Quest for coverage: Insuring the uninsured

The destination is agreed upon -- health care for all Americans -- but the road is jammed by differences of opinion on how to get there.

By Joel B. Finkelstein, AMNews staff. April 7, 2003.

Universal health care, single payer, coverage for all. No matter what you call it, America seems to be moving toward wholesale reforms that promise to change the face of how physicians deliver care.

The medical community, politicians and academics agree that current health care trends are unsustainable.

The United States spends more on health care per capita than any other developed nation, yet more than 41.2 million people were uninsured in 2001. A growing number of Americans lack reliable access to physicians and medical services. Increases in health insurance premiums were in the double digits again last year, making it more difficult for employers and workers to continue paying for coverage. States are staggering under massive Medicaid budgets. And Medicare costs are expected to explode with the aging of the population.

"The basic concern is that the patchwork [of health coverage] is just not working," said Jay H. Glasser, PhD, president of the American Public Health Assn. The situation is only going to get worse, he added.

In the past couple of years, recognition of these problems and the ultimate collapse of the current system they are expected to precipitate has generated an increase in reform proposals from all sides of the debate.

While the Bush administration and industry groups believe they can save the system by placing a heavier reliance on private health plans, proponents of more radical changes that would do away with market competition altogether also have gained a voice on Capitol Hill.