With a very heated debate about Health Care in the United States it is good to remind everyone the meaning of the terms used during the town hall, White House and household discussions. Below you can find a short article by Monica Oss, CEO of the National Association of Addiction Treatment Providers (NAATP):
There are four basic terms that shape the debate: health care system; health insurance; universal coverage; and nationalized health care system. So here it goes:
Health Care System. The term refers to “a country’s system of delivering services for the prevention and treatment of disease and for the promotion of physical and mental well-being,” according to the Encyclopedia of American History. Our health care system is the entirety of health care professionals and provider organizations-from your primary care doctor, to the local community health center, to your community hospital, to the local MinuteClinic. The health care system is shaped by health care financing-but it is really about the ‘what’ and ‘how’ of service delivery.
There is lots of debate about expensive-versus-inexpensive health care system design. Is it really less expensive to have fewer provider organizations? Should we have a system with lots of health care professionals focused on prevention? Do hospitals really take more than their fair share from the system?
Health Insurance. Health insurance is defined by the Britannica Concise Encyclopedia as a “system for the advance financing of medical expenses through…a common fund to pay for…services specified in an insurance policy or law.” Essentially, health insurance is how we finance consumer access (beyond private consumer payments) to the health care system. Lowest-cost health insurance has very high deductibles or very limited catastrophic coverage of medical conditions. Highest-cost health insurance has low deductibles (and copayments) with unlimited catastrophic coverage for medical conditions, palliative care, and rehabilitative services.
The big debate right now is what kind of health insurance should be ‘standard.’ Does everyone get very limited medical coverage? Do we tax the employer-sponsored health insurance that offers extended coverage? Should we provide vouchers and/or tax credits for Americans to purchase low-cost, high-deductible health insurance-and leave the rest up to the individual?
Universal Coverage. Universal coverage is the general concept that all Americans should have some form of health insurance. By definition, it is “health insurance coverage for all persons in a state or country, rather than for some subset of the population,” according to reference.md. “It may extend to the unemployed as well as to the employed; to aliens as well as to citizens; for pre-existing conditions as well as for current illnesses; for mental as well as for physical conditions.”
Most stakeholders in the health reform debate agree-we want universal coverage. We don’t want citizens dying of treatable diseases like pneumonia or failing to get low-cost support services for chronic diseases. The question in the universal coverage debate is coverage of what (see “health insurance” above)? The cheap way to attain universal coverage is to mandate that all people must have health insurance coverage (like we do with auto insurance) and provide ‘subsidized’ insurance for the very poor and tax credits (but not payment for the health insurance) for everyone else. The expensive way to attain universal coverage is to mandate that all people have coverage-and provide ‘subsidized’ insurance for everyone.
Nationalized Health Care System. The concept “nationalized health care system” is complex one with varying definitions. Even locating a solid definition online is a daunting task. Nonetheless, there are three options for a nationalized health care system in the United States . The first, which doesn’t have much traction in the current debate, is a nationally run health care system (like the United Kingdom ) where health care professionals are actually government employees. The second option is a system where all health insurance plans are operated by government (i.e. the debate over the ‘public plan’), but the health care system (professionals and provider organizations) are private entities-like Medicare fee-for-service. The third option is a system where the administration of national coverage is operated by the government, but the actual health insurance plan can have either private sector or public sector sponsors-like the Federal Employee Health Benefit Plan.