Physicians' group calls for universal health coverage

In this story:

Core details

Public comments invited

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By Michele Dula Baum
CNN.com Health Writer

(CNN) -- A physicians' group representing doctors who "are the lifelines" of U.S. health care is calling for a national dialog on universal health insurance.

"We live with this issue every day," Dr. Richard Roberts, president of the American Academy of Family Physicians, said Thursday. "We hear this problem day in and day out."

At a briefing held at the National Press Club in Washington, Roberts and other representatives of the 93,000-member organization, presented the outline of a plan designed to provide coverage for all Americans.

"Nearly 1 in 4 Americans are without any or adequate health insurance," said Roberts, a professor of family medicine at the University of Wisconsin in Madison, pointing to 42 million uninsured and 20 million underinsured people. "It's a problem that has grown only worse with time."

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What can be done to improve health care coverage for all Americans?

The group's proposal identifies key elements necessary for true universal coverage. Among them are:

Providing "basic health care" to all, without financial barriers to such care.
A shared financial responsibility between public and private funding sources.
A "rational approach" to end-of-life care.
Protection against catastrophic health care expenditures.
An opportunity to purchase middle-level health services on an individual basis.

"We think this is cautious, carefully thought out and yet innovative" approach, Roberts said.

Core details

Among the details is a provision that insurance would cover the full cost of basic health care services without co-payments or deductibles. The physicians' plan also would limit out-of-pocket costs for those services not covered to $5,000 a year for individuals or $8,000 per family. An additional 20 percent co-payment would bring total out-of-pocket costs to a $10,000 limit per family.

The program is not intended to replace Medicare or similar programs for the armed services, the Indian Health Service or Veterans Affairs. Enrollees now covered by Medicaid and the Children's Health Insurance Program would be folded into the new plan for basic services only. Still "other services that Medicaid currently covers would remain in place," according to the plan.

Administration of the program would be left to the states, with funds distributed on a per capita basis.

The academy plan is one of many being developed within the health care industry.

"We'd be happy to take a look at the proposal," said Richard Coorsh, a spokesman for the Health Insurance Association of America, a consortium of 300 private health insurers providing coverage to 123 million Americans. "We appreciate the interest in the issue."

HIAA proposals are included in the current issue of Health Affairs magazine, at http://www.healthaffairs.org.

The HIAA and Families USA has been working for months on efforts to "find common ground" on universal health care, he said, adding "We believe that the issue of help to provide coverage to the nation's nearly 43 million uninsured Americans should be the nation's most important domestic priority."

Public comments invited

The academy is seeking public comment on its proposal until the end of February. The entire document is available on the group's Web site at http://www.aafp.org/unicov/.

"We wanted to invite America in," said the physician, who is also an attorney. "Many of us have felt hamstrung about how to fix it."

The AAFP's proposal follows a two-year process of planning and discussion. A final draft will be presented to the organization's Congress of Delegates at a national meeting in October in Atlanta, Georgia.

"The current system is fundamentally flawed," said Roberts, calling for reform "from a global perspective."

Still, physicians recognize that this issue is "very complicated," he said. "But we need to take the next step to get past the fractious political debate of the past eight or nine years."