¶ … National health plan [...] how and why a national health plan should be introduced in the United States. Health care in the United States is a big business. As such, a national health plan threatens the bottom lines of gigantic health maintenance organizations, and they have fought national health care consistently. They fight a plan that could cause their demise, but ensure the increased health and well being of millions of Americans. It is time we stopped letting big business set the agenda for the health of the American people. NATIONAL HEALTH PLAN

The Clinton administration's plan for national health care reform did not become a national health plan, but it opened the door for argument and debate about health care reform in the United States. Many experts and citizens still believe a national plan for health care should be instituted in America. How to institute a workable and viable plan is still being argued, but with the state of health care in America today, something must be done to ensure Americans of good quality health care they can afford.

One of the major problems facing Americans and their health care today is the cost of insurance. Many small businesses say providing insurance for their workers is their number one cause for worry and concern. The cost of providing insurance has risen steadily over the past ten years, and it continues to rise at alarming rates. This rise in premiums causes more small (and even medium and large) businesses to either cut back the health insurance available to their employees, or forgo insurance all together, which creates an ever-widening gap between the insured and the uninsured. According to Physicians for a National Health Program (PNHP), over 42 million Americans are currently uninsured (Editors), and that number does not include many more who are underinsured. This means virtually millions of Americans cannot afford to visit a doctor when they are ill. In addition, if their illnesses become life threatening and they do seek medical care, either it will eventually be written off by the medical provider as uncollectible, which raises prices for everyone with insurance, or it will create a crushing financial burden for the uninsured person. Often, people without insurance simply do not seek medical care or advice until their disease is too far advanced, and treatment is no longer viable. This means that people in our country die every day because they do not have access to medical care, and this is not acceptable for a wealthy and prosperous nation such as ours.

Another problem facing Americans is the ability of current health plans to determine the type and quality of health care their patients receive. In testimony before Congress, Doctor Donald J. Palmisano recounted just some of the power wielded by large health plans in the country:

The antitrust laws have been interpreted to allow health plans such a high degree of leverage that an appropriate balance of interests no longer exists in the market for health care delivery and finance. As a result, the power of health plans to determine the kind of health care that patients receive is virtually unchecked. While health plans have achieved many significant accomplishments, it is not healthy for any interest group to have virtually unlimited power over an issue as significant and sensitive as the kind of treatment needed by an individual with an illness or injury (Palmisano).

In addition, these gigantic Health Maintenance Organizations (HMOs) and Preferred Provider Organizations (PPOs), also have the control and power to decide just what type of medical care a physician can give to a patient. In many cases, they even limit (in many states) what the physician can even tell the patient about the services covered by the plan, and what services the patient might need, but the plan will not cover (Palmisano). In addition, as managed care plans continue to limit the physician's abilities and medical care they can give, the entire medical community tends to fall inward instead of searching out new medical techniques and methods. In other words, research, and as such, medical breakthroughs tend to diminish, with the only research and methodology completed by the few physicians unaffiliated with constricting health plans.

Some experts argue the national health plan would switch public health from a traditional focus on

The leap to community from other forms of health care, however, which have traditionally focused (probably to too great an extent) on the autonomous individual patient's preferences, values and wishes, is large indeed (Goold 98).
The Clinton Health Security Act of 1993 (HSA) would have created a network of state and regional "health alliances" which would have contracted with health insurance plans, but the alliances would have directly received payments from employers and individuals. The plan would have covered all facets of medical care, from checkups to prescription drugs, at affordable prices. It also would have contained benefits for long-term care (Walterscheid).

However, there were many proponents to the plan. Some experts felt the plan was not comprehensive enough, and did not cover enough basic, preventative health care. For example, the plan did not cover some areas of mental health treatment, such as alcoholism. Others felt it should not be affiliated at all with health insurance plans. Then there were the social implications of including such treatments as abortion, physician-assisted suicide, and euthanasia in the areas of treatment. All of these concerns were eventually answered, but they raised questions in the minds of the public that were never quite eliminated.

Finally, the public somehow went sour on the entire idea of nationalized health care, probably because of an intensive advertising campaign funded by large health care organizations who felt their business was at risk, and by special interest groups that supported the health care industry. Still others felt the cost to themselves was too large for the benefit to others. "So, from the outset, the hard economic realities falsified collective moral illusions of the HSA's benefits to all Americans. There is no collective public identity. "The" American people are not benefited when some substantial segment of them -- numbering in the millions -- is hurt" (Epstein 197). In other words, taking care of everyone would be too costly for some.

To enact a viable national health care plan is not impossible, but it seems to be increasingly difficult to get any type of plan through Congress. Several plans have been proposed and debated, but none have passed through to law. The PHNP believes, a national plan is possible, and in fact, a necessity. "Since we have more than enough resources for everyone, we must first assure that everyone is placed in a single, universal risk pool. We need to fund that pool equitably, so each person pays his or her fair share, but no person suffers financial hardship due to health care costs" (Editors). How would a national health plan really work? Modeling our plan after several successful plans in other countries, (such as Canada), would help ensure the plan would work, would save money, and would serve everyone equally.

Many other nations have proven that administrative waste can be reduced by relying on an efficient system of public administration. Resources are used for patient care rather than to support a private bureaucracy. The experience of our Medicare system shows this. Traditional Medicare has an administrative cost of less than 2% compared to private health plan administrative costs of 9% to 30%. Thus, our universal risk pool should be publicly administered so that our health care resources are directed exclusively to patient care (Editors).

If our country is ever to enact a viable health care plan for its citizens, it must weigh the costs and benefits of the plan, and it must create a plan that is free from the influence of special interest groups and public companies whose only interest is their bottom line. The health of our nation is in jeopardy from health care providers who spend more time worrying about the cost of procedures than they do about the health and welfare of the people they insure. As one expert notes, "The grand task for all legal and social institutions is to try to find some way to arrange for human affairs to secure the largest net benefit to the public at large. It is not to serve the provincial or parochial ends of any one group, however discrete and powerful" (Epstein 417).

In conclusion, our country may have a long way to go to enact health care reform in the guise of a national health care plan, but if we are to create a thoroughly healthy society, where everyone, regardless of income, has the ability to maintain a healthy lifestyle, and receive high quality health care when they need it. However, as…