Universal Opportunity, Not Universal Coverage
Tens of millions of Americans lack health insurance. Extending coverage to them has been a core goal of health reform proposals since the 1960s. President Richard Nixon offered a universal health plan in his first administration, but since then Republicans have hesitated to commit the nation to so costly an undertaking. Is it time to rethink? Should Republicans accept universal coverage as a goal? We posed this question to NewMajority's contributors.
Universal health coverage is possible to achieve although I would call it "Universal Opportunity." High deductible, catastrophic coverage could be achieved for the 10 to 15 million truly unable to afford care. It would cost about $2500 per year at most. That would make it a $30-50 billion program. Then invest in more community health centers for primary care and you provide the full safety net for the near poor. The rest should have the opportunity to buy this form of insurance and if they choose not to do so, not much could be done. I think you could create an extension of Medicaid or perhaps even Medicare for those with certain chronic conditions that leave them in the lurch.
The problem with all of this is the cost problem in the current system. That will bankrupt the country whether we have universal coverage or not. Here we need to really think hard about controlling costs. I would start with reintroduction of some control over community facilities. There is too much duplication of services -- open heart programs at community hospitals, proliferation of transplant programs. We do need some local community planning about the health resources needed based on demand.
To read other contributions to this symposium, click here.