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WASHINGTON -- To improve the economy and well-being of the nation, all Americans must be provided with health insurance, a prestigious panel of the Institute of Medicine said Wednesday.
The panel urged Congress and the president to develop a strategy to achieve universal coverage by 2010.
''There is no justifiable excuse for delay,'' says Mary Sue Coleman, co-chair of the institute's committee on the uninsured and president of the University of Michigan.
The report does not endorse a method of achieving broad health coverage. But it does outline several options, including tax credits to help people buy insurance, expanding Medicare to those younger than 65, requiring employers to offer coverage or mandating that individuals carry insurance. The most controversial option -- and one the institute says is most likely to achieve universal coverage -- is a government-funded national health program.
Achieving coverage by 2010 might prove difficult. Efforts to expand health coverage date to the early 1900s, but the broadest proposals have failed politically under both Republican and Democratic administrations. In recent years, small steps have been taken, such as opening government health programs to more children.
The institute says the time is right to debate broad reform, capitalizing on election year politics, unease about the growing number of uninsured and frustration by consumers and employers about rising health care costs.
''The benefits of universal coverage would enrich all Americans . . . in terms of improved health . . . greater economic productivity, financial security or the stabilization of communities' health care systems,'' concludes the institute's 205-page report.
The institute, part of the National Academy of Sciences, capped three years of work and five earlier reports on the uninsured with the call for immediate action.
The committee included academics, business leaders, insurers and health care providers. The report comes as the number of U.S. residents without health insurance rose at the fastest clip in a decade, hitting 43.6 million in 2002, the latest year statistics are available.
The political spotlight is also on the issue, with the Bush administration promoting tax credits to help the uninsured buy coverage, and each Democratic presidential candidate touting some form of health system reform. Joining the institute on Wednesday were former senator Bob Dole, a Republican, and former representative Paul Rogers, a Democrat, who backed its conclusions and urged a bipartisan solution.
Being uninsured means patients get less medical treatment, and about 18,000 a year die as a result, the institute says. It also costs health providers more than $35 billion a year for uncompensated care. Cutbacks resulting from such budget losses have also meant crowded emergency rooms as hospitals trim staff.
''There's a growing realization that it (universal coverage) isn't just a matter of taking care of the uninsured, but it's in the enlightened self-interest of everyone,'' says Arthur Kellermann, co-chair of the committee and chairman of the Department of Emergency Medicine at Emory University.
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