Nonpartisan Coalition Releases Report Calling for Universal Health System

The National Coalition on Health Care, a nonpartisan alliance of employers, unions, insurers, consumers, political leaders and health care providers, on Tuesday issued a report calling for "a sweeping overhaul" of the U.S. health care system, the Wall Street Journal reports (Lueck, Wall Street Journal, 7/21). The report recommends:

• Implementing health care coverage for all U.S. residents within two or three years after enacting such legislation;
  


• Establishing a congressionally chartered, independent board that would seek to stop the acceleration in health spending;
  


• Devising a second congressionally chartered board to develop and refine national medical practice guidelines with the best available scientific data, which could be used to establish best practices in medical malpractice lawsuits;
  


• Launching a systemwide effort to decrease medical errors and improve quality by linking payments to quantifiable measures of quality; and
  


• Developing a technology infrastructure, which would include protocols for electronic patient records and electronic prescription ordering, billing and patient privacy (VandeWater, St. Louis Post-Dispatch, 7/21).

The coalition's report does not promote any specific approach to reorganizing the system, according to the AP/Las Vegas Sun. For instance, it lists options for universal health coverage such as a single-payer system, employer mandates and expanded public health insurance programs (Sherman, AP/Las Vegas Sun, 7/20). Coalition leaders did not offer cost estimates for their proposals (MacDonald, Hartford Courant, 7/21). The report, called "Building a Better Health Care System," says, "America is already a nation of health care haves and have-nots. Reform should aim to assure that all Americans receive excellent health care and are able to enjoy the quality of life ... for which such care is essential" (St. Louis Post-Dispatch, 7/21). The report also says, "The escalation of health care costs is not only a health care issue. It is also a major national economic problem." The board recommended by the report would set limits on payments to providers for a set package of medical benefits and would restrict increases in insurance premiums, according to the Journal (Wall Street Journal, 7/21).

According to the Post-Dispatch, the "broad concepts in the report got widespread agreement among [the coalition's] diverse membership base." Eighty-seven of the group's members, including the AFL-CIO, Pfizer, AT&T, the California Employees' Retirement System and the Presbyterian Church USA, support the group's recommendations, while General Electric, UnitedHealth Group and Kaiser Permanente are listed on the coalition's Web site as some of the half-dozen other organizations that did not sponsor the report. Coalition Executive Director Patricia Schoeni said in an interview that the group's membership has doubled in the past two years to over more than 90 members, adding, "Organizations have come to realize they can't handle this issue by themselves." Schoeni said GE did not participate in the drafting of the proposals because it recently joined the coalition, and UnitedHealth and Kaiser Permanente were concerned that the employers would not support the recommended coverage mandates (St. Louis Post-Dispatch, 7/21).

According to the Journal, the report is "unlikely to result in any changes anytime soon" because Congress has "little appetite ... to take on a task so enormous and controversial" (Wall Street Journal, 7/21). However, former Rep. Paul Rogers (D-Fla.), the coalition's co-chair, said the recommendations are a "balanced set of specifications" that could garner support because leaders from both parties support changes to the health system. Former Iowa Gov. Robert Ray (R), also a coalition co-chair, added, "For reform to happen, all of us will have to give a little." Senate Finance Committee Chair Chuck Grassley (R-Iowa) said that health care reform cannot be a "one-size-fits-all" solution, adding, "As Congress works to address this issue, it is helpful to have recommendations from groups such as the national coalition" (Hartford Courant, 7/21).

The report's recommendations are "far more aggressive" than the health care proposals supported by President Bush and presumptive Democratic presidential nominee Sen. John Kerry (Mass.), according to the Journal. Henry Simmons, president of the coalition, said, "We don't see anything in the national debate now that's big enough ... to address the problem" (Wall Street Journal, 7/21). Bush has proposed a plan that would cost about $90.5 billion over 10 years and would extend health coverage to an estimated 2.1 million U.S. residents. Kerry has proposed a plan that would cost $653 billion over 10 years and would expand health coverage to an estimated 26.7 million residents. Kerry has said that he would help finance the plan with the repeal of tax cuts for families whose annual incomes exceed $200,000 (California Healthline, 7/19). The report is available online. Note: You must have Adobe Acrobat Reader to view the report.