Outsourcing strategies and business implications

National Health Care Plan in the United States

Today, health care in the United States represents the responsibility of various separate legal entities. According to the Core Health Indicators developed by the World Health Organization, the United States spends more money on health care, both on a per-capita basis as well as a proportion of the Gross Domestic Product (GDP) than any other country in the world. Studies position the United States health care spendings at around 16% of the nation's GDP, and the latter is expected to grow until reaching, by 2017, 19.5% of GDP. The numbers, for the year 2007 are showing that the United States spent $7,439 per person on health care, or a total of $2.26 trillion.

As the Institute of Medicine of the National Academy of Sciences indicates, the U.S. is the last of the wealthy and industrialized nations that has not yet applied a type of universal health care system.

Currently, in the United States, about 84% of the population benefits from some type of health insurance. 60% of them benefit of the system through their employer, 9% purchased it individually, and 27% benefit it as it was provided by government programs (note that a certain overlapping occures with the presented figures).

While federal law mandates the public access to emergency services whether or not the needing citizen can pay for them, several publicly-funded programs help in providing for the disabled, elderly, children, veterans and the poor.

Thus, the programs developed by the U.S. government accounted for more than 45% of the health care expenditure, making the federal government the main insurer of the nation, its per capita spending on health care positioning it among the top ten highest spenders of the United Nations member countries in the year 2004. Nevertheless, when compared to OECD, this value is still well below the average percentage of 72.5% in OECD countries.

In 2006, around 16% of all Americans did not have any health insurance coverage, percentage translated into about 47 million people. The costs of health insurances are unfortunately rising even faster that inflation of wages, and medical bills are U.S.' most common reason for personal bankruptcy.

The concept of "National Health Care Plan"

An idea that had received its first call already from the President Truman, universal health gained significant popularity with former President Bill Clinton. Even thought his proposal it is perceived today as a failure, it managed to make many in America think about a national health care plan. Ever since Clinton's proposal, the idea has been subject to many debates and has been continuously waved into election topics, where has been seen as a possible cure to the U.S. health care crisis.

What exactly does it mean "National health care"?

National health care, or also commonly known as universal health care, single payer system or united health care system, would be a system similar to the current U.S. Medical health care program for people with low-income, but it would apply to all citizens of the United States, regardles of their abilty to pay.

Many countries in the world apply a national health care system, and - with the exception of the United States - all industrialized countries have some type of single-payer national health care system, such as the UK and Canada.

It is impossible to say that there exist the "right formula "for a united, universal or national health care system. Every country has different manners of fulfilling the objective of insuring every citizen in their country.

How the United States could accomplish such a health care system, and if this would be indeed better and more cost-effective than the current system are some of the most important debate areas. With such a system come many advantages and disadvantages:

Advantages:

national health care system would insure that every citizen benefits from health care coverage

Administrative costs would be drastically reduced (possibility of buying medications in bulk, etc.).

Costs for the businesses will decrease ("business community pays for 55% of the nation's total health costs, the government just 45%. And many businesses want to get rid of their health costs."

The current expensive U.S. health system produces today poorer results in health than do the systems in other nations that are significantly cheaper.

Disadvantages:

Private insurance companies would be in danger of being excluded from the market

Income taxes might increase

The majority of people, if asked, would not argue that basic health care should represent a human right to be available to all Americans, and they would also agree that the current American health care system is not functioning properly and thus we should all unite on health care issues in the United States

My personal opinion would also follow the above mentioned idea... all Americans should be covered by a health care system, and the one activating today does not comply with this vision. It is understandable that maybe it is impossible to literally cover the entire population of the U.S. with a health care system... nevertheless, 47 milion of Americans not covered it not a number that would represent - in my opinion - a successful system.

Not to mention that the fact that the health spendings for emergency situations for people that are not covered by a health care system are payed by the government, that in order to cover such costs increases health premiums for contributors (such as companies that regularely offer a health plan to their employees), thus making it more difficult for them to pay those premiums (and thus insure their employees), so that in the end more companies choose not to offer health care plans to their employees, increasing the number of persons not covered by health care plans, and again the government spendings... The health premiums... And thus giving birth to a vicious circle

Thus, the debate on universal national health care system will continue to accompany our society for a certain amount of time - or at least until the system will be available to significantly more Americans - and, as expected, this issue is also a topic for politicians in the 2008 elections, as will be also presented briefly in the following pages:

Both candidates, Senator Hillary Rodham Clinton and Senator Barack Obama see the importance of having a national health care plan within the United States, and both have developed - with their team of specialists - a plan for how to introduce this system, using different approaches to health care. (for a more detailed analysis of the two plans check Annex 1 of the paper).

The plan developed by Mrs. Clinton's team would requisite all Americans to obtain coverage and would also provide subsidies in order to make it more affordable. Also, large employers are required to offer health care coverage to their employees, while the small employers will receive incentives to do so.

On the other hand, Mr. Obama's plan would only require children to obtain coverage; his plan would also require employers to provide with the coverage or, if they will not provide it, they should contribute to a new public program aimed to make insurance more affordable to people that are not covered by their employers or by the government.

As quoted from New York Times' November 16, 2007 article "It Was Clinton vs. Obama on Health Care" by Michael Cooper, Obama comments that "the only difference between Senator Clinton's health care plan and mine is that she thinks the problem for people without health care is that nobody has mandated -- forced -- them to get health care. [...] That's not what I'm seeing around Nevada. What I see are people who would love to have health care. They desperately want it. But the problem is they can't afford it."