Action to provide healthcare coverage to the nation's 47 million uninsured residents must be taken immediately, Senators and health experts agreed at Wednesday's Senate Finance Committee Hearing.
"For too long, Congress has remained idle as the costs of healthcare spiral out of control," said Sen. Max Baucus (D-Mont.), committee chairman. "The problem has grown too large, too dire, for Congress not to act."
"With every day that passes, we only make fixing the system more difficult," added Sen. Chuck Grassley (R-Iowa), a ranking member of the panel.
Baucus outlined what he called, "five broad principles of reform." The first of the principles is universal coverage, followed by sharing the burden of healthcare, controlling costs, prevention and shared responsibility. "Universal coverage is essential if we are to make meaningful progress on the other four principles," Baucus said.
The strongest disagreement at the hearing centered on funding various efforts to provide universal coverage. Sen. Ron Wyden (D-Ore.) disagreed with the popular notion that enacting universal coverage would require raising taxes.
"I think the money is there; we're just not spending it in the right places," Wyden said. "Isn't it possible to get good coverage for the uninsured with the $2.3 trillion we spend today?"
Richard Frank, vice chair of Boston-based Citizens' Health Care Working Group, said his group's research has revealed that most Americans are willing to pay more if that will ensure healthcare coverage for all Americans.
Not all of the uninsured are without access to coverage, said John Sheils, vice president of the Lewin Group, a Falls Church, Va.-based research group. "We have 6 million uninsured who are offered coverage through work but have declined it, presumably due to cost," Sheils said.
Senators and witnesses agreed that the funding and expansion of State Children's Health Insurance Plans should be a priority as Congress considers universal coverage. Wyden noted the Robert Wood Johnson Foundation's announcement that nearly 70 percent of low-income children are uninsured, while employers are increasingly less likely to offer health insurance to low-income parents.
Stuart Altman, professor of National Health Policy at Brandeis University, urged Congress to reauthorize SCHIP, which he said should be seen as a flexible model for universal coverage at the federal level. "I want to emphasize the value of the state involvement in this," Altman said.
Another debated model for universal healthcare coverage was Massachusetts' statewide effort to require healthcare coverage of all of its citizens.
James Mongan, MD, president and chief executive of Boston-based Partners HealthCare, said Massachusetts has been successful in its universal coverage initiative thanks to a formula that includes regulatory and market approaches, intellectual humility and shared responsibility – elements he believes can be applied to a national program.
The committee debated additional aspects of universal healthcare coverage, such as reducing administrative costs, moving to a single-payer system, making insurance companies more competitive, and eliminating the employer-based insurance model.