Expanding Medicare and employer plans to achieve universal health insurance

Article Abstract:

The most viable components of the health financing system in the United States are Medicare and employer-provided insurance. Both are popular and efficient. Medicaid is not only a major program for financing health care for the poor, it is the only significant source of financing for long-term care. The program has numerous faults, including substandard provider payment rates, and bureaucratic complexity that prevents many eligible people from receiving benefits. The least satisfactory sources of insurance coverage are individual and small group plans, which are neither efficient nor equitable. Strengthening the best parts of the current system and remedying its faults is the best way to make changes quickly. First, employers would be required to provide basic health insurance coverage to all full- and part-time employees and dependents, or contribute to coverage under Medicare. Medicare benefits would be expanded to include prenatal care and health care for children. States would have the option of paying for Medicaid beneficiaries and other poor, but would share the cost with the federal government. The states could elect to supplement Medicare with coverage of prescription drugs, dental care, and other services. Reform of long-term care is important, but should be addressed separately. All remaining uninsured would be covered under Medicaid, and assessed a tax equal to 2 percent of their income. Financing would be accomplished through two new trust funds, and other changes would be required in the current financing structure. Provider payments would be modified to restore equality for those physicians with a large caseload of poor patients. Hospitals would be paid a flat rate, and would not be allowed to charge patients above the allowed rate. The annual cost to the federal government would be approximately $25 billion. (Consumer Summary produced by Reliance Medical Information, Inc.)

Planning, Employee benefits, Medicare, National health insurance

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Extending health maintenance organization insurance to the uninsured: a controlled measure of health care utilization

Article Abstract:

Enrolling uninsured people into managed care plans may not increase costs substantially. Researchers analyzed various measures of health care utilization in 346 previously uninsured people who were enrolled into an HMO and 382 people already enrolled in one. There was no significant difference between the two groups in terms of number of hospital admissions, number of days in the hospital or the use of outpatient services. However, the odds of visiting a physician was 30% higher in the previously uninsured group. This was mostly due to their perception that they had health problems.

Economic aspects, Medical care, Medical care utilization, Health maintenance organizations

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Incremental coverage of the uninsured

Article Abstract:

Health insurance could be offered to the uninsured by expanding on programs that already provide services to the poor and elderly. Medicaid could be expanded to cover more children in families under the federal poverty level. Parents of children receiving Medicaid could also be covered. Medicare could also be expanded to provide benefits to older people between 55 and 64 as well as the family members of Medicare beneficiaries who are not covered by another plan. These expansions could be funded by savings in other programs and increased taxes on tobacco.

Editorial, Finance, Health insurance

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