Universal Health Care Surging in Popularity with Policy-Makers
Krisberg, Kim, The Nation's Health
Universal health care--once dismissed by policy-makers--has landed a starring role on the U.S. policy agenda, with a range of state, federal and private leaders now embracing the issue as a way to target the nation's growing health care woes.
Responding to rising uninsurance rates and health costs, more and more state and federal policy-makers are laying out plans for curbing the problems. Most recently at the state level, California and Pennsylvania debuted plans fashioned after a 2006 Massachusetts health care law, which requires all residents to have health insurance and expands the state's Medicaid eligibility standards. Ideas at the national level include a proposal from Sen. Edward Kennedy, D-Mass., to expand the Medicare program to people younger than 65 and give enrollees the option of choosing any of the plans offered to members of Congress, the president and federal employees. Congressional legislators have come together to propose expanding eligibility requirements under the State Children's Health Insurance Program and allowing employers to buy coverage through SCHIP for employees' children. President Bush also outlined a new health care proposal in his State of the Union address, calling for tax incentives that would help people afford health coverage, and universal health care plans are popping up on the platforms of numerous presidential hopefuls.
"We've seen a rising number of uninsured in this country and that's a huge factor," said Elise Gould, PhD, a health economist at the Economic Policy Institute in Washington, D.C. "Second and perhaps even more importantly, we're seeing people becoming afraid of losing the benefits they already have. There's rising insecurity: Lots of people uninsured, businesses dropping retirement coverage, more burden on the individual--it's not just coming from one camp, it's coming from all over the place."
Almost 47 million Americans are currently living without health insurance, according to the latest U.S. Census Bureau figures, and the rate of people who receive health coverage via their employers is decreasing. Coinciding with rising uninsurance rates are skyrocketing health care costs: A January study in Health Affairs found that while health care spending growth has slowed, total spending continues to increase. Health care spending accounted for 16 percent of the nation's gross domestic product in 2005, topping off at a total of $2 trillion, the study reported. Funding and resources for safety net programs such as Medicaid and SCHIP, which together provide health care for millions of low-income families, are being stretched dangerously thin, and segments of the American population many thought were buffered against uninsurance, such as those with employer-sponsored coverage, are beginning to feel the strain of a fragmented health care system.
However, the convergence of so many issues is bringing some new and innovative ideas to the table--especially from state policy-makers--and creating an atmosphere in which not taking action may no longer be an option.
One model that policymakers could use to create a more inclusive and universal health system is Medicare, which boasts low administrative costs and a large purchasing pool, Gould said. While there's been an unraveling of the employer-based market, the system works for those who can take part, Gould said, and to address the uninsured, "you don't want to erode that market more, you want to build upon it."
Bush's plan, which Gould said provides no incentive for employers to provide insurance and instead encourages people to seek less expensive coverage outside of their employment, could lead to an erosion of employer-based health coverage. In other words, enticing healthy people to pull out of their employers' overall "risk pool" would leave behind the employees with the highest health costs, such as people with chronic illnesses, and make it harder for employers to provide coverage, Gould said. …