The Healing of America: A Global Quest for Better, Cheaper, and Fairer Health Care

by T.R. Reid

THE NATIONAL HEALTH INSURANCE MODEL This system has elements of both Bismarck and Beveridge:The providers of health care are private, but the payer is a government-run insurance program that every citizen pays into. The national, or provincial, insurance plan collects monthly premiums and pays medical bills. Since there’s no need for marketing, no expensive underwriting offices to deny claims, and no profit, these universal insurance programs tend to be cheaper and much simpler administratively than American-style private insurance. As a single payer covering everybody, the national insurance plan tends to have considerable market power to negotiate for lower prices. NHI countries also control costs by limiting the medical services they will pay for or by making patients wait to be treated. The paradigmatic NHI system is Canada’s; its universal application and its equal treatment for all satisfy Canada’s national sense of community. Australia and some newly industrialized nations, including Taiwan and South Korea, have adopted variations on the NHI model.