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News of the Day ... in Perspective


National Academy of Sciences calls for “universal coverage” by 2010

The Institute of Medicine of the NAS issued a call for universal health insurance, claiming that 18,000 deaths per year in the U.S. can be attributed to lack of insurance. Former Senate Republican Leader Robert Dole endorsed the call to action and said that lack of insurance for 43 million Americans would be a “big, big issue” in this year’s election (Robert Pear, New York Times, 1/15/04).

The IOM panel was chaired by Soshanna Sofaer of Baruch College, who authored the report. Sofaer was a prominent member of the Clinton Task Force on Health Care Reform, leading the Working Group on Coverage for Low-Income and Non-Working Families.

The IOM study received funding from the Robert Wood Johnson Foundation, an influential participant in the Clinton Task Force.

Additional information:

A method proposed for universal coverage by Sofaer in Clinton Task Force Documents: “Presumptive coverage assumes that everyone eligible for participation in the new health care system is automatically covered by an approved health plan from the moment of implementation.... The presumptive coverage mandate would be enforced through the tax code. Individuals would be required to verify on their tax form that they have health insurance. Those who do not have insurance would be required to pay back premiums for up to one year….” (See www.aapsonline.org, click on “Clinton Taskforce Records.” A one-megabyte file of selected summaries is available on request from [email protected])

The IOM report showed a correlation but no causal connection between insurance and health outcomes. Only 18 of the 164 separate studies looked at income, an important confounding variable. A potential control group is the Medicaid population–recipients do about as badly as or worse than the uninsured at receiving medical services or maintaining good health (Greg Scandlen, NCPA Brief Analysis #416, 8/21/2002, www.ncpa.org).

Covering the Uninsured: the Wrong Goal, AAPS News, April 2003.

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