Health Care 101: Terms & Phrases That Define the Debate

Confused by the health care jargon? Join the club. Here are some definitions that make make sense out of the controversy.

Co-op: A non-profit health cooperative, or “co-op,” is a member-owned group that assembles a network of salaried medical providers and negotiates payment rates with them. Membership is voluntary; consumers decide whether a co-op’s costs, coverage, provider networks and other features are superior to those of private plans. Sen. Kent Conrad, D-N.D., a key member of the Senate Finance Committee, first proposed the idea of a co-op alternative to a public health insurance plan.
Public option: A public option, or “nationalized plan,” is a government-run, government-funded health insurance option offered as an alternative to private insurance companies. Obama has said a public option will make health care more affordable, because people would pay premiums 10 to 20 percent  less than they would in a private insurance plan.
Private insurance: Health coverage provided by companies like Blue Cross Blue Shield, GHI, United Health Care and others.
“Single payer”: A term used to describe a system that would collect all health care fees and pay out all health care costs. This type of financing system has been proposed to eliminate administrative waste because it would force doctors and hospitals to bill one entity for services—rather than several private insurance companies that have different billing procedures.
Trigger: Some Democrats, like Sen. Max Baucus, have proposed a so-called “trigger” in the health care reform legislation, which would keep a government plan on reserve in case private insurers don’t meet certain benchmarks.
Medicare & Medicaid: Medicare is a government-backed program for seniors 65 years or older. Medicaid is a health option for low-income individuals and families.
“Socialized” medicine: Critics of Obama’s health care reform, like Republican National Committee Chairman Michael Steele, have called the idea of a public option “socialist”—he means the option would, in his opinion, drive private insurers out of business and substitute a government-regulated system that provides health care for all. “Socialism” is usually defined as any of various economic and political theories advocating collective or governmental ownership and administration of the means of production and distribution of goods. This differs from former east-bloc Revolutionary Socialism in that democratic practices and controls are maintained.
“Rationing” care: Critics charge that a government-run health insurance system would lead to health care “rationing”—meaning that care would be given according to need; the authorizing priority for which would be established by non-elected bureaucrats. Obama has countered this charge, saying the “public option” will provide greater access to health care.
Health insurance exchange: A phrase used to describe a “marketplace” for various health care options—including a government plan—that will increase competition.
Doughnut hole: A gap in coverage for seniors within the defined standard benefit under the Medicare Part D prescription drug program. The doughnut hole requires seniors to pay full cost for drug prescriptions after they reach a spending limit.
Electronic records: The Obama administration has called for all records to be computerized within the next 5 years so as  to modernize the health care system and lower costs.