Advisory group recommends universal coverage

Americans would be willing to pay extra to expand access to health care, finds a panel directed by Congress to look for answers.

By Elaine Monaghan, amednews staff. June 26, 2006.

Washington -- A group charged by Congress with assessing Americans' views on how to fix the health care system concluded that most people find it "unintelligible" and recommended universal coverage by 2012.

"While most Americans are generally satisfied with their health care, too many Americans are being let down by their health care institutions," the Citizens' Health Care Working Group wrote in its interim recommendations, issued this month. "Many people are afraid of the health care system, they are bewildered by its complexity and are suspicious about who it aims to serve."

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The panel, appointed in February 2005 by the U.S. comptroller general, will present its findings to Congress and President Bush after a 90-day period of public debate.

The 14-member body includes physicians, nurses, hospital officials, economists and other experts. It based its interim report on six hearings with experts, 31 meetings and other events in more than 50 communities, all major health care opinion surveys conducted since 2002, more than 10,000 responses to its own Internet polls and nearly 5,000 commentaries submitted by the public.

"[Consumers] see a rigid system with a set of ingrained operating procedures that long ago became disconnected from the mission of providing people with humane, respectful and technically excellent health care," wrote the group, whose formation was mandated by the Medicare Prescription Drug, Improvement and Modernization Act of 2003.

The effort is supported by a bipartisan group of lawmakers and myriad health care, consumer, business, labor and medical groups, including the American Academy of Family Physicians, American College of Physicians and American Medical Student Assn.

The law required that a national discussion focus on what benefits and services should be provided, how Americans want care delivered, how it should be financed, and what trade-offs people are willing to make to ensure affordable, high-quality coverage.

"The opinion polls we examined, the community meetings we held, and the Web-based surveys and comments we received all showed large majorities of people willing to make additional financial investments in the service of expanding the protection against the costs of illness and the expansion of access to quality care," the group wrote.

The panel recommended that:

It should be public policy that all Americans have affordable health care. The report referred to taxes on income, business, sales, tobacco and alcohol as possible revenue sources.
A "core" benefit package should be defined, covering physical, mental and dental health. The panel wants an independent, nonpartisan, private-public group to identify and update recommendations for what would be covered, using scientific and transparent methods. Core services would encompass wellness, preventive services, primary and acute care, prescription drugs, education and treatment, and management of health problems.
A national program, private or public, should shield all Americans against high out-of-pocket costs and provide financial protection for low-income people.
The federal government should lead a national effort to develop and expand integrated public-private community networks of health care institutions and professionals that would provide high-quality care to vulnerable populations.
Quality of care and efficiency should be encouraged by using federally funded programs such as Medicare and Medicaid to promote integrated systems, information technology and electronic record systems, fraud and waste reduction, and consumer-friendly data on pricing.
The way end-of-life services are financed and provided should be restructured to increase access for people with incurable conditions to services in the setting they choose.

The AMA has its own plan to increase coverage through tax credits and insurance market reforms. The Association is considering expanding this policy to make buying insurance a personal responsibility.

Within 120 days of the Sept. 1 end of the comment period on the citizens' group report, the panel must submit final recommendations to Congress and the president. Bush then has 45 days to submit his own report to lawmakers, who then must hold hearings on the subject.