Universal Health Insurance Coverage or Economic Relief — A False Choice (New Eng Jour Med)

[pinto]

:thumbsup: :thumbsup:

Good argument for universal health care - pinto

http://content.nejm.org/cgi/content/full/360/5/437?query=TOC

Universal Health Insurance Coverage or Economic Relief — A False Choice
Jonathan Gruber, Ph.D.

These are exciting times for advocates of universal health care coverage, with sizable Democratic majorities in both houses of Congress and a Democratic president who made universal coverage a central pledge of his campaign. Indeed, Senators Max Baucus (D-MT) and Edward Kennedy (D-MA) are hard at work on universal-coverage legislation, and Senators Ron Wyden (D-OR) and Robert Bennett (R-UT) have already submitted a bipartisan bill that would accomplish that goal. But despite this enthusiasm, many observers are skeptical that the United States can foot the bill for universal coverage in such economically trying times. Universal coverage, their argument runs, is a luxury that we must do without in order to make way for other programs that will stimulate the economy.

This argument presents a false choice. Indeed, I would counter that now is exactly the right time for universal coverage, because it can play such an important role in growing our economy, while also enabling us to shift the focus of health policy discussions to approaches for addressing our largest long-term fiscal challenge: escalating health care costs.

The first step toward universal coverage would be to send resources to the states for maintaining and expanding their public insurance programs. For example, the recent legislation reauthorizing the State Children's Health Insurance Program (SCHIP), which was vetoed by President George W. Bush, included large incentive payments to states for enrolling children who were already eligible for, but were not yet enrolled in, state public insurance programs. These bonus payments would have offset much of the cost that states would have incurred for the newly insured children, providing a major source of federal funds to cash-strapped states.

<snip>

Designing, passing, and implementing policies that will bring health care costs under control, however, will require herculean efforts on the part of U.S. policymakers. Universal health insurance coverage is, in a sense, central to these efforts, because squaring away a baseline level of coverage will allow policymakers to focus their energies on cost control. The health policy community has long been fighting a two-front war, and the goals of universal coverage and cost control can sometimes conflict. Having everyone pulling in the same direction — with the recognition that certain financial limits will be required to ensure ongoing health care for all — is key to developing the consensus necessary for cost control. I have witnessed this effect firsthand in Massachusetts, where for years our advocacy community focused exclusively on expanding coverage for medical expenditures and therefore opposed most initiatives that might have put that goal at risk, even those that might have meant controlling costs. Since Massachusetts passed its universal-coverage plan, this powerful advocacy community has shifted its attention to controlling costs as a means of preserving the program's affordability to the state. The result was the passage last year of an opening salvo in the cost-control wars here in Massachusetts — Senate bill 2526, An Act to Promote Cost Containment, Transparency and Efficiency in the Delivery of Quality Health Care. Other countries, such as the Netherlands and Switzerland, have demonstrated that it is possible to have both universal coverage (even coverage provided through private insurance companies) and much lower health care spending.

Thus, the choice between fixing our health insurance system and fixing our economy is a false one. A smart health care reform bill, which has at its center universal health insurance coverage for our citizens, can improve both individual health and the economy's health, both today and in the long run.

Source Information
Dr. Gruber is a professor of economics at the Massachusetts Institute of Technology, Cambridge.

The New England Journal of Medicine is owned, published, and copyrighted © 2009 Massachusetts Medical Society. All rights reserved.

http://content.nejm.org/cgi/content/full/360/5/437?query=TOC

[Donnachaidh]

1. NO insurance.

Advocating universal INSURANCE is NOT a solution. It allows the CANCER of insurance to GROW.

[pinto]

3. I think the author is arguing for a path to Medicare/Medicaid for all.

It's a good goal, imho. And I realize it won't happen in one fell swoop.

I pay ~ $95 a month for Medicare coverage and it works well. I'd like us all to have access to the program. I prefer that the federal government be the insurer, rather than a private entity.

Also, the author notes the underlying problem - the costs of private insurance. For individuals and employers.

There's a way out of this morass, and the author makes a point for some steps.

Thanks for your response.

[Cleita]

5. Not only that, the $96 a month pays for 80% of the medical doctor bill. I have to

pay an additional $250 a month for the extra 20% and prescription coverage to privateers (yes I mean that). I would rather give the money to Medicare to get full coverage instead of to the parasites whom I know spend only a third on health care. However, I know Medicare could deliver the same coverage for half that premium.

[DCKit]

2. This professor of economics never spent half his work week filling out insurance forms...

so he could get paid. I believe a majority of doctors are on-board with a single-payer, Medicare-style program that doesn't require them to lie or beg for payment.

[pinto]

4. I think that's where he's going -

"The first step toward universal coverage would be to send resources to the states for maintaining and expanding their public insurance programs."

[reggie the dog]

6. universal health insurance

fuck the econimc stimulus package, health care is about taking care of people, not money. Just let the governemnt be the sole provider of health insurance.