 have many objectives addressing the concerns of the current health care system. One of the objectives is to have 100% of population with some form of health insurance by the year 2010. The research to determine how well Healthy People 2010 is reaching this goal shows the objective is moving backwards instead of forward (HealthyPeople, 2006). In order to achieve this objective, creation of the policy Health Insurance for Everyone (HIFE) mandates each state create a program to provide health insurance for citizens of their state. The federal government will provide financial support through a sliding income scale. HIFE will allow all medically necessary services. HIFE encourages states to form bargaining teams for setting prices with the medical industry based on diseases. Each State will ensure everyone has health insurance with three months of being born or moving to the state.

Formulation

When looking at the objective of providing health care insurance to everyone, one of the first steps is to identify the issues that have prevented people from having health insurance and why there is a growing population that is opting for less health insurance coverage. The main reason people give for not being able to purchase health insurance is they cannot afford the coverage. Cost is also the reason people give for reducing their health insurance coverage (Tanner, 2006). By providing affordable health insurance coverage to all based on a sliding income scale cost will no longer be a factor-limiting people from accessing health care.

Another issue the objective raises is the disparities in health among the people in the United States and the disparities of health of the United States compared to other industrialized countries. In the United States, minorities are more likely to have worse health outcomes then non-minorities (HHS, 2002.) The World Health Organization (2006) ranks the United States 37th in the world for quality health care. Health disparities in this country are mainly due to people unable to afford appropriate health care due to lack of health insurance. Don R. McClanne, MD, states the quality of health care and health care outcomes would increase because everyone has equal access (Matusiak, 2005). Providing a policy that provides health insurance for all will reduce the health disparities in our country and in comparison to other countries.

Another part of the formulation process is the ability to provide the funding necessary to implement the policy. The United States total spending in 2004 health care was 1.9 trillion or $6,280 per person (NCHC, 2006). The proposed funding would cover the expenses of the entire program while achieving the goal of insuring everyone equally. Matthew Matusiak, Ph. D, (2005) with the help of Physicians Working Group determined a health insurance program for everyone would cost $1.86 trillion dollars per year. In order to provide the funding four methods of raising most of these funds are the suggestions by their study.

1. A payroll tax on all employers of 3.3%

2. Maintain current Medicare payroll taxes of 1.45% per employee

3. All tax subsidies to insurance companies stop and payments for public employee's private health coverage go to the fund for health insurance

4. Close the ability for corporation to have tax shelters

5. Repeal the Bush tax cut of 2001

To meet the remaining cost and to help reduce abuse of the system for unneeded care is the implementation of co-payments ranging from $5 - $20 for office visits, hospitalization, and prescription drugs. Once established the administration cost will reduce dramatically to a point administration cost are similar to what the cost is for Medicare/Medicaid program and other countries administrative costs. Currently large health insurance companies use about 30% of each premium dollar for administration purpose compared to Medicare/Medicaid, which has on average two percent administrative cost (Matusiak, 2005).

Implementation

Implementation of HIFE takes several steps. The first step is planning, which involves creating a committee and the office of HIFE in the State's Health Department. The HIFE office of each state will discuss and set limits of items such as the cost of procedures and health insurance, paying of organizations, how to enroll everyone, and monitor the progress. The second step is to provide training to the staff and setting up the needed infrastructure for the program. Part of this process includes building the technology infrastructure. Based on the most common technology programs for each state will help dictate what type of technology infrastructure is required. The third step is informing the people about the details of the program. This will help the public to understand what is required of them and what they will receive through this program. The fourth and final step is the actual starting of the program. Beginning with the enrollment and working with the medical community to meet the requirements of the program (WHO, 2003).

Implementation of HIFE requires health insurance companies to agree to the set price for all medically necessary services applied to everyone equally. The states will have contracts with physicians, hospitals, and other medical facilities agree to perform the services at the agreed upon fee. Each state will require all insurance companies to insure any person regardless of race, religion, age, or health condition. Every two years representatives from each state will work with the insurance companies, medical facilities,