updated 1/14/2004 2:16:27 PM ET 2004-01-14T19:16:27

Calling the lack of health insurance deadly, costly and a cause of insecurity even among the insured, the Institute of Medicine for the first time is urging the United States to adopt universal coverage by 2010.

  1. Don't miss these Health stories
    1. Splash News
      More women opting for preventive mastectomy - but should they be?

      Rates of women who are opting for preventive mastectomies, such as Angeline Jolie, have increased by an estimated 50 percent in recent years, experts say. But many doctors are puzzled because the operation doesn't carry a 100 percent guarantee, it's major surgery -- and women have other options, from a once-a-day pill to careful monitoring.

    2. Larry Page's damaged vocal cords: Treatment comes with trade-offs
    3. Report questioning salt guidelines riles heart experts
    4. CDC: 2012 was deadliest year for West Nile in US
    5. What stresses moms most? Themselves, survey says

Ten years after Congress rejected President Clinton’s proposed overhaul of the health care system, the Institute said in a report released Wednesday that only major reform at the federal level will make universal coverage a reality.

“It is time for our nation to extend coverage to everyone,” said the report, the last of six studies over three years that explored aspects of the lack of health insurance.

Problem 'will only get worse'
It rejected incremental expansions of insurance coverage as inadequate. The problem “is not going away,” Mary Sue Coleman, president of the University of Michigan and head of the committee that prepared the report, said. “It will only get worse.”

The Census Bureau reported that 43.6 million people lacked health insurance at some point in 2002, up from 39.8 million in 2000.

In addition to covering everyone, health insurance should be continuous, affordable for individuals and families and sustainable for society, the study said.

The report, however, avoided the political thicket of endorsing a specific proposal or estimating how much universal coverage would cost, except to say it would be expensive. It noted instead three general approaches that it said could result in insurance for nearly every American:

  • Requiring employers to provide health insurance, with the government providing coverage for those not covered in the workplace.
  • Requiring individuals to obtain coverage and providing tax credits to help them pay for it.
  • Establishing a single-payer system administered by the federal government that would eliminate insurance premiums and enrollment qualifications but require increased taxes.

Bipartisan support required
Former Republican Sen. Bob Dole, who attended a news conference on the report, praised the goal of universal coverage, but said a partisan effort that was set on one approach would be doomed to failure.

“If properly framed, the lack of coverage ... can be one of the big, big issues in this election,” Dole said.

The study agreed that strong, bipartisan political support is necessary whichever option is selected. The Institute is an arm of the National Academy of Sciences, a private organization chartered by Congress to provide scientific advice to the government.

Health and Human Services Secretary Tommy Thompson said universal coverage by 2010 is “not realistic.”

In a meeting with reporters this week, Thompson said, “I just don’t think it’s in the cards. I don’t think that administratively or that legislatively it’s feasible.”

The Bush administration last year proposed spending up to $89 billion in health care tax credits to help those who do not have employer-based coverage, but the Republican-led Congress took no action.

Thompson said the president would have more to say about the uninsured in next week’s State of the Union address.

Among Democratic presidential candidates, Rep. Dennis Kucinich of Ohio, former Sen. Carol Moseley Braun of Illinois and Al Sharpton support a single-payer system to cover everyone. The other candidates are proposing more limited reforms, with Rep. Dick Gephardt of Missouri supporting a requirement for employers to provide health insurance coverage to workers.

Unnecessary deaths and illnesses
In previous reports, the institute has estimated that the lack of health insurance causes 18,000 unnecessary deaths in the United States and costs the nation $65 billion to $130 billion annually.

Layoffs and cutbacks in health benefits by employers have led even those with insurance to worry that they could lose it. Lack of adequate health insurance “creates insecurity for everyone, because losing that coverage tomorrow is so easy,” the report said.

The Census Bureau said a decline in workplace-based coverage was the main reason for the increase in uninsured between 2001 and 2002.

Dr. Arthur L. Kellermann of the Emory University School of Medicine in Atlanta, an author of the report, said that with rising costs, increasing numbers of uninsured and growing financial pressures on health care providers, “I believe we’re reaching the point where the system is unsustainable.”

The study also said that in the interim, federal and state governments should ensure that everyone eligible for low-income health insurance be covered. States have been restricting enrollment in Medicaid and State Children’s Health Insurance Programs to deal with budget deficits.

© 2012 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

Discuss:

Discussion comments

,

Most active discussions

  1. votes comments
  2. votes comments
  3. votes comments
  4. votes comments