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Healthcare Glossary

Arun Gupta Sep 17, 2009

ADMINISTRATIVE COSTS — The percentage of healthcare spending that goes to activities such as paperwork, administration, review and insurance underwriting. A 2003 study found that administrative costs in the U.S. healthcare industry accounted for 31 percent of expenditures, as opposed to 16.7 percent in Canada.

EXCESSIVE COSTS — The percentage of U.S. healthcare spending considered unnecessary. One study found that in 2003, around 28 percent of U.S. healthcare costs, or $477 billion, were unnecessary, compared to other developed countries — even after accounting for differences in wealth and population health. Excessive costs include administration, profit, high prescription drug costs, lack of risk sharing, an emphasis on treatment rather than preventive medicine, poor medical record technology and “heroic medicine” and “defensive medicine.”

HEALTH INSURANCE EXCHANGE — An exchange, according to MSNBC , “would allow uninsured individuals and small employers to purchase insurance by shopping at a federally regulated, web-based marketplace similar to a travel website such as Orbitz. Purchasers would be given a menu of competing plans, mostly privatesector ones, but also one federally sponsored plan that would compete on cost and quality with the private-sector plans.”

MANDATES — All uninsured Americans would be required to purchase health insurance, and businesses with annual payrolls of more than $250,000 would be obligated to purchase insurance for fulltime employees.

MASSACHUSETTS PLAN — Instituted in 2006, the Massachusetts plan aimed to provide healthcare to all residents. Three years later, half of those previously uninsured remain so, despite tax penalties. The plan fails to address the expense and rising costs of private healthcare plans and the program has faced a series of cutbacks.

MULTI-PAYER — A public agency offers universal healthcare coverage while individuals often purchase private plans as a supplement. Forbes Magazine claims 90 percent of the French buy private insurance because the public plan does not pick up 20 to 40 percent of healthcare bills.

 

OBAMA ADMINISTRATION PLAN — The plan has three parts. The first one involves rules that would end “discrimination against people with pre-existing conditions,” “limit” discrimination based on age and gender, prevent insurers from “dropping coverage when people are sick,” and other provisions dealing with Medicare, preventive care and out-of-pocket expenses. The second part would create a healthcare “exchange” limited to small businesses and individuals. The third provision mandates that the plan be “deficit neutral,” that is, not add to the federal deficit.

PUBLIC OPTION — The Obama administration defined this as a government program competing with private healthcare providers, offering quality coverage and open to all legal U.S. residents. A robust public option could have spelled the end of many for-profit healthcare providers because of the government’s purchasing power, lower administrative costs and elimination of profits. Under pressure from the private healthcare industry, however, the public option has been scaled back to a limited “exchange.”

RATIONING — A term often used to disparage government-run healthcare, claiming services are limited by bureaucrats. Medical dictionaries define rationing as “planning for the equitable allocation, apportionment or distribution of available health resources.” No medical system can provide unlimited treatment to any individual at any time regardless of cost. According to Media Matters, insurance companies already ration care by “restricting coverage of procedures and tests like MR Is and CAT scans … denying coverage for pre-existing medical conditions” and cancelling policies of people with serious conditions such as cancer.

RECISSION — Insurance companies often cancel coverage for patients with expensive medical conditions, claiming they misrepresented their medical histories. A recent memorandum from the U.S. House Committee on Energy and Commerce noted that three large insurance companies admitted rescinding at least 19,776 policies from 2003 to 2007 for a savings of more than $300 million. The memo added that this total “significantly undercounts” the number of recissions because of incomplete data provided.

SINGLE PAYER — Health insurance is socialized, as in Canada and Japan. A public agency oversees the financing of healthcare, usually through income and business taxes, but healthcare delivery is facilitated by the private sector, often nonprofit. The National Health Insurance Act (HR 676) would institute single payer in the United States.

 

SOCIALIZED MEDICINE — The government administers healthcare financing, owns and operates the hospitals, and pays doctors. This system exists in England and Spain and is also how the U.S. Veterans Administration works.

UNIVERSAL HEALTHCARE — A government-sponsored system in which all citizens are guaranteed health care. The United States is the only industrialized country that does not have this kind of system.


ILLUSTRATIONS BY LEO GARCIA.

Check out all of The Indypendent’s healthcare coverage in this issue:

What’s Left Is Right by Arun Gupta

Conspiracy Nation: Right-wing demagogues reach out to a supposedly beleagured white middle class, telling them they are being squeezed by parasitic traitors from above and below by Chip Berlet

The Myths of Canada Care by Susan Rosenthal

First Person: Fear and Anger in Staten Island by Laura Boylan

Healthcare Glossary by Jaisal Noor and Arun Gupta