The National Health Insurance (NHI) concept depicts a statutory health insurance scheme aimed at insuring individuals against health care expenditure on the national capacity. The legislature usually establishes the NHI scheme for administration through the public sector, private sector, or both. Countries with active NHIs include the UK, Australia, Canada, and Germany. The need for massive healthcare reforms in the US has policy makers and implementers consider the pros and cons of having NHI. This paper discusses the driving and restraining factors of proposed NHI that could shape my nursing practice environment.
In the US, complex factors interact through the health care sector to help drive the need for NHI and its perceived benefits. One of these factors is health care affordability. According to Quadagno (2005), the high costs associated with health care act as a barrier for a majority of Americans. That is, many would report high drug, lab, and transport expenses as reasons why they delay or never seek health care. These expenses are especially a burden for patients from vulnerable, undocumented, minority, and rural populations as well as those suffering from chronic illnesses (Quadagno, 2005).
Such costs seem unreasonably high while a majority of individuals in these categories remain uninsured and under-insured. Also, the quality of health care for the population remains in question as legislators come to a realization that the US health care system is not equitable for its people. These problems come up during house debates and political campaigns as some of the top issues under consideration for policy makers. The eventual effects of such situations is a force aimed at driving the country towards NHI (Hoffman, 2009).
Second, the availability factor looks at the extent to which Americans can access health and health care related services. Blumberg, Long, Kenney, and Goin (2013) suggest that despite the visible inefficiencies, the US has one of the most advanced healthcare systems in the world. The advancement implies that the country has solved most of the issues related to facility location, operating hours, compliance with laws, quality of services, type and number of health workers, and hospital supplies. That is, at least every state has a variety of high-order private or public hospitals that can serve its population. This situation couples with the effort to increase the extent to which individuals from marginalized areas can access these facilities. In essence, the resource availability factor acts as an opportunity for the current and future administration to push its NHI agenda.
However, there are also a variety of factors that restrain this legislation as follows. First, the perceived political ideologies linked to NHI could act as a barrier to its successful establishment and implementation during the reforms. The country’s political wing views most policy makers who lobby in favor of NHI as socialists. They perceive such individuals as the drivers of the rather controversial ideologies in ways that challenge the whole idea of capitalism and economic authority. Thus, the political status quo denies NHI the ability to pass legislation and take charge of the country’s health care system. Every average politician, for that matter, would quote socialism as an unrealistic ideology that will fail in governing the financial, policy, and practice sectors of the American health care system (Hoffman, 2009).
Finally, it is also vital to consider the acceptability index of NHI among institutional-based stakeholders and patients. These attitudes emerge as one of the main factors that can influence policy acceptability. Evidently, the perceived negative attitude towards NHI among the population stems from the idea of paying taxes to help finance a system that takes care of the unemployed and undocumented individuals. Also, there is fear among providers and hospital supply manufacturers that NHI would result in utter federal control of the healthcare sector. This control, coupled with a surge in the demand for health care would mean the inability to manage heavy workloads in the wake of limited resources and staff shortages (Light, 2003).
As a DNP-prepared nurse, I support the call to consider NHI as a solution to the country’s health care problems. This pledge shows that I acknowledge my position in learning and educating policy makers, implementers, and patients on the reality behind NHI. I know the importance of such a system in helping advance the country’s health care efficiency. In essence, countries such as Australia and the UK have been able to utilize the system for enhanced and equitable service provision.
References
Blumberg, L., Long, S., Kenney, G., & Goin, D. (2013). Public Understanding of Basic Health Insurance Concepts on the Eve of Health Reform. Washington, DC: The Urban Institute .
Hoffman, C. (2009). National Health Insurance: A Brief History of Reform Efforts in the US. Washington, DC: The Henry J Kaiser Family Foundation .
Light, D. (2003). Universal Health Care: Lessons From the British Experience. American Journal of Public Health, 93 (1), 25-30.
Quadagno, J. (2005). Why the United States Has No National Health Insurance: Stakeholder Mobilization Against the Welfare State . Journal of Health and Social Behavior, 45, 25-44.
