The forces of virtue are lining up to attack the uninsured problem. With an estimated 43 million Americans lacking medical coverage during a time of unparalleled economic prosperity, there is no shortage of commitment or ideas about how to solve this embarrassing dilemma.
And that's part of the problem. During the next three months, the nation will be bombarded by studies, statistics, speeches and congressional hearings on what needs to be done and how to accomplish it. But without a clear focus and direction, the effort will likely stall.
Furthermore, the information blitz on the uninsured will compete with other healthcare reform efforts for lawmakers' attention. Issues crowding the congressional agenda are managed-care patient protection, Medicare reform, medical-records confidentiality, long-term care and the revision of provider payments mandated by the Balanced Budget Act of 1997. All have support and need fixing.
But none is more important than improving access to health insurance. Providers and their lobbyists should concentrate on building consensus, with teamwork and leadership from the American Hospital Association, the American Medical Association, the Catholic Health Association and others who profess to champion the access issue.
While universal health coverage is a worthy goal, the coalition may want to be more realistic and lower its sights. Using the tax code to create incentives for the uninsured to purchase medical coverage offers perhaps the most politically prudent path. Tax credits to subsidize lower-income workers and those who work for companies that don't offer insurance have the backing of influential leaders from both sides of the political spectrum. For example, socialized medicine advocate Rep. Jim McDermott (D-Wash.) and Rep. James Rogan, the California Republican who served as one of the House managers during President Clinton's impeachment hearings, are introducing a tax-credit bill.
Their proposal features a tax credit equaling 30% of health insurance premiums to workers not offered coverage through their employers and to those who are self-employed. The McDermott-Rogan bill won't solve the problem, but it's a big step in the right direction.
The provider coalition should support this bill in principle and then vigorously work to sell the concept through a grass-roots campaign. That is a modest and achievable goal, but only if the effort is swift and sincere.