National Health Insurance and Its Disadvantages


National health insurance (NHI) invariably becomes a reason for heated debates since the beginning of its history in 1912 (Bodenheimer & Grumbach, 2012, p. 187). As new reforms are made and proposed, the disadvantages of the phenomenon that are either generic or specific (related to a particular aspect of NHI) can be singled out.

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A major issue of NHI is the funding and reimbursement of health care providers. As pointed out by Bodenheimer and Grumbach (2012), NHI can be funded by governmental, employment-based, or private means, but all these means experience the problem of rising healthcare costs (White, 2013). It can be illustrated by the fact that nowadays employers tend to consider increasing premiums, for example, for the obese as this group is expected to require more frequent and costly health care, which is an admittedly discriminatory practice (LaVan & Katz, 2009). Low reimbursement rates remain an issue of NHI (McDoom, Koppelman, & Drainoni, 2012).

The funding problem is related to another one: the matter of efficiency. For example, the 2010 Patient Protection and Affordable Care Act expanded the insurance meant to protect the most vulnerable parts of the population (elderly and poor) to over 30 million people (Bodenheimer & Grumbach, 2012, p. 187). The Act has resulted in an increased strain on health care, which calls for improvements in the effectiveness of the work of providers (Cohen, 2015).

Efficient spending, effective organization, and coordination have always been a challenge for NHI, but they can be considered the only way of containing costs and improving healthcare (Cohen, 2015, p. 718). This aspect cannot be considered an irresolvable issue, but its persistence indicates that more needs to be done to improve the situation.

Apart from that, NHI keeps being criticized for its lack of inclusiveness. NHI remains limited and proceeds to ignore the needs of various groups of the population, which is partially the result of the lack of an understanding of these needs on the level of insurance providers (McDoom et al., 2012). Another reason for this issue is the remaining discrimination and inequality of the US population, which proceeds to limit the access of vulnerable people to health care even after the implementation of the Affordable Care Act. For example, it is confirmed that women (especially elderly and widowed) tended to experience lower rates of coverage in 2011 (Salganicoff, 2015, p. 49).

Similarly, it is believed that a number of barriers, including lack of education and information available, prevents beneficiaries from choosing appropriate insurance plans (Newhouse & McGuire, 2014). It is noteworthy that the position of vulnerable and previous discriminated groups proceeds to improve, but the issue is persistent (Salganicoff, 2015).


Finally, it should be mentioned that different types and aspects of NHI tend to be criticized to a different extent and for different reasons. For example, according to Newhouse and McGuire (2014), Medicare Part C was specific in generally being “viewed as a policy disappointment” since it has failed to popularize managed care plans (p. 351), even though the authors suggest that the recent changes in the policy might have affected this aspect of NHI in a positive way. Similarly, the mandates that attempt to make the coverage universal or near-universal raised the question of the freedom of choice (Cohen, 2015).

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To sum up, the issues that are related to NHI are numerous, and they require the attention of the government and stakeholders. As a result, it can be concluded that the criticism of this aspect of healthcare is likely to promote its improvement.


Bodenheimer, T. & Grumbach, K. (2012). Understanding health policy. New York, NY: McGraw-Hill Medical.

Cohen, J. P. (2015). Implementing the affordable care act: Remaining hurdles. Clinical Therapeutics, 37(4), 717-719. Web.

LaVan, H., & Katz, M. (2009). Managing Obesity: Human Resource Managers’ Perspectives. Compensation & Benefits Review, 41(2), 54-61. Web.

McDoom, M., Koppelman, E., & Drainoni, M. (2012). Barriers to accessible health care for medicaid eligible people with disabilities: A Comparative Analysis. Journal Of Disability Policy Studies, 25(3), 154-163. Web.

Newhouse, J. & McGuire, T. (2014). How Successful Is Medicare Advantage? Milbank Quarterly, 92(2), 351-394. Web.

Salganicoff, A. (2015). Women and Medicare: An unfinished agenda. Generations, 39(2), 43-50. Web.

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White, J. (2013). The 2010 U.S. health care reform: Approaching and avoiding how other countries finance health care. Health Economics, Policy and Law, 8(3), 289-315. Web.

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