The health care delivery system in the United States is unjust and inhumane. The costs are higher – 14 percent of the Gross Domestic Product, compared to the 6-10 percent of GDP of other industrialized nations where coverage is comprehensive and universal. Over 40 million people in the United States are uninsured and additional tens of millions more have inadequate health care coverage. Four million Medicare patients spent over $3,000 on drugs in 2001.
The “solution” of increasing market-driven health care through private, for-profit insurance companies in order to control costs and improve care has failed miserably. In fact, health care costs are skyrocketing at the same time that co-payments have increased and benefits have been scaled back. The events of Sept. 11, coupled with the recession, have put millions more at risk for loss of health coverage or decreased benefits. The situation will only get worse as the national economy continues to stagnate and billions are diverted for national defense and the military.
Elected officials at the state level must work together to lobby and pressure the federal government to take on the responsibility of providing publicly-funded, comprehensive, universal health coverage to all residents of the United States.
New York State has 3.2 million uninsured. Tens of thousands have lost coverage due to the combined impact of recession and the further economic devastation after Sept. 11. It is not just the economic health of our state that is failing. The environmental fallout from Sept. 11 has exacerbated public health risks that have been building up for years.
PRIORITIES FOR THE GOVERNOR
The health care crisis in our state must be one of the first issues addressed by the incoming governor. The governor should call on the state legislature to immediately commission a study to explore a statewide universal health coverage plan, as has been done in the California’s Health Care Options Project, where nine competing options were put forward in the state-commissioned study. The respected independent Lewin group reviewed all nine California options and found that only the single-payer plans offered truly universal health care coverage, and that the single-payer plans were far less expensive than those that proposed continuing to give private insurers a major role in health care. (For more information about HCOP, go to www.healthcareoptions.ca.gov.)
The incoming governor should organize public hearings and forums throughout the state to elicit feedback from residents about their ideas and concerns. These forums will also serve to include as many constituencies as possible in shaping the new state plan, and will help to debunk the myth that universal coverage will cost too much or limit choice.
Important efforts towards developing statewide universal coverage have been initiated in Vermont, Maine, Massachusetts, Oregon, California and Washington. The costs of universal coverage on a state level would mirror that of a national single-payer program, in that overall health care spending would remain at or below the current levels by utilizing substantial administrative savings to expand coverage to the uninsured. For example, in the Vermont single-payer plan, health care costs would decrease by 1 percent in the first year. Into the fifth year of the plan, costs would be reduced by 11 percent, with all residents receiving comprehensive coverage.
Although the expansion of piecemeal programs such as Child Health Plus and Family Health Plus has provided additional coverage, they do not cast a wide enough safety net. Moreover, means-tested programs stigmatize the poor and often lead to disparities in access and quality. The only way to ensure that segments of the population that usually fall between the cracks – such as immigrants and the self-employed – are adequately covered is to provide care to everyone, regardless of financial status, pre-existing conditions or employment status.
On the national level, the incoming governor should endorse the Health Care Access Resolution (House Concurrent Resolution 99) introduced by Rep John Conyers (D-Mich.), chair of the Congressional Universal Health Care Task Force, as a first step toward galvanizing broad support and re-igniting the national debate on the health care crisis. This resolution directs Congress to enact legislation by October 2004 that provides access to comprehensive health care for all Americans.
Later this year Rep Conyers is expected to introduce a bill in Congress explicitly proposing a publicly financed and publicly administered single-payer health care system for the United States. The new governor should actively support this bill.
In order to achieve a stable universal health care system in the United States we will need a national program. Meanwhile, however, political support for such a program will in part grow out of successful state initiatives. New York State must be a leader in this fight.
The deteriorating public health system in New York State must be included in health care reform. Recent public health emergencies – such as the anthrax attacks, environmental and occupational health issues following the World Trade Center collapse, and the West Nile outbreak – have demonstrated the importance of a well-funded, well-organized public health infrastructure.
The rise in infant mortality rates, chronic illnesses and communicable diseases is a clear indictment of the fact that the government has starved public health services; as a result, the lives of millions have been endangered. We need to protect and expand the social safety net for our most vulnerable residents. We must not let the focus on domestic security and zero tolerance policies divert attention and resources away from improving the quality of life for the people of New York.
New York needs a publicly funded, publicly administered health insurance program with no co-pays and deductibles that covers everyone residing in the state.
The New York Chapter of Physicians for a National Health Program issued this statement in August. See their web site, www.pnhp.org, for more information on this issue.