10-04-06, 9:05 am

  BETHESDA, Md. (PAI) – A congressionally created special health care panel set a national goal of universal health care coverage by 2012, but its report and recommendations are far from the end of the story.   That’s because findings by the Citizens Health Care Working Group, which included United Food and Commercial Workers President Joe Hansen, go to GOP President George W. Bush and the GOP-run Congress. Bush has 45 days to review them and send them on to Capitol Hill, with his own comments. Lawmakers are required to hold hearings on them. And there could be drastic changes by Bush.   Besides calling for universal coverage, the panel repeats a draft recommendation it made in May: That a non-profit, non-partisan, independent commission – and not the health insurance companies – should use best available expertise to create a “core benefits” package of medical services and illnesses that must be covered all the time, by every firm, in every case. That was one of few slams at the highly profitable industry.   And the working group takes no stand on how the U.S. should achieve universal coverage. But it lays out two options, one market-based and the other a “social insurance” model similar to Medicare and other government-run health systems. The panel said many people commenting at its hearings cited Medicare, the federal workers’ health system or the Veterans Administration’s system as examples of what works right.   Saying its report distilled comments from 23,000 individuals, a series of public hearings, a wide range of groups, experts in the field and intensive polling, the CHWG called for “a vision and a plan for achieving broad-based change in the delivery and financing of health care in America.”   But it warned “the issues involved are complex and challenging, and that it will take time, technical expertise and, especially, a great deal of political will to implement these strategies. The American people, who have called for these changes, will, in the end, be the ones to sustain this new vision.”   The report drew mixed reactions after its release on Sept. 25. Many groups, including the AFL-CIO, called it a good first step, but all differed with it on some specific recommendations.  The fed warned the panel’s goal of funding catastrophic care cover-age first, so that illnesses don’t bankrupt people, could leave the broader plan behind.   The longtime Jewish labor group Workmen’s Circle noted great support for universal government-run health care, and said we could afford it. The Universal Health Care Action Network, which several unions back, said the report did not reflect a two-thirds majority for government-run single-payer health care. (See separate story).   The panel began its report by declaring it found a consensus for “reliable, affordable care” in “a system in which everyone is covered for most health care costs.” And it found an overwhelming majority of respondents saying everyone – including individuals, government and businesses – should pay “their fair share” of health care costs. What that fair share is, though, was left undefined.   The working group said people “want a plan that, unlike many existing health insurance plans, cannot be cancelled or lost because of a change in employment status, be priced at unaffordable levels, or exclude those with pre-existing health conditions or ongoing health problems.”     And the panel declared “many Americans want to choose their health care providers and be able to communicate openly with them so they can make good decisions about their care.” That’s another knock at the health insurance industry. So was the panel’s finding that people “believe a simpler, more seamless system could provide coverage to everyone more efficiently than the current system.”   “For many, difficulties with cost and access to health care suggested a failure to apply widely held principles of fairness, careful management of resources, and shared responsibility,” the working group’s report noted dryly.   But before the nation tackles universal coverage, it should handle the problem of protecting people against going broke due to catastrophic health care cost crises, the health care working group said. That’s where it presented health care system models.   Its “market-based model” calls for: Mandating everyone get coverage against high out-of-pocket costs, offering people “a choice of standardized high-cost insurance products, whose details would be easy to understand and easy to compare,” different protection for different prices, consumer choice in buying insurance, and premiums based on ability to pay with subsidies for low-income people. “Employers would retain a role in paying for or providing health plans,” in the market-based model, the report said.  It gave no details of what or how extensive that role would be.   The second, “social insurance,” model for covering catastrophic costs would be similar to Medicare. It would require universal participation – not just by the elderly – and, like Medicare, be run “by the federal government through private-sector contractors,” though the working group did not say what a “private-sector contractor” is.   The program would be funded through a combination of premiums and earmarked federal revenues. Premiums would be structured to be fair and affordable, based on a sliding scale or surcharges related to income” and there would be premium subsidies for the poor, it added.   In an example, the government-run program would protect against individuals paying out of pocket for covered health services “that exceed some percentage of income – such as 20 percent of taxable income above the federal poverty level – or that exceed a fixed dollar amount of individual liability, such as $30,000, whichever is lower.”

From ILCA