Institute of Medicine Report Calls for U.S. Universal Health Coverage System by 2010

The Institute of Medicine on Wednesday issued a report in which the agency for the first time formally recommended that by 2010 the United States implement a universal health insurance system to "prevent more unnecessary suffering, death and economic costs to society," the Washington Post reports (Stein, Washington Post, 1/15). The IOM based the report, titled "Insuring America's Health: Principles and Recommendations," on three years of research and five previous reports on the cost of health insurance (Kemper, Los Angeles Times, 1/15). A committee of academics, business leaders, health insurers and health care providers drafted the 205-page report (Appleby, USA Today, 1/15). The report concluded that the large number of uninsured U.S. residents -- about 43.6 million, or 15.2% of the population -- "results in unnecessary sickness and death, weakens the nation's economy and undermines the entire health care system," the Times reports (Los Angeles Times, 1/15). According to the 16-member committee, "The lack of health insurance for tens of millions of Americans has serious negative consequences and economic costs not only for the uninsured themselves but also for their families, the communities they live in and the whole country," adding, "The situation is dire and expected to worsen." The five previous IOM reports found that:

Uninsured residents receive about 50% less medical care as those with health insurance, a trend that "tends to leave them sicker and likely to die younger," the Post reports.
About 18,000 residents die each year because they lack health insurance.
The risk of financial catastrophe for families is increased when one member lacks health insurance because of the potential cost of treatment for illnesses and injuries.
The nation loses $65 billion to $130 billion each year because of the poor health and premature deaths of uninsured residents.

Mary Sue Coleman, president of the University of Michigan and co-chair of the committee, said that the new report should serve as the "tipping point for creating the national momentum necessary to finally accomplish this elusive goal," the Post reports. "There have been times in our history when we have galvanized ourselves to action. This may be one of those points in history," Coleman said (Washington Post, 1/15).

Report Recommendations

The report did not endorse a specific proposal for a universal health insurance system but said that incremental coverage expansions implemented to date "haven't put much of a dent in the problems of the uninsured," the Wall Street Journal reports (Lueck, Wall Street Journal, 1/15). The report concluded that "small steps are inadequate" to address the issue (Los Angeles Times, 1/15). The report also attributed the lack of progress on the development of a universal health insurance system to "a dearth of strong political leadership and opposition to particular ideas from health care providers and business interests," according to the Journal (Wall Street Journal, 1/15). The report recommended that federal officials, politicians and policy makers implement a health insurance system that is:

Universal;
Continuous, to allow workers who change jobs to retain coverage;
Affordable to individuals and families;
Affordable and sustainable to society;
Effective, "efficient, safe, timely, patient-centered and equitable" (Washington Post, 1/15).

The report also evaluated four generic proposals to expand health insurance, such as: a single-payer system in which the federal government would provide coverage under one standard health plan; a program that would expand Medicare and Medicaid and provide tax credits to help individuals cover health insurance costs; a proposal that would require employers to provide coverage or pay into a government program; and a proposal that would provide tax credits to help individuals cover health insurance costs and would require individuals and families to purchase health coverage. The report concluded that the single-payer system was the only proposal likely to lead to universal health coverage, although such a system would cost more than the other proposals.

Reaction

HHS Secretary Tommy Thompson said that a universal health insurance system is "not realistic," adding, "I don't think, administratively or legislatively, it's feasible" (Los Angeles Times, 1/15). White House spokesperson Trent Duffy said, "The president is working toward making health care affordable and accessible to as many Americans who desire to have it through ... a host of measures, without creating a government-run health care system that rations and may ultimately be counterproductive to the high quality of care that Americans enjoy today" (Washington Post, 1/15). Senate Majority Leader Bill Frist (R-Tenn.) said, "I am concerned that the report may not focus enough on the reasons why health care costs continue to rise and how to pay for any reform." However, Senate Minority Leader Tom Daschle (D-S.D.) called a universal health insurance system "doable," adding, "This is, I believe, the single most important domestic issue facing our country" (Pear, New York Times, 1/15). The report "made it clear that the cost of continued inaction is unacceptable," Sen. Edward Kennedy (D-Mass.) said. Stuart Butler of the Heritage Foundation said that the report was "pretty much on the mark" but raised some concerns about the cost of a universal health insurance system. Ron Pollack of Families USA said that he hoped the report would "catapult this issue to the top of the agenda" (Washington Post, 1/15). MPR's "Marketplace Morning Report" on Wednesday reported on the IOM report. The segment includes comments from Henry Aaron, a senior fellow for economic studies at the Brookings Institution (Wicai, "Marketplace Morning Report," NPR, 1/14). The complete segment is available online in RealPlayer.

United States Needs Universal Health Care System 'Now,' Opinion Piece States

The health care system in the United States "is clearly broken," San Francisco Chronicle columnist David Lazarus writes in an opinion piece. According to Lazarus, "[c]ompanies are being strangled by runaway medical expenses," and "employees and other members of the public are increasingly struggling to obtain adequate care at reasonable prices." Lazarus writes that the "United States needs a universal health care system, and it needs it now" (Lazarus, San Francisco Chronicle, 1/14).

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