Ensuring coverage: Approach needs a second look

Post-attack unemployment is virtually certain to equal more uninsured Americans. Will lawmakers now be willing to hear about how to fix the system for good times and bad?

Editorial. Nov. 5, 2001.

The shock wave from the Sept. 11 attack on America has rocked the nation's economy, costing many thousands of Americans their jobs. In all likelihood it also will significantly increase the number of uninsured, because most Americans have employer-based health coverage.

Only recently, the U.S. Census Bureau reported a slight drop in the number of Americans without health insurance -- 38.7 million in 2000, down 600,000 from the year before. But unemployment was already on the rise before the Sept. 11 attack as the stock market and overall economy slipped. Many more layoffs followed the attack, and there doesn't appear to be an end in sight. New joblessness claims recently hit their highest mark in nine years.

The boom years took the pressure off finding solutions to the problem, even as the number of Americans without health coverage remained unconscionably high in the tens of millions. These recent job cuts underscore the vulnerability inherent in the current system. What's always been with us are the problems the system also creates for the self-employed and for those whose employers won't offer coverage.

It is time for policymakers to look again at an approach supported by the AMA and others. It would provide for refundable tax credits -- tax deductions, alone, are not enough -- to allow workers to purchase health care coverage for themselves and their families that best meets their personal needs, not a plan picked for the convenience of an employer. Coverage would also be portable, so that a worker could stay with the health plan, even if forced to change jobs. Details of the AMA proposal can be found on the Web site (http://www.ama-assn.org/ama/pub/category/3373.html). [...]