Health Care Reform – The Larger Landscape

Millions of Americans do not have health insurance. Studies consistently show the uninsured have worse access to health care and worse outcomes. They often face increased financial challenges, including bankruptcy. The cost of caring for those without insurance makes health care more expensive for everyone — including employers and individuals. Currently, health care spending accounts for 16 percent of the gross domestic product, more than any other industrialized country.

Many health care groups, elected officials, and Americans believe that something needs to be done to stop rising costs and make sure that everyone has access to care. However, consensus tends to break down when specific plans are offered as the solution. Though attempts have been made in the past to further universal health care in the U.S., none to date have succeeded. Now may be a unique time in American history when all the forces to compel change – government commitment, expert counsel, and the will of the American people – are present and a real solution to this longstanding issue is possible.

What others are saying about health care reform? Read the health care reform news feed.

Facts About the Uninsured

A recent study was commissioned by the Kaiser Family Foundation and published in the Journal of the American Medical Association* in March 2007. Based on an analysis of eight years of data and more than 30,000 observations that following an accidental injury the following were true:

• The uninsured were less likely than the insured to receive any medical care (78.8% vs. 88.7%).
• The uninsured with a new chronic condition were also less likely to receive care (81.7% vs. 91.5%).
• The uninsured with an injury were also twice as likely as those with insurance to have received none of the recommended follow-up care (19.3% vs. 9.2%).
• The uninsured are more likely to report not fully recovering and no longer being treated following an accident and approximately seven months after the initial health shock; the uninsured with new chronic conditions reported worse health status than the insured with similar conditions.
  

Kaiser Permanente and Health Care Reform

Kaiser Permanente believes everyone should have access to affordable, high-quality health care. It is the essence of our mission. The fact that millions of Americans are without health care coverage needs to be addressed. Kaiser Permanente believes reform should ensure maximum fairness, feasibility, and value to Americans, without disrupting those who currently are insured.

With more than 8.7 million members nationwide, Kaiser Permanente is deeply committed to affordable, quality health care for their members and their communities and has a longstanding reputation of leadership on major health policy issues. Kaiser Permanente has put forward principles that the organization supports, such as shared responsibility, prevention as a cornerstone to good health, and the need for broad-based, reliable funding.

In addition, George Halvorson, Steve Zatkin, senior vice president and general counsel, Kaiser Foundation Health Plan, Inc., and Jay Crosson, executive director, Permanente Federation, co-authored an article in Health Affairs in December 2006 that proposed one possible solution for universal coverage in California.

Kaiser Permanente Guiding Principles for Health Care Reform

• Increase enrollment of people eligible for current public programs but not currently enrolled.
• Provide affordable and guaranteed basic health coverage for the low-income uninsured who are not eligible for other coverage.
• Provide affordable, guaranteed issue health coverage options for higher income uninsured who have chosen not to purchase coverage, or whose health status makes them uninsurable.
• Utilize broad-based, dependable, dedicated, and equitable funding sources for the financial subsidies needed to fund these programs.
• Provide an incentive for every individual to obtain health coverage.
• Provide an incentive for employers who do not now offer health coverage to do so.
• Avoid significant disruption to the existing employer-based and individual health coverage markets.
• Directly support, strengthen, and expand the safety net of public and private health providers who now provide large amounts of uncompensated care.
• Maximize California ’s use of available federal Medicaid funding.
• Limit the aggregate cost of the overall program.
• Establish a data flow that can facilitate and support patient care for the newly insured.

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Universal Health Care Coverage and Health Care Reform

*JAMA. 2007;297:1073-1084: Insurance Coverage, Medical Care Use, and Short-term Health Changes Following an Unintentional Injury or the Onset of a Chronic Condition, Jack Hadley, PhD