UCSF policy expert presents recommendation for health coverage

A health policy specialist at the University of California, San Francisco has developed a strategy to provide universal health care for major and chronic illness for everyone by instituting a plan that incorporates aspects of both a single-payer model and a plan similar to a preferred provider organization, known as a PPO.

Harold Luft, PhD, professor of health policy and health economics at UCSFs Institute for Health Policy Studies, presents his strategy in a commentary article in the March 14, 2007 issue of the "Journal of the American Medical Association."

"The United States spends a greater share of its gross domestic product on health care than other nations, yet more than 15.9 percent of its population lacks health insurance coverage," he writes. Lufts plan ensures that everyone has coverage for catastrophic illness or injury and chronic conditions, while giving people many more options than they have currently when it comes to the rest of their health coverage.

"A hybrid approach, combining universal risk pools, mandated coverage with income subsidies, and a restructured payment mechanism has the potential to improve both equity and efficiency," he writes.

While Medicare is the prototypical single-payer model, Luft says it is fraught with problems because of the political nature of the program. "We dont have a political system to allow a well-meaning bureaucracy to do the right thing," he says.

Luft points to countries such as France and Germany that have coverage pools paid into by employers for health care, making the point that his proposal has worked in other places.

"In the United States, employers sponsor specific health plans, and if the premium cost is higher than employees think its worth or it is more than they can afford, they may opt out of having coverage," Luft says. "But if a person who has opted out is involved in an accident that involves hospitalization and expensive surgeri

Contact: Carol Hyman
University of California - San Francisco

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