Evidence-based health policy supports single-payer health insurance reform.

摘要

The deteriorating state of health insurance coverage in the United States is well documented. In 2006, the US Census Bureau reported 47 million Americans were uninsured, up 2.2 million from 2005. However, this is only part of the story: 82 million Americans reported a period of un-insurance over the last 2 years. That's more than 1/3 of the non-Medicaid population under the age of 65. Private employer-funded health insurance premiums have increased 59% and employee contributions have grown by 57% for single coverage and 49% for family coverage since 2001. Little wonder that the number of Americans covered by private employer-funded health insurance is shrinking. Meanwhile, as of this writing, Congress is struggling to overturn President Bush's veto of the State Child Health Insurance Program (SCHIP). The Bush administration says expanding SCHIP to include low- to middle-income families will induce them or their employers to drop private coverage to put their children into publicly-funded programs. In the insurance world, this is called "crowd out." There is some truth to this claim. The nonpartisan Congressional Budget Office estimates that the bill vetoed by President Bush would increase enrollment in SCHIP and Medicaid by 5.8 million in 2012. Without SCHIP, 3.8 million children would be uninsured and it is possible that the remaining 2 million would come from families who might be able to buy private health insurance. However, as is editorialized in the New York Times, "it is often a good thing to substitute S-CHIP for private coverage. If the available private policy has skimpy benefits or is so costly it devours a family budget with large premiums and cost-sharing, the child may not get needed medical care."