Health care financing for all Americans

Article Abstract:

Almost 34 million Americans lack health insurance coverage, denying many access to needed medical care. The Health Insurance Association of America (HIAA), a trade association of over 300 private health insurance companies, has proposed a plan to extend health care to all Americans. There are four essential elements: reforms to ensure the availability of private insurance for small employers; more affordable coverage to small businesses; tax assistance targeted to small employers and their employees; and expansion of public coverage for the poor and near-poor. Two thirds of workers without health insurance are employed by companies with fewer than 25 workers; health insurance rates are too expensive for many of these companies. The rising cost of health care has made insuring these companies unprofitable, and small-employer market reforms are necessary. Four reforms are proposed for this market, based on a private reinsurance mechanism. First, state pools would be available for medically uninsurable individuals. Many current state laws prevent the development of a prototype plan to lower insurance costs. Second, more affordable insurance should be available to small-employer groups. Third, tax assistance to small employers and their employees would enable coverage of most workers. Fourth, expansion of public coverage of the poor and near poor would go far in reducing the number of uninsured individuals. At the same time, costs must be contained through the development of managed-care systems. Both private and public sector must cooperate for the system to work. (Consumer Summary produced by Reliance Medical Information, Inc.)

Reports, Health Insurance Association of America

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The first 30 years of Medicare and Medicaid

Article Abstract:

Trends in enrollment and spending for the government-sponsored health care programs Medicare and Medicaid are discussed. Medicare covers the elderly and certain disabled people. Medicaid covers low-income families, the aged, and the disabled. Enrollment in both programs, which are 30 years old, has increased greatly since they were launched. In 1995, the programs provided health coverage to one quarter of Americans. Medicaid covered 36 million, Medicare insured 38 million, and 5 million were covered by both programs. The programs spent $272 billion in 1993, which was 31% of total health care spending. Spending has increased rapidly because more people are enrolling in the programs. Medicare is funded by payroll tax paid jointly by employers and employees. Medicaid is paid for by federal and state governments. Poor families use a small share of total Medicaid spending, with the majority going to long-term care for the disabled and aged. Medicaid covers nursing home care for low-income aged, while Medicare pays for short-term nursing home costs.

Aged, Elderly, Statistics, Disabled persons, Medicaid, Insurance, Medicare

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Single-source financing systems: a solution for the United States?

Article Abstract:

Health care reform proposals follow two basic models. One is based on competition between multiple financing sources with associated cost containment measures. The other reflects the single-source financing of Canadian and European systems with their objective of providing universal health care access. The time required for our system to change depends on the vulnerability felt by the middle and upper-middle classes. Insurance industry organizations such as the Health Insurance Association of America are working to reduce the worst aspects of experience-rated underwriting, particularly for small businesses, which should delay demand for system changes. Single source funding can provide a stable funding base which allows planning and implementation on a state or local level, entitles all citizens to equal health care access and encourages prevention programs.

Evaluation, Health planning, Health care reform

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