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Talk of Universal Health Care Grows
Massachusetts' law last year _ guaranteeing universal coverage _ jump-started the action in state capitols.
In the last month, governors, legislative leaders and blue-ribbon commissions have declared universal coverage an attainable goal in Iowa, Kansas, Minnesota, New Mexico, Oregon, Washington state and Wisconsin. Massachusetts and Vermont are to put their programs into effect this year, while Maine is tweaking its existing system. Many more are considering significant expansions.
REPORTER'S QUERY The Washington Post is looking for challenging medical cases--ones that have been resolved but in which the patient's symptoms were puzzling to doctors or suggested an immediate diagnosis that would have been wrong.
Patients must have medical records documenting their care, and must be willing to share them with a reporter. Please include day and evening phone numbers and an e-mail address. E-mail medicalmysteries@washpost.com with your name and details. Please put "Medical Mystery" in the subject line.In Depth
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HOW UNIVERSAL HEALTH CARE COVERAGE WOULD WORK: The overall goal is to get everyone, or nearly everyone, health insurance. The plans also aim to cut costs by improving efficiency, and to improve the quality of care. The plans being discussed would accomplish that in the following ways.
_ All would build on the existing public and private insurance system to provide insurance and health care access to most or all the uninsured in their states _ now some 46 million people nationwide.
_ All aim to expand existing Medicaid programs to cover more of the poor and working poor who don't have insurance. They would require employers who don't provide insurance to do so. They seek some financial contributions or savings from doctors and insurers.
_ They would establish a state mechanism that creates an insurance product, or sets up a marketplace, so that small businesses and individuals can get reasonably priced insurance.
_ Some plans mandate that every individual must have insurance _ not unlike mandatory auto insurance for every driver _ with financial help for those too poor to buy it outright.
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THE BIGGEST BARRIER: The biggest stumbling block is money. Who pays?
In California, doctors and hospitals are already unhappy with Schwarzenegger's plan to levy a 2 percent fee on doctors and a 4 percent fee on hospitals. He would cap profits for insurers by requiring that 85 percent of revenue be devoted to treating patients: That idea alone sent the stock of health insurer Wellpoint Inc., with 34 million members, down 3.5 percent.
"He made enemies of every doctor and hospital in California when he did that," said Helen Darling, president of the National Business Group on Health, a consortium of companies trying to lower health costs.
