All children, or everyone?
Next Steps For Tennessee: A Conversation With Gov. Phil Bredesen
By Alan Weil
Health Affairs
May 22, 2007
Gov. Bredeson: One major frustration for me… was people who were working on their own, or for some company that didn’t offer insurance, and were getting their insurance from TennCare but were perfectly capable of working someplace that does offer health insurance. This world is full of people who make choices about where they’re working based on things like availability of pension plans and health insurance. I don’t see why people in Tennessee should be immune from those same choices.
I believe that children ought to have really broad access to care. There shouldn’t ever be any limitations on their getting care because of the unwillingness of a parent to pay a copay or something like that. When you get to adults, I don’t feel nearly so strongly. This is a free country, and adults make decisions about what’s important to them.
http://content.healthaffairs.org/cgi/content/abstract/hlthaff.26.4.w456
And…
Letters
The New York Times
May 22, 2007
The difference between universal coverage and universal health care is not semantic; it is real and fundamental. If we truly want all children to get the health care they need, then we must simply give all children the health care they need, not require parents to repeatedly prove that their children are worthy of publicly financed services.
When a child needs health care, he must be presumed eligible, not the opposite. That’s how every other civilized country in the world does it, and they do it for a fraction of the cost we spend per capita in the United States.
Georganne Chapin
President and Chief Executive, Hudson Health Plan
http://www.nytimes.com/2007/05/22/opinion/l22herbert.html
Comment:
By Don McCanne, MD
The SCHIP enrollment lessons are quite clear. If we really do want to have all children insured, enrollment must be completely automatic for every child. That will never happen with a fragmented system of multiple public and private plans with varying thresholds of eligibility and changes in eligibility status.
And adults? Is it rational public policy that we continue to protect the right of a person to choose a job that does not provide health insurance, as if that is the price of freedom? Or would it be more rational to automatically enroll every adult in a universal health insurance program regardless of employment status?
We can also learn from the various current state efforts at reform. These universal programs would cover everyone, except for those who do not meet eligibility requirements, or do not have the required funds, or who are lost in the administrative maze of public and private plans. Wait. That’s not reform. That’s what we have now.