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A Path to U.S. Health Insurance Reform?

June 28, 2024

Written by Denrick Cooper

Spoon Feed
To fulfill a societal obligation to provide healthcare to all, two things must be done: healthcare insurance must be universal, basic, and free, while also providing supplemental care in a healthcare market.

Liberty, justice, and universal health care for all!
This opinion piece, written from an economist’s perspective, urgently highlights the pressing problems with the current state of U.S. health coverage and proposes solutions.

Since the Affordable Care Act, 30 million Americans have gained health insurance. Despite having medical insurance, patients still face incomplete and insecure coverage. One-third of employer-provided insurance plans are high-deductible, which leave a significant financial burden on the patient. 12% of Americans face potential loss of insurance coverage, often leading to continued lack of coverage. As different socially vulnerable populations have been added in a piecemeal fashion under the umbrella of medical coverage, the fragmented nature has contributed to problems in the overall system.

The driving force of this change is the ideology that we must have, “a clear social commitment to providing everyone with essential medical care, regardless of resources.” The authors suggest universal coverage that contains 3 aspects: automaticity, basic, and free at the point of care, while offering optional supplemental coverage. Amid concerns about potential tax increases from the proposed reform, the authors argue that taxes may not need to rise. They suggest allocating taxpayer dollars towards providing basic universal health care coverage, while private health care spending could cover supplementary care.

How will this change my practice?
I am all about universal coverage. From an economic standpoint, I think reforming our current system is a large task, and although the article provides solutions, it does not address (I think purposefully) the intricacies of how we get to a universal healthcare system. However, I think the largest takeaway is not so much the HOW, but the WHY! The societal obligation to provide basic coverage compels us to overcome the obstacles of a potential system in the future.

A Blueprint for U.S. Health Insurance Reform. Ann Intern Med. 2024 May 14. doi: 10.7326/M24-0091. Online ahead of print. PMID: 38739923

2 thoughts on “A Path to U.S. Health Insurance Reform?

  • I am disappointed this article is on JournalFeed without a clear point-counterpoint format that is typically done with more controversial topics. This is not a balanced representation with differing opinions being offered.

    • Thanks so much for the comment. It is a fair point you make. I have 3 thoughts:

      • We have previously written about the single payer system – good, bad, and ugly – and have tried to present various sides of this here.
      • There was not a direct counterpoint article in this issue of Annals of IM. Since I wrote a fairly robust critique of single payer in the past, I thought we were being balanced, but I probably should have added an editor’s note linking to my prior critique.
      • The authors are expressing opinions that are not necessarily political, though they could be seen in that light. It seems there is a general consensus among most people in the U.S. that healthcare for all is a good and noble goal, even a moral imperative. So, the first premise – provision of some form of universal, basic coverage – seems in keeping with this priority. The second premise acknowledges than many people in the U.S. will want to purchase coverage that goes beyond the basics, which also seems reasonable and apolitical to me.

      We want to be fair, balanced and discuss various points of view. Like my home institution’s policy on free expression and institutional neutrality, we at JournalFeed want to foster open discussion and realize that, just like in a university setting, our role is to, “is to encourage debates, not settle them.” We are open to readers’ thoughts and want to provide a place for debate, discussion of ideas, and civil discourse. Again, thanks for taking to time to offer feedback and discussion!

What are your thoughts?