Government Panel Advocates Basic Universal Health Care

In an interim report released in June, a committee set up by Congress to gauge public opinion on the current health care system and formulate a plan for achieving reform advocated providing basic universal health care coverage for all Americans by 2012.

Created by the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 and appointed by the U.S. Comptroller General, the Citizens’ Health Care Working Group is made up of 14 members chosen to represent diverse perspectives, including those of consumers, business, labor, health care providers, and the disabled. In addition to hearing the testimonies of health care experts and public officials, the panel collected extensive input from the public through community hearings, surveys, and individual commentaries on health care matters.

The group will present its final recommendations to the president and Congress following a 90-day public comment period ending August 31. The president will then submit a report on the recommendations to Congress within 45 days of receiving them, and five congressional committees will hold hearings on the findings.

The panel asked members of the public for their opinions on what health benefits should be provided, how health care should be delivered, how coverage should be financed, and what trade-offs in benefits or financing would be justifiable to ensure access to affordable, high-quality health care coverage and services.

"A picture has been sketched for us of a health care system that is unintelligible to most people," panel members said in the report."They 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."

The group recommended that Americans be provided with access to a set of affordable and appropriate core health services by 2012, with financial assistance given to those who need it. Across every venue, the report said, the panel heard a common message: "Americans should have a health care system where everyone participates, regardless of their financial resources or health status, with benefits that are sufficiently comprehensive to provide access to appropriate, high-quality care without endangering individual or family financial security."

In their report, the group acknowledged that new dedicated revenue streams would likely be needed to support these comprehensive health care initiatives, which may include enrollee contributions, income taxes, business or payroll taxes, or value-added taxes. At the same time, panel members emphasized the need for broad strategies to improve quality of care and efficiency.

To ensure that no one is impoverished by health care costs, the panel recommended the establishment of a national program, private or public, that would offer financial protection for all Americans. The program would provide universal coverage, protection against very high out-of-pocket medical costs, and additional assistance for low income individuals and families.

The group also called for the creation of a "core" package of physical, mental, and dental health benefits that would be established using a fair, independent, transparent, and scientific process. In addition, the group advocated the development of integrated community networks of health care providers aimed at providing care to vulnerable populations, and a restructuring of the financing and provision of end-of-life services, to better accommodate the individual wishes of the terminally ill.

"We recognize that the issues involved are complex and challenging, and that it will take time and a great deal of technical expertise, as well as political will, to make the changes we think are necessary," panel members said in the report.

Over the 90-day comment period, the members added, "we will continue to actively pursue public input as we deliberate and further refine these proposals. During this process, we will provide greater detail and explanation of our recommendations, as well as further analysis of what we are hearing from the American people, before issuing the final recommendations to the Congress and the President."