vol45.3 LR.pdf - International Hospital Federation

Policy: US health insurance reform
participants. So while the Democrats may hold the majority of seats,
the Democratic membership is divided on health-care legislation.
The issue that seems to spark the most heated debate is the
provision of a public option that will compete with the private
insurance industry. Because there are numerous health-care
proposals that are winding their way through Congress, the public is
confused as to what is the President’s preferred proposal and which
plan is the one on which to focus. In recent weeks, there has been
concerted efforts to damage any plan coming out of Congress
which may doom a health insurance restructuring all together.
A New York Times telephone survey of 895 adults reported that
overall 72% of the public supported a public health insurance plan
that would compete with the private insurance plans. 20 When
examined by political affiliation, 87% of Democrats support a
public plan, 73% of Independents, and 50% of Republicans. A
CNN/Opinion Research Corporation Poll conducted three weeks
later with 1136 adults reveal a generational difference in opinions. 21
A majority of Americans over the age of 50 oppose Obama’s plan;
a majority of those under 50 support it. Since the Obama plan has
not been published rather the broad outlines described above
have been released, there is more confusion than understanding
about what will be in the final health-care plan. Congress is now in
recess and the legislators have returned to their districts to hear
from their constituencies on health-care and other issues. There
have been heated discussions with those for and against a healthcare
restructuring. The public does not seem to realize that the
focus should be on insurance coverage.
A federal role for health care in the United States dates to 1912
when former President Theodore Roosevelt called for universal
health care for all Americans. 22 There has been incremental
improvements in the health system over the period. The most
dramatic change in the system was introduced by President
Lyndon Johnson’s introduction of Medicare and Medicaid in 1965
to care for the elderly and poor, respectively. Each time since 1965
when there has been promise for further change, the vested
interests from employers, insurers, physicians, hospitals, and
pharmaceutical companies and suppliers have nullified any
change. If health-care reform is going to succeed after 40 years of
repeated attempts, it must be done through a strong advocacy
effort where education of the citizenry is at its core. ❏
References
1.
Leonhardt, D. (July 21, 2009). The New York Times, A1.
2.
The White House, Health Care Guiding Principles.
http://www.whitehouse.gov/issues/health_care/ Retrieved August 10, 2009.
3, 4, 5.
Keehan, S., Sisko, A., Truffer, C., Smith, S., Cowan, C., Poisal, J., Clemens. M. K. (February
2008). Health spending projections through 2017. Health Affairs Web Exclusive W146:21.
6.
Neilson-Bohlman, L., Panzer, A. M., Kindig, D. A., Health literacy: A prescription to end
confusion (2004). Washington, DC: National Academies Press: Institute of Medicine.
7.
Howard, D. Health insurance survey results. National Association of Health Services
Executives Board Meeting Presentation, Chicago, October 10, 2006.
8.
Brown, E. R., Ojeda, V. D., Wyn, R., and Levan, R. (April 2000). Racial and ethnic disparities in
access to health insurance and health care. UCLA Center for Health Policy Research and The
Henry J. Kaiser Family Foundation Los Angeles, CA.
9.
Baker, D. W., Gazmararian, J. A., Williams, M. V., Scott, T., Parker, R. M., Green, D., Ren, J.
and Peel, J. (August 2002). Functional health literacy and the risk of hospital admission
among Medicare managed care enrollees. Medical Care 92:1278-83
10.
Health Literacy Interest Group. (April 6, 2009) Academic Value of Health Literacy Health
Literacy Symposium Leadership Dinner
11.
Parker, R.M., Baker, D.W., Williams, M.V., Nurss, J. R. (1995). The test of functional health
literacy in adults: A new instrument for measuring patient’s literacy skills. Journal of General
Internal Medicine 10:10 537 – 541.
12, 13, 14.
Baker, D. W., Gazmararian, J. A., Williams, M. V., Scott, T., Parker, R. M., Green, D., Ren,
J., and Peel, J. (August 2002). Functional Health Literacy and the Risk of Hospital Admission
Among Medicare Managed Care Enrollees. American Journal of Public Health 92:8 1278-
1283.
15.
Howard, D. Health Insurance Literacy Survey, University of Colorado at Denver, July 21,
2009.
16, 17.
Nurss, J. R., Parker, R. M , Williams, M. V., and Baker, D. W. (1995). TOFHLA Test of
Functional Health Literacy in Adults Manual Snow Camp, NC: Peppercorn Books and Press,
Inc.
18.
U.S. House of Representatives, Committee on Energy and Commerce Committee
http://energycommerce.house.gov/index.php?option=com_content&view=category&layout=
blog&id=160&Itemid=61 Retrieved August 1, 2009.
19.
United States Senate, Committee on Finance http://finance.senate.gov/
sitepages/committee.htm Retrieved August 1, 2009.
20.
Sack, K. and M. Connolly (June 20, 2009). New York Times,
http://www.nytimes.com/2009/06/21/health/policy/21poll.html?_r=1 retrieved August 10,
2009.
21.
CNN Poll Americans Split on Obama’s Health Care Proposals. (August 5, 2009).
http://politicalticker.blogs.cnn.com/2009/08/05/cnn-poll-americans-split-on-obamas-healthcare-proposals/
22.
A Brief History of Government and Health Care.
http://www.cnn.com/2009/HEALTH/08/04/timeline.healthcare/index.html. Retrieved August
10, 2009
06 World Hospitals and Health Services Vol. 45 No. 3