The New York Times
May 3, 2002
As a private psychiatrist with about 45 percent of my patients on Medicaid or Medicare, I agree with Marc Siegel (Op-Ed, May 1) that Medicare should be expanded. But let’s not stop with prescription drugs. The program should cover all Americans. We could change its name to National Health Insurance. Were this to happen, I’d gladly accept a pay cut.
J. WESLEY BOYD, M.D. Northampton, Mass. The writer is a lecturer in religion at Smith College and in psychiatry at Harvard Medical School.
The original Op-Ed by Marc Siegel (“… choosing not to take Medicare patients should not be seen as simply a neutral business decision.”):
Comment: “National Health Insurance” or “NHI” is a neutral term that can be used for broad audiences. Now that health reform is back in the news and on many agendas, it is helpful to have a term that represents comprehensive reform but without invoking concepts for which organized opposition already exists. “Medicare for All” provokes negative responses from those that are unhappy with the affects of neglect and political damage done to our Medicare program. “Single payer” provokes responses from those that have been saturated with misinformation about the Canadian system. These terms are certainly acceptable for selected, targeted audiences, but might not be the best terms for large, broad audiences.
“National Health Insurance” suggests the option of comprehensive reform, a concept that is now being accepted as an alternative to our current incremental approaches, now that the public is showing concern about the failures of incrementalism (skyrocketing premiums, excessive cost-sharing, and more uninsured). Once the forum is opened up to National Health Insurance, we can use this opportunity to explain to the public the beneficial features such as equity in funding, comprehensiveness, improved access, and elimination of financial barriers while containing costs.
Although no single terminology would be appropriate for all circumstances, National Health Insurance, or NHI, should be in our tool box as we communicate to the nation the advantages of reform that would provide affordable, comprehensive care for everyone.