A national health program: northern light at the end of the tunnel

Article Abstract:

The medical system in the United States has been plagued by run-away costs both in the continued escalation of the expense of medical care and the size and cost of the system's administrating bureaucracy. Meanwhile 37 million Americans are uninsured and at risk both of inadequate health care and financial ruin if they become sick. The situation of medical care within the United States is exemplified by the Medicaid system, where costs that had soared rapidly out of control were brought in check with a system of diagnosis related groups (DRGs). This in turn required a bureaucracy to manage the system and install a cost-management apparatus, which today represents 30 percent of all Medicare costs. Desperately needed nursing professionals have been diverted from the bedside to become utilization reviewers and admission screeners. Within commercial insurance companies, overhead has risen to 12 percent of premiums. Comparisons between the cost of medical care in the United States and in Canada, the country with the next largest expenditure for health care, show that the administrative and overhead costs in Canada are considerably less than in the U.S. The situation cannot be reconciled in a piecemeal manner but demands an integrated national health plan to cover all Americans. Initially there would not be considerable savings in implementing a national health plan, as savings on administration would be offset by increased and universal coverage. One idea proposed would establish a tax-funded plan that would be locally controlled. Everyone would be fully protected and provided with all approved service. Individuals wishing services that were not covered (e.g., cosmetic surgery) would pay for those services on their own. A similar situation currently exists in Canada where both physicians and patients, according to recent surveys, appear satisfied with medical care.

Analysis, Medical care, Political aspects, Health planning, Medicare, column

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Liberal benefits, conservative spending

Article Abstract:

An organization known as Physicians for a National Health Program proposes a plan to cover all Americans under a publicly administered, tax-financed national health program (NHP). Private insurers, Medicaid and Medicare would be replaced by a single public payer, which would result in immediate administrative savings. The NHP would have a single insurer in each state, with local control subject to national standards, and everyone would be covered for all medically necessary services, including drugs and long-term care. There would be no duplication by private insurers, and no copayments or deductibles. Health care facilities would receive a global budget, and there would be no itemized patient-specific hospital bills. The experience in Quebec suggests that an increase in demand by the poor was offset by a decrease by the affluent, so that the overall rate of use of medical services remained the same and costs did not increase. Savings would accrue through simplification of administrative tasks and increased efficiency. A budgetary strategy is outlined, including start-up costs, job training and placement programs for displaced administrative personnel, improved long-term care and revitalized public health programs. Financing would be accomplished through payroll taxes, general government revenues, and payments by individuals. Individuals would pay through a new federal income tax on high-income families, a cap on mortgage interest deductions for luxury homes, a securities transfer tax, an energy tax to promote conservation and an excise tax on air and water pollutants, increased excise taxes on cigarettes and alcohol, and a tax on fossil fuels to reduce carbon monoxide emissions. (Consumer Summary produced by Reliance Medical Information, Inc.)

Economic aspects, Finance, Reports, Statistics, Medical care, Cost of, Health care costs, Physicians for a National Health Program

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A national long-term care program for the United States: a caring vision

Article Abstract:

Physicians for a National Health Program has proposed a plan for long-term care (LTC) of the sick as part of a national health program. The plan would be funded by the federal government but each state would have its own LTC Planning and Payment Board and local LTC agencies to run the program. Doctors, nurses, social workers and therapists in the LTC agencies would assess patients' needs, coordinate services and monitor provider certification. Nursing homes, home care agencies, social service organizations and other LTC institutions would receive a set amount of money each year from the LTC agencies rather than be paid on a per-patient basis. But individual physicians would have a choice between being paid per visit or procedure or working for an LTC institution. Anyone who needed help with daily activities would be qualified for LTC services, regardless of age or income.

Planning, Long-term care of the sick, Long term care

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