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National Health Insurance: Contrarguments


In this paper, the arguments of the opponents that were presented to advocate for a national healthcare insurance (NHI) are going to be countered. Our opponents have provided a clear and succinct overview of their position, and their arguments are most convincing, but we find that we disagree with several points that they have chosen to defend.

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“The UK and Canada on the other hand are said to be happy with their healthcare system despite at times long waiting times for what is classified as non-essential procedures or operations. (Bodenheimer & Grumbach 2012).”

The question of whether the countries are happy with their healthcare system is, naturally, important, but the definition of happy does not necessarily presuppose good, sound, non-discriminatory, and efficient systems. For example, the limitations of NHI in the UK include the long waiting lists, lack of the choice of provider (monopolies are never good for service quality), and the possibly lower standard of healthcare for the governmentally insured when compared to those who choose private plans (Odeyemi & Nixon, 2013).

Private plans are an option, but their costs make them less affordable. However, their existence proves that at least a part of the population (12%) is not happy with NHI and is simultaneously capable of affording private plans (Odeyemi & Nixon, 2013, p. 112). Part of the unhappy population may be unable to purchase a more attractive alternative.

Basically, it can be suggested that the quality of healthcare in the world varies with respect to different variables. Unfortunately, the issues of the US healthcare system (the problem of funding, efficiency, change management, discrimination) are not exclusively American. Similarly, the issues that are related to NHI are quite universal: they include the increased number of patients (the waiting time), increased expenditures (the never resolved problem of funding), and the increased strain on healthcare professionals (which might lead to lower-quality care, even though it is unacceptable).

“One interesting comparison of measuring the quality of care provided can be seen in 2 studies,” and the following comparison.

Any two studies are unlikely to provide a clear and consistent picture of the state of events. Ryan and Damberg (2013) offer an overview of research devoted to pay for performance studies and conclude that this practice has the potential of leading to quality improvement when properly managed. In particular, it is a fact that pay for performance programs are difficult to assess, which emphasizes the importance of proper reporting. As a result of this issue, it is hard to track the actual changes that pay for performance caused in the UK healthcare since the indicators can be manipulated (Bodenheimer & Grumbach, 2012, p. 172).

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“Health Expenditures – The U.S. spends more per capita than any other nation across the globe,” and the following argumentation that emphasizes the importance of reducing the expenditures.

Our opponents are completely right in showing the strain that healthcare costs place upon businesses and individual people. However, it is noteworthy that the strain is not going to disappear with the expansion of NHI; the insurance is going to be paid for by taxpayers since governmental funding is essentially fuelled by taxpayers (Bodenheimer & Grumbach, 2012; White, 2013). The 2010 Patient Protection and Affordable Care Act showed that the increase in the number of insured to 30 million people (Bodenheimer & Grumbach, 2012, p. 187) puts an extra strain on the governmental and institutional resources (Cohen, 2015, p. 718). It is absolutely necessary to reduce costs and make healthcare effective, but NHI is unlikely to improve the situation.

“Access to Care – Health insurance companies will no longer be able to discriminate persons with preexisting conditions.”

This point is questionable due to the fact that discrimination has a number of levels and is not necessarily intentional. People with preexisting conditions can be discriminated against on more than one basis; for example, they can be black or female. An example of less conventional discrimination is that of the people who lack education: they experience communication barriers, which are capable of decreasing the quality of service (Newhouse & McGuire, 2014).

This kind of discrimination may be unintentional, but the weakness of this population can be employed for the advantage of health insurance companies as well. Moreover, the example of the UK demonstrates that the quality of NHI, when compared to private health insurance, might be discriminatory as well, which is hardly unintended (Odeyemi & Nixon, 2013, p. 112). In general, the discriminatory practices can be expected to disappear as soon as discrimination disappears as a social phenomenon.


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.

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

Odeyemi, I. & Nixon, J. (2013). The role and uptake of private health insurance in different health care systems: are there lessons for developing countries?. Clinicoeconomics And Outcomes Research, 5, 109-118. Web.

Ryan, A. & Damberg, C. (2013). What can the past of pay-for-performance tell us about the future of Value-Based Purchasing in Medicare? Healthcare, 1(1-2), 42-49. Web.

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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