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National Academy Calls for Universal Health Insurance

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WASHINGTON _ The Institute of Medicine called Wednesday for universal health insurance in the United States, warning that 43 million uninsured Americans represent a threat to the health care of everyone.

The branch of the prestigious National Academies, in the last of six reports on health insurance in America, said the country should have a goal of extending coverage to all its citizens by 2010.

"I really do believe we are reaching the point where this situation is unsustainable," said Arthur Kellermann, professor of emergency medicine at Emory University in Atlanta and co-chair of the institute's Committee on the Consequences of Uninsurance.

The recommendation, unveiled on the day that President Bush proposed building a space station on the moon and sending humans to Mars, was not embraced by his administration.

"I just don't think it's in the cards," Health and Human Services Secretary Tommy Thompson told reporters. "I don't think that administratively or legislatively it's feasible."

The institute did not estimate what universal coverage would cost, and it did not advocate a specific universal health plan. Instead, it offered a "checklist" of five principles for assessing proposals.

It said universal health insurance should be universal, continuous, affordable, sustainable and should promote access to high-quality health care.

In the report and in a news conference unveiling it, the committee emphasized that every American, insured and uninsured, has a stake in the issue.

It said lack of health insurance leads to 18,000 unnecessary deaths each year and causes uninsured children to have less medical care than their insured classmates.

The high level of "uninsurance" can adversely affect the overall health status of a community and the financial stability of health care institutions and providers, the report stated.

"Right now we don't have enough hospital beds in metropolitan Atlanta to meet needs of the community," Kellermann said. He said hospitals all over the country "have had to take the airlines' approach: fill every seat."

A principal reason for financial problems leading to this situation, he said, is lack of reimbursement for care provided to persons without insurance.

"These are shared interest issues. This is not just a matter of charity," said Kellermann. "This is a matter of public interest. We need to solve the problem."

He said that when a small clinic that is financially stressed by unreimbursed care closes "in northern Maine or eastern Oregon or south Georgia, where there are a lot of farmers who don't have insurance, the entire community suffers."

At the news conference, committee members were asked why, if the country could send the Rover robotic explorer to Mars, it couldn't see that all its people did not have health insurance.

"Well, Rover didn't have to go through Congress to get there," quipped former Sen. Bob Dole, R-Kan., who appeared with former Rep. Paul Rogers, D-Fla., to endorse the report.

Dole warned against one-track proposals in which "it's either my way or the status quo." He said a bipartisan effort would be necessary for the proposal to survive.

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