Description of National Health Insurance

In the endless debate over the American health care system, basic terms are not normally defined. Universal health care is not the same as socialized medicine. The term "national health insurance" is far closer to universal care than to socialized medicine. Whatever the nature of the medical system, the concept of national insurance is to provide --- at the very least --- a guaranteed level of basic health services for those who cannot afford private health insurance.

Insurance

• The medical profession under national health insurance remains a private industry. There are some examples of total state control over health insurance, such as the Cuban system, but this is far from the central core of national or universal insurance. In short, national health insurance is modeled after Canada's system, in which individuals choose their own doctors and medical procedures, and the medical clinic or the doctor as an individual then bills the government.

Single Payer

• All forms of national or universal health, whatever the role of the state, rest upon the advantages of the single payer system. "Single payer" means that for every citizen of the country in question, medical bills are paid by the state -- the "single payer." The argument is that this will decrease red tape, bureaucracy and needless administrative costs. There will be one payer to all medical professionals, not numerous insurance firms. Libertarian groups such as the Cato Institute, however, have argued that this is false, and that bureaucracy is actually increased in a single payer system.

Payment versus Delivery

• The distinction between socialized care and universal or national care can be explained in the concept of payment versus delivery. Universal care only worries about the nature of the payer; in this case, the federal or state government. Socialized care would put all medical decisions in the hands of the state. This is rejected by the universalist idea. Only the payment for health care would be borne by the state. Medicine as a practice will still be in the hands of doctors, hospitals and clinics. What is eliminated in the national system is the reliance on managed care. Managed care has little to do with medicine and much to do with minimizing the amount of cash insurers need to pay out.

Private versus Public

• In countries such as Great Britain, there is an option to opt out of the state system and buy private insurance. In Canada, that is not permitted. The British system permits the private sector to compete against the public sector. According to National Public Radio, about 50 percent of Canadians want the option to buy private insurance. Even if private insurance were available, those who either did not want it or could not afford it would still have basic care financed by the income and sales tax. This "safety net" is the basic idea embodied in national health insurance.