Prior to last Monday's White House health care forum in Des Moines, Iowa, one of fiveregional forums being held across the country, the Iowa Senate passed two significant
health care reform measures - one symbolic and one substantive.
Concord - Rep. Jill Shaffer Hammond (D-Hills. Dist. 3) today
introduced an innovative bill that would allow small businesses,
non-profits, and their employees to purchase health insurance through
the state employee health plan. HB617 would help tens of thousands of
New Hampshire residents and small employers by increasing their options
in the insurance market. The bill could reduce health insurance costs
for business owners and employees who take advantage of the option to
join the state employee plan.
According to The Boston Globe,
a national shortage of primary care doctors is hitting Massachusetts
especially hard. The state's 2006 health insurance mandate has
resulted in an additional 439,000 newly insured residents trying to
seek care from an already over-stressed medical profession. According
to an annual survey by the Massachusetts Medical Society, wait times
for new patients to see primary care doctors are running an average of
50 days, though some doctors report delays up to 100 days.
eliminate disparities in access to coverage, expansion programs cannot include
costly co-pays or other financial barriers to accessing care. These are especially hurtful to low-income
communities. Better options
include: raising income eligibility limits for Medicaid, expanding access to
the State Children's Health Insurance Program, and creating public/private
expansions that provide sliding-scale premium subsidies with no or limited
A "medical home," or primary care
setting where one's health care needs are looked after and care is
coordinated, is an important part of
health care access and a strategy for eliminating
disparities. Patients with a
medical home are more likely to get reminders to receive preventive care,
such as screenings for cholesterol, breast cancer, and prostate cancer.
medical homes, states need to reform primary care reimbursement by measuring
and rewarding medical homes, testing care delivery models, and maximizing the
potential of health information technology.
In 2000, the World Health Organization ranked the US health care system 37th in the world despite spending more than any other country. In 2007, according to the US Census Bureau, the US ranked 42nd in life expectancy.
If you are a person of color, a low-wage worker, non-English speaking,
or live in a low-income community, the picture is much worse. For
instance, the life expectancy for African-Americans
is 73.3 years, five years shorter than it is for whites. For
African-American men, it is 69.8 years, just above averages in Iran and
Syria, but below Nicaragua and Morocco.
Incremental steps to improve the health care system can lay the
foundation for comprehensive reform that provides health care for all.
Comprehensive reforms enacted in Massachusetts, Vermont, Maine and San Francisco were, in large part, the result of pragmatic incremental steps those states had already taken. For example, a Families USA report discusses the many reforms Massachusetts put in place over the years that led to its comprehensive 2006 reform. Not every state is as far along in moving comprehensive health care reform, but
each state does have numerous options for increasing access to
coverage, reducing the growth of health care costs, and improving the
quality of care.