Unanimity on Universal Health Coverage?

Remember Harry and Louise? In ads sponsored by the Health Insurance Association of America in 1993, the couple helped turn the public against the healthcare reform plan proposed by President Clinton.

Now, Harry and Louise are back. But this time, they're singing a new tune. And it's a refrain loudly echoed by 47 million uninsured Americans.1 Sponsored by a variety of groups, the new ad calls strongly for universal health coverage.2

But where does the health insurance industry stand this time? You might be a little surprised. As early as 2002, Blue Shield of California proposed that universal coverage come through both public program expansions and mandates on individuals and employers. Recent state health reform efforts have also shown that health plans can be a big ally. For example, in 2006, Blue Cross Blue Shield of Massachusetts Foundation's "Roadmap to Coverage" helped create a framework for reform in that state. And in California, several of the state's largest health plans joined hands in an attempt to achieve universal coverage last year. These health plans were open to major compromises, such as a requirement that plans issue and price coverage without regard to an applicant's health status.3

In 2007, America's Health Insurance Plans (AHIP, the successor organization to HIAA) was among 16 business, medical, and consumer groups calling for Congress to extend health coverage to the nation's uninsured children and adults.4 These groups may still not agree on exactly how to achieve universal coverage. But most do agree on this: The time has come for sweeping health care reform.

Why the change of heart? In short, the cost of doing nothing outweighs the cost of doing something. Consider that in 2007, two out of three U.S. adults or about 116 million people found themselves in one or more of these situations: They were underinsured or uninsured for a time; they went without needed care due to costs; or, they struggled to pay their medical bills.5 In fact, nearly 9 million have lost their health insurance since 2000.5 The U.S. spends more than twice as much per person on health care as other nations. Still, it ranks dead last in access to care when compared with five other industrialized nations.6

It's clear that the U.S. health care system can't sustain trends like these.

With a new President in office, many people wonder whether universal coverage could be coming soon. It might help if President-elect Barack Obama takes a cue from the approach of many state-sponsored proposals. Promoting shared responsibility, shared risk, and shared expertise among the key players, for example, may be a step in the right direction. And, if viewed as potential allies, not adversaries, health insurance plans will likely bring many solutions to Harry and Louise's table.

Sources:

1 The Henry J. Kaiser Family Foundation website. The Kaiser Commission on Medicaid and the Uninsured. "Five Basic Facts on the Uninsured." Found at http://www.kff.org/uninsured/7806.cfm
2 http://harryandlouisereturn.com
3 Bodaken, BG. "Where Does The Insurance Industry Stand On Health Reform Today?" Health Affairs. Vol. 27, No. 3.
4 http://www.AHIPBelieves.com
5 Commonwealth Fund website. "Losing Ground: How the Loss of Adequate Health Insurance Is Burdening Working Families." Found at: http://www.commonwealthfund.org/publications/publications_show.htm?doc_id=700872
6 Commonwealth Fund website. "New Update of International Health System Comparisons." Found at: http://www.commonwealthfund.org/newsroom/newsroom_show.htm?doc_id=482616