No one can say for certain, of course. Really, it’s anyone’s guess what will happen over the course of three decades. If you’d have described the Social Security system or even the Civilian Conservation Corps to someone in the 1910s, they’d have thought you were loony, yet both of those things were a reality under Roosevelt.

Ultimately, things will go one of two ways: Toward a single-payer, socialized medical insurance scheme or toward a scheme based in the free market.

Socialized Medicine?

The UK has had socialized medicine for more than half a century. In spite of dire predictions of some politicians, simply having socialized medicine doesn’t destroy a country. It does affect service levels, as the UK has struggled for some time to provide medical services in a fast and efficient manner.

One thing to remember, as well, is that private medical insurance isn’t likely to disappear altogether. Somewhere between 10 and 15 percent of residents of the UK pay for private medical insurance. In many cases, this is simply a way for them to bypass the queues of the National Health Service.

If we continue the direction we are headed, it’s likely that this will be the end result. A system like the new one that mandates individuals buy insurance yet also places strict regulations on insurance providers will not last long, and a single-payer solution will have to be implemented.

Market-based Medicine?

The medical insurance industry is in desperate need of reform, which is why so many people have been open to the kinds of sweeping changes passed this year. However, there are those that argue for more market-based reforms. For example, changing the structure of how FDA trials and approvals work, and reforming malpractice legislation would go a long way to reducing the costs of medical insurance.

These kinds of changes aren’t likely to occur, unless the recent bill is repealed or declared unconstitutional by the Supreme Court. It would also require changes in presidential as well as congressional leadership. While that isn’t likely to happen today, it may happen over the course of the decades.

Photo via mightyohm

Here are some of the basic ideas surrounding medical insurance in the UK that you may or may not already know:

• The National Health Service provides for basic health needs to people in the UK. That’s the basic principle, anyways. The NHS pays for and/or administers health care for folks. When you go to a doctor, there is only one payer that the doctor has to deal with. They won’t bill a separate insurance company (in many cases) because they don’t have to.
• You have to wait your turn for medical care. The medical system in the UK is famous for its queues. For certain types of medical care – such as routine checkups and such – you can usually get a pretty quick appointment. However, the waiting list for some specialty medical doctors and for certain procedures is quite long.
• There is still private medical insurance. This is how many people in the UK get around the queues. If you have private medical insurance, you can go to a physician who can often see you right away. There are certain things that private medical insurance won’t cover, of course, and there are things that it does. Mostly, private medical insurance in the UK is a way to get quicker service.
• The quality of care varies from one area to the next. While you’ve probably heard horrible things from some folks about the medical care situation in the UK, you’ve probably heard great things from someone else. That’s because care can vary greatly from one area to the next. Some NHS hospitals, for example, have a stellar reputation while people avoid others if at all possible.

Contrary to the political rhetoric you’re likely to hear, the medical insurance system in the UK is neither perfect nor the world’s worse. Whether it’s any better than what the U.S. has today is, as always, open for discussion.

Photo via roblisameehan

In fact, the issue of constitutionality is causing Republicans to lobby against that provision being present in any health care reform package that may come out of Congress.

The Supreme Court

There are several politicians in both parties who struggle with making purchasing health insurance mandatory for all Americans whether the coverage is administered privately or by the government.

It’s also thought that any required medical insurance would not be upheld by the Supreme Court because it is not part of the constitution.

In an article on the Tenth Amendment Center website, Professor Rod Natelson, a national expert on the framing and adoption of the United States Constitution, agrees.

In his response to a Los Angeles Times Op-Ed where another Constitutional suggested the constitution was broad enough to include mandatory health insurance, Professor Natelson writes, ” However, the claim that the Founding Fathers would have thought the Constitution allows Congress to impose health care mandates is little short of absurd.”

Professor Natelson further goes on to suggest the use of the word commerce in the Constitution related to rules pertaining to merchants. That did not include other economic or non-economic activities such as health care.

State Opposition

Even with the likelihood of the Supreme Court not upholding a health insurance mandate, many states aren’t taking any chances. So far, up to 34 states have filed amendments to their own state constitution prohibiting any health insurance purchasing requirement.

There appears to be a long way to go to resolving this issue. The current bill language imposes a penalty on people who do not have health insurance.

How the legislation will proceed now, is anyone’s guess.

Photo via leoncillo sabino