In a panel aimed at addressing issues surrounding the accessibility of health insurance to Americans Monday night, three professionals proposed a wide range of answers to the growing concern.
The panel was comprised of Dr. Steffie Woolhandler, associate professor of medicine at Harvard Medical School, Dr. Daniel Johnson, a clinical professor of radiology and former president of the American Medical Association, and Rep. David Price, D.-Dist. 4. The panelists answered in short individual presentations.
“There are some things on which we have agreement—we want quality health care that’s affordable,” Johnson said. “A big problem is that the patient is insulated from the cost because somebody else is paying for it.”
Johnson’s presentation focused on the benefits of a system that allows for “expanded choices, individual selection and ownership with the right to change [plans]” as opposed to a “one-size-fits-all” health system.
“There are a variety of ways to implement health care, each with advantages and disadvantages,” Johnson said. “That’s what markets do best—they put all the imperfect elements together and make thinks work.”
Woolhandler disagreed and argued that the key to providing more favorable health insurance coverage is to increase public accountability rather than to increase the level of privatization.
Her group, Physicians for a National Health Program, is united around the concept of a single-payer system, in which the government finances health care but keeps its delivery in private control.
“Canada’s low health care costs are the result of much lower administrative costs,” Woolhandler said. “Clinical costs are the same, but when you add on the overhead costs—the paper-work costs—that’s where the difference comes from.”
Woolhandler’s presentation advocated a program of National Health Insurance “that’s universal [and] comprehensive—one that operates with the efficiency of the Canadian system but with slightly higher American costs.”
Price, in an effort to “lend a practical focus” to the panel’s ideas, spoke about the political forces in place that prevent certain change.
“It wasn’t hard for insurance companies in the 1990s to strategically reverse moves towards a market [based] health care system made under the Clinton administration,” Price said.
Price also stressed that reform efforts, including many tax initiatives, were not intended to serve as permanent remedies to health care issues.
Programs such as tax initiatives aimed at making health care more affordable, Price warned, may have simply been implemented at the wrong time and should not be dismissed simply because of past failures.
Price added that programs such as the Child Health Insurance Program—a federal program providing health care to families that don’t qualify for health care and can’t afford health insurance—demonstrate such efforts can be successful.
“The mantra now is that it’s got to be incremental change,” Price said, adding that non-federal programs aimed at changing health insurance could be equally effective.
Dr. Victor Dzau, chancellor for health affairs and president and CEO of Duke University Health System, helped chair the meeting.
He said the mechanism decreasing “access” to healthcare was a domino effect that ended with employers withdrawing insurance due to the high cost of providing coverage options.
“It’s a multitude of forces that got us to the point where every year more and more people are uninsured,” Dzau said.
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