Contact:
Christy Hicks, 212-452-7723

A Proposal for Universal Coverage from The Century Foundation's Health Care Fellow

New York, N.Y., May 5, 2005—Your access to health care in the United States, and the quality of care you receive, has long depended on where you work. However, medical costs for employers—up 59 percent since 2000—are leading many companies to pare back coverage. An increasing number of people are paying more for less health care. For more than 45 million uninsured Americans, even basic health care is a luxury they can't afford. All this adds up to a problem in this country that is fast becoming a crisis.

Leif Wellington Haase, a fellow at The Century Foundation, believes we can avert a crisis and expand the availability of affordable quality health care by getting employers out of the health insurance business. He lays out an innovative plan for achieving universal coverage in A New Deal for Health: How to Cover Everyone and Get Medical Costs under Control, his new report for The Century Foundation.

In the report, Haase proposes that the employer-based system be replaced with a system in which the federal government would subsidize individual and family purchase of private health insurance policies. Everyone would receive a government subsidy. Older, poorer, and disabled Americans would receive larger payments.

Other features of the proposal include:

• The federal government would establish three levels of insurance coverage and negotiate with private insurers over premiums and rules.
  
  
• The purchase of health insurance would be mandatory.
  
  
• An independent board would evaluate the cost-effectiveness of medical procedures.
  
  
• Medicare, Medicaid, and other government programs would be phased out.
  
  
• A large new investment would be made in the public health system for public education and other activities to encourage the practice of healthier lifestyles.

This proposal would keep intact the existing relationship between doctors, insurers, and patients and preserve U.S. leadership in medical innovation. Haase believes that an important advantage to this approach is that it allows people to see the doctors of their choice.

"The U.S. is the only developed country that bases health coverage on employment status," said Haase. "The current system hurts those least likely to get health coverage through the workplace-the young, minorities, and those who work for small businesses. It hampers the ability of U.S. companies to compete in global markets, creates unnecessary administrative costs, and drives people to seek expensive and unneeded care in hospital emergency rooms," he added.

Haase finds that this system would not only provide better health care coverage for more people, but also that it would, over time help to control costs. He suggests that the program could be financed through redirecting the payment streams that currently pay for U.S. health care. He believes that reaching universal coverage, streamlining the health care system, and bolstering public health will result in changes that will improve the value of health care spending over time.

A New Deal for Health: How to Cover Everyone and Get Medical Costs under Control is the latest in a series of Century Foundation publications intended to explain the nation's health care challenges and to offer innovative approaches for improving the system. As an institution, the Foundation takes no position on the various remedies proposed by these authors, but believes strongly that public education and debate need to be continued and sharpened.

A New Deal for Health: How to Cover Everyone and Get Medical Costs under Control is available online at The Century Foundation's Web site, www.tcf.org and at its health policy site, www.healthpolicywatch.org. Hard copies of the report are available from The Century Foundation. Contact Christy Hicks at hicks@tcf.org or (212) 452-7723 for more information or to schedule an interview with Leif Wellington Haase.

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