Analysis: The politics of health reform


healthcareWASHINGTON, Nov. 10 (UPI) -- Healthcare reform will emerge as a key political issue over the next two years, says Joel E. Miller, senior vice president for operations at the National Coalition on Health Care.

"Because more and more employers are dropping coverage and more and more workers are deciding that coverage is too expensive even when it's offered, we think that over the next couple of years there will be a full-scale debate on health reform leading up to the presidential elections," he said.

The number of uninsured Americans rose 800,000 between 2003 and 2004 and has increased by 6 million since 2000, according to the NCHC. Approximately 46 million Americans, or 15.7 percent of the population, were without health insurance in 2004, according to the latest government data available.

In addition to the 46 million with no insurance, Miller estimates that 30 million to 40 million Americans have inadequate health insurance, which means that they pay at least 10 percent of medical costs out of pocket.

"The main issue here is that health insurance premiums for the average employer have increased 87 percent since 2000," Miller said. "That's four times the rate of inflation and four times the rate of wage increases."

"Unfortunately, this trajectory is going to expand over time."

In order to effectively deal with the problem of the uninsured, Miller believes that the government must take action in two stages. Firstly, current programs like Medicaid and Medicare need to be expanded to incorporate more people, procedures and drugs. Secondly, and perhaps further down the line, a universal and publicly financed system needs to be implemented.

While Joel E. Miller believes that popular support for healthcare reform will pressure politicians to pursue change in the two years before the 2008 elections, Thomas Miller, a resident fellow at the conservative American Enterprise Institute who specializes in healthcare policy, doesn't think that the reforms the NCHC has in mind are politically or economically feasible.

Thomas Miller doesn't believe that political attitudes towards healthcare reform are "any different right now than they have been in past years -- there isn't a pot of money that is going to pour in" and make universal coverage a realizable goal.

Politics aside, Thomas Miller doesn't believe universal coverage is a goal that should be pursued. "'Universal coverage' has become an empty phrase, an all-or-nothing thing. As we go forward, we need to think about improving quality rather than simply expanding coverage," he said.

While Joel E. Miller believes moving towards a universally mandated health system similar to those in Japan, Australia or much of Europe would be positive because it would ensure that all Americans have health insurance, Thomas Miller believes that universal systems are generally overrated.

"Universal coverage doesn't mean that people are happy with their coverage. Many in those countries aren't getting the care that they would like to have. Universal coverage itself is not a solution," he said.

Despite Thomas Miller's doubts, Joel E. Miller believes that as more and more people find themselves without health insurance, the popular pressure on politicians to overhaul the nation's health system will reach a tipping point. And, if current trends continue, this tipping point could come sooner rather than later.

"Regardless of the recent elections, I think the problem of the uninsured is going to get spotlighted as a very important domestic issue, and politicians will reach across the aisle to come up with some new approaches for solving this difficult problem," he said.

source - UPI