The reform movement gains more credibility
San Francisco Chronicle
April 27, 2003
The long road to a national health plan
By Kevin Grumbach and Philip R. Lee **
Most experts concede that the simplest way to guarantee coverage for all Americans is to make every resident automatically eligible for coverage under a single public plan, avoiding the chaos and transience of eligibility linked to specific employers or degrading and cumbersome "means testing" of family income. Single-payer systems also have appealing economic virtues, operating with far lower administrative overhead costs than private insurance and exercising greater care to rein in health care inflation.
California recently contracted with the Lewin Group, a private independent consulting firm, to analyze 10 alternative proposals to increase coverage. The firm concluded that pay-or-play models, which require employers to finance coverage, would increase state health care costs by $2 billion, while a single- payer plan could reduce overall costs by $7 billion -- and provide comprehensive coverage to all Californians.
The single-payer plan would also trim $18 billion in unnecessary administrative costs and excessive prices for prescription drugs and medical supplies -- more than enough to afford universal coverage.
But policy logic has never been sufficient to ensure political victory for single-payer proposals. Big Government and Big Taxes are not attractive brand labels in the current emporium of electable ideas.
The need for a universal health care program and health security for all Americans is rightfully returning to the forefront of policy debate.
A recent issue of the American Journal of Public Health proposed several benchmarks for judging reform proposals: universal and equitable coverage, comprehensive benefits and quality health care, affordable and equitable financing, simplified administration and sensibly organized work, accountability and a strong public health system.
The hard work ahead is to create the political change that can implement a universal health care plan that would achieve these goals.
**Dr. Kevin Grumbach is a professor of family and community medicine at UCSF and a founding member of the California Physicians Alliance. He practices family medicine at San Francisco General Hospital. Dr. Philip R. Lee, who served as assistant secretary of health in the Johnson and Clinton administrations, is the former chancellor of UCSF and was founding director of UCSF's Institute for Health Policy Studies, where he is a senior scholar.
http://www.sfgate.com/cgi-bin/article.cgi?file=/chronicle/archive/2003/04/27 /IN105921.DTL
Comment: There is no more credible source on health policy than Dr. Grumbach and Dr. Lee. It is time for us to end the political stalemate that has allowed the perpetuation of profound health care injustices. Let's now turn to leaders like Dr. Grumbach and Dr. Lee and get on with the very serious business of truly reforming our health care system.