The language of health care

When it comes to health care, language is crucial. Today, our national dialogue is moving away from words like “mandates” and towards the more acceptable “shared responsibility.” Here’s a quick look around the health-care dictionary.

Universal health insurance: A comprehensive plan that covers all Americans. Contrary to popular belief, this is not “socialized medicine.” It could be a combination of plans run by the federal government and private insurers. The federal government could administer a plan that is operated by existing private insurers. These are termed “hybrid” solutions. France is an example of this type of system.

Single-payer: A health-insurance plan administered by the state or federal government that is paid for through a single fund. Medicare and Medicaid are considered single-payer systems. Different versions of single-payer exist in Canada and Taiwan.

Guarantee issue: Health-insurance plans would guarantee that all applicants receive coverage. The dreaded “pre-existing condition” would no longer prevent patients from receiving coverage.

Individual mandate: A plan that would require all individuals pay for health insurance. Today, California requires its car owners to hold a minimum auto-insurance policy or face penalties. This would operate in similar fashion.

Employer mandate: A plan that would require all employers to provide—or contribute toward—minimal health insurance for all of their employees.

Shared responsibility: A plan that means all parties—patients, employers and health-insurance plans—share the responsibility of universal health coverage. In California, hospitals agreed to a “hospital tax” as their part of shared responsibility.

Cost shift: Today, the cost of paying for medical treatment to the uninsured is “shifted” onto those who can pay. When the uninsured get sick, they typically wind up in the emergency room rather than a physician’s office. Not only is this form of treatment wildly expensive, it’s rarely paid for. By insuring the uninsured, this cost shift is significantly reduced.

Cost containment: Experts estimate that about 30 percent of the service doctors and hospitals provide is unneeded. Health-care costs can be controlled by streamlining service and reducing unnecessary care. Expanding electronic health records, reducing hospital infections, tightening the escalating costs of drugs and emphasizing prevention are just some of the many ways to contain costs.