Friday, Nov. 21, 2003 | 9:09 a.m.
IT HAS TAKEN 10 years, but universal health insurance and a way to make it work is back on the table.
I am sure most people either don't remember or are constantly trying to forget the efforts of President Bill Clinton and our then-first lady, Hillary Rodham Clinton, to fashion a health care program that would enable all Americans to know the benefits of health insurance.
I am just joking about that memory thing, it was the first big test of the Clinton presidency and it proved at least one thing, this country -- as much as the people cried out for health care coverage -- was not ready for the answer. At least one that put the government in the middle of the mix.
Fast forward 10 years and the problem has not gone away. If anything, the number of Americans who are without health insurance has increased dramatically as have the costs to deliver adequate care. If it was a problem in 1993 it is darn near an epidemic today with health care needs screaming out to be met and the dollars needed to fulfill that need all but non-existent.
Tuesday's New York Times carried an Op-Ed piece written by two men of very different backgrounds. Victor Fuchs is a professor emeritus of economics at Stanford University. He is the author of "Who Shall Live?"
His co-author is one of the three brilliant Emanuel brothers of Chicago. Ezekiel is an oncologist and bioethicist. He has written "No Margin, No Mission." His brothers are equally accomplished. Ari is a top Hollywood agent and brother Rahm is a first-term U.S. congressman from Chicago who, in another life, was one of the brains behind President Clinton's successful White House victories. More importantly, he is the father of three of my favorite children.
But back to the really smart brother and the article he helped write. I will most likely do a poor job sharing the gist of their work but I believe it is important enough to give it a try. After all, every American wants and needs the ability to get good medical care and most of us are even willing to pay for it. The how-to-do-it part has always been the stopper because too many oxen seem to get gored when the people's needs are considered first.
"The Universal Cure" starts with the premise that as much as health care costs have remained somewhat stable for the past few years, we are on the brink of a price catastrophe that will send health care costs soaring out of sight. The policy reaction has been to fiddle around the edges with plans that may reduce costs for some but increase them for others, with nothing being done to expand coverage to the tens of millions of Americans who remain naked in the face of medical disaster.
"What we need is a fair proposal that is simple, efficient and appealing to disparate constituencies. For more than a decade, as members of the medical and economics communities, we have advocated such an alternative: universal health care vouchers."
There, they said it. Vouchers. Vouchers which would be made available to every American who could use them to purchase a policy that would cover doctor visits, hospitalization, pharmacy needs, some mental and dental services and catastrophic coverage. If any person wanted more, it would be available for additional dollars.
The beauty of such a proposal is that individuals would be able to buy into existing plans or new ones that would be formed. Additionally, and this one is really important, a person's health care insurance would be his or her decision and not one made by an employer.
Medical choices would be real and very personal and the business community could get out of the role of making health care decisions for people it has no business making. Employment decisions could then be based on salaries and other benefits that would not include health insurance because the individuals would have done that for themselves.
From a political standpoint, the idea has merit because the Democrats will get what they have long desired -- universal health coverage -- and the Republicans will accept it because it will be paid for with their favorite word -- vouchers. Everybody wins.
And, who knows, if it works the way these guys think it will, there may come a time when programs like Medicare and Medicaid will simply go away as the voucher programs take their places.
For sure, there are many details that would need to be worked out, but just think, a health care system available to all Americans that includes personal choices of doctors and insurance plans that would most likely cost less than the $1.4 trillion we already spend on health care -- for which the taxpayers contribute $840 billion annually -- and which would no longer leave any child or adult behind the health care eight ball.
Near the beginning of their piece the authors use the following line, which I believe is a great place for me to end. It speaks volumes about the need for health care reform and the need to do it now. They write:
"In a morally responsible country, everyone should have health insurance."
You can argue that point, but in a morally responsible country you cannot win it!
archive
