Living with NHI

Our current healthcare delivery system is failing, and a number of health policy leaders have proposed some version of a national health insurance (NHI) program to reform it. Lawmakers, the nation's business community, unions, and the uninsured and underinsured are all pursuing ways to reduce the nation's healthcare expenditures. Most proposed NHI plans would be federally sponsored and state administered and funded by a combination of employer contributions and general revenues. If the government were the sole entity collecting premiums and making payments, the arrangement would reduce the nation's healthcare costs by an estimated 10 percent. NHI would eventually assign hospitals a "global budget," rather than reimburse them for specific services rendered. Although NHI as a whole will mean a loss of revenue for most hospitals, it may actually strengthen efficient and effective geographically linked healthcare systems (and thus could be an advantage to many healthcare systems). NHI would also allow hospitals to shift focus from the bottom line to patient care. Although NHI would mean less revenue for physicians, it would mean greater access to healthcare for members of communities.