Understanding the Health Care Reform Debate
Health Insurance, Universal Coverage, Medicare
Most of the current debate about health care reform, including the "public option," is about insurance for medical care - not about how or where or to whom the care is delivered.
Medicare
Of course, everyone knows the term, but what is it, again? Medicare is a federal insurance program established in 1965 to provide hospital and medical coverage for people 65 and over. Medicare does not pay for every medical bill.
It is a stable, popular feature of the US health care system.
- Relevance to the debate: Based on 40 years of experience, Medicare has long been considered a cost- efficient program run by the federal government. A lower percent of Medicare’s overall budget is spent on overhead than is the case with most commercial insurance companies. Less money on overhead means more money spent on care.
Universal coverage
This term means, simply, that there’s a national system in place that enables all citizens to obtain health insurance, so that health care is paid for, in part or fully. Universal coverage doesn’t mean everyone gets every form of health care.
“Universal coverage” is an insurance term, not a medical one. It applies to insurance, not to health care itself. You could have universal coverage on the Mars, but it wouldn’t do you any good if there weren’t any Martian doctors. There is vigorous debate over how to achieve universal coverage.
- Relevance to the debate: Most industrialized nations have some form of universal coverage, often through a combination of private and public insurance programs. The US is unique in the industrialized world in that a significant percentage of the population lack health insurance.
Universal Access to Insurance
This term describes availability of health insurance, not health care. It means that any person could, in theory, obtain health insurance. Exactly how that might occur varies. One way would be to do away with denials of coverage due to pre-existing conditions, for instance, prior health state’s employment or other factors.
People who cannot obtain coverage from commercial insurers can find public insurance coverage. Medicare is an example of universal access to care, limited by age.
- Relevance to the debate: There is debate over how to expand insurance coverage to more Americans, because about 30 million lack it.
Universal Access to Health Care
As hard as it is to achieve universal access to health insurance, it’s even harder to get universal access to actual medical and preventive health care.
Universal access to health care would mean everyone--regardless of where they lived, or their income, education, ethnicity, gender, whether they had disabilities, or a host of other variables--would all have access to medical care.
In the US, we take universal access to clean water for granted (it wasn’t always the case). In an ideal world, everyone would have universal access to preventive treatments as well as other forms of health care.
- Relevance to the debate: No matter what kind of health reform is enacted in 2009, it will not achieve universal access to health care, unfortunately.
Words such as "public option," "moral hazard" and "mandates" may be complicated and a tad technical. But, to understand the health care reform debate of 2009, it's important to understand what everyone's talking about.
Health reform is Being Discussed Across America
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