National Health Care InsuranceHealth insurance
Heath reform and state health insurance. Understanding health policy: Clinical approach, 7e Access Medicine.
Reforms in the United States for more than 100 years have advocated the adoption of a national health insurance scheme, a state warranty that every individual is insured for primary health care. After all, in 2010 the United States took a big, albeit imperfect, leap towards the goal of universally affordable health insurance. There have been six spells of intensive activities on the topic of state health insurance, alternated with spells of carelessness.
Between 1912 and 1916, 1946 to 1949, 1963 to 1965, 1970 to 1974, 1991 to 1994 and 2009 to 2015, it was the subject of the great national debates. During 1916, 1949, 1974 and 1994 the national health insurance was rejected and left to the late arrival of the country. In 1965, Medicare and Medicaid introduced health insurance guarantees for two groups - the older and some of the needy.
The adoption of the Patient Protection and Care Act, also known as the Affordable Care Act (ACA) or "Obamacare", in 2010 paved the way for the extension of cover to cover million individuals without insurance. The national health insurance is the health insurance warranty for all inhabitants of the country - what is generally called " general cover ".
" A large part of the national health insurance proposal focuses on both the policy controversy and the question of how to afford general cover. The national health insurance proposal may also cover payments by the service supplier and control of costs. Understanding the controversy surrounding general health care will become easier if we return to the four fundamental forms of health finance described in Section 2: disbursement, personal insurance, employment-related personal insurance and public funding.
It is agreed that disbursement is not the only way to finance expensive, modern healthcare. In the case of state health insurance, the disbursements are replaced by one or a combination of the other three types of funding. In the case of the state-financed national health insurance schemes, the resources are drawn from a state or quasi-governmental funding body, which in turn covers the costs of hospital, doctors, Health Care Organisations (HMOs) and other health service suppliers.
In the case of personal or occupational health insurance, the resources are confiscated from personal insurance agencies, which then cover the costs of the service provider. In the past, health care funding in the United States began with a payout and developed through personal insurance, employment-based insurance, and ultimately state funding of Medicare and Medicaid (see Section 2).
The chronological order is the other way round in the US National Health Insurance system. Initial efforts at national health insurance law were made to propose state programmes; serious maintenance of labour market-related national health insurance was only introduced in 1971, and individual acquired cover was only introduced in the 1980s (Table 15-1). Subsequent to this historic development, first the state-financed national health insurances are discussed, then the privately, employment-related and then acquired insurance.
It is a pluralist model, relying on all three funding models: public funding, employment-oriented public funding, and employmentoriented public funding.