National Health Insurance for the U.S.

Summary of Recent History of the Issue

Health care costs in the United States, as a proportion of gross national product, increased from 1981·8.1 percent to 1990·12.2 percent. Health care spending as a proportion of gross domestic product is higher in the United States than in any other country (Heidenheimer, Heclo, & Adams, 1995). Such spending is three-times higher in the United States than in the United Kingdom. Such a differential might be justified if health outcomes in the United States were clearly superior to this in Britain. Health outcomes in the United States, however, are often inferior to those in the United Kingdom (Appleby, 1992). Infant mortality is 10 percent more prevalent in the United States than in Britain. Male life expectancy in Britain is four months greater than that in the United States, although female life expectancy in the United States is nine months longer than that in Britain. Thus, the more costly and more exclusionary health care system in the United States fails to produce superior medical outcomes to the British system.

Approximately 60 percent of the American population is covered by private health care insurance programs (Congressional Budget Office, 1993). Most of these programs·the very great majority·are either fully or partly funded by employers, while the remainder are funded fully by the covered individuals and families. For the remaining 40 percent of the population, the d

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versal access (Rovner, 1991b). As well as constituting the adoption of the universality concept to health care, this proposal holds implications for delivery system reorganization. President Clinton proposed health care reform in 1993. This proposal included some aspects of national health insurance. The proposal was vigorously attacked by the health insurance industry, managed care companies, conservatives generally, and the newly elected Republican-controlled Congress. The proposal was defeated in Congress. Officially, health care reform in the United States has been stalled by politics since the Republican-controlled Congress defeated Democrat President Clinton's reform proposal. Unofficially, health care reform has moved ahead rapidly, if not effectively, in the United States since the defeat of the reform proposal in 1993. The focal points of the de facto reform that has occurred and which continues to evolve, however, are the growing pervasiveness of the managed care concept, together with substantial and steady expansion of community-based care (Mitchell, Uehlinger, & Owen, 1996; Mechanic, 1996). Neither of these innovations provide national health care insurance. PL 104-191 became law in September 1996. The law
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Some common words found in the essay are:
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Approximate Word count = 1805
Approximate Pages = 7 (250 words per page)

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