Academic journal article Frontiers of Health Services Management

Response to Frontiers Issue on the Uninsured

Academic journal article Frontiers of Health Services Management

Response to Frontiers Issue on the Uninsured

Article excerpt

THE FOLLOWING REMARKS continue the discussion in the Summer 2005 issue of Frontiers on "Critical Conditions: Providing Healthcare to America's Uninsured." Emily Friedman wrote a feature article and Rick Curtis wrote a Commentary, to which Ms. Friedman briefly replied. The discussion continues below:

Rick Curtis: I do not believe, as Emily Friedman incorrectly inferred from my commentary, that individuals should be mandated to buy coverage in the individual market, which I agree is inefficient, dysfunctional, and unfair.

I did say (and do believe) that any real solution to the uninsured problem must include individual responsibility to participate in coverage-something previous failed efforts have obfuscated-and I suggested factors that might motivate public support. I also suggested coverage vehicles that enjoy bipartisan support: pools that, like FEHBP, offer choice of plans; and parental responsibility to cover kids, with SCHIP coverage available for those without good employer coverage.

I don't know of any realistic approach to cover everyone that does not require such individual responsibility. Whether reforms involve employer coverage mandates that require workers to pay their share; coverage through public programs that require individuals to pay income or payroll taxes; or individual mandates with tax credits-or some combination-non-poor individuals would contribute and government would need to "somehow ensure that coverage is readily available and affordable for everyone. …

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