The Institute of Medicine urged Congress and the president to develop a strategy to reach universal coverage by 2010 given the growing number of Americans without health insurance and the dire consequences of being uninsured. In a report released today, the IOM reviewed four models of coverage: a federally administered single-payer system; mandatory employer-based coverage; mandatory individual coverage with a refundable tax credit; and a merger of Medicaid and the State Children's Health Insurance Program combined with an extension of Medicare to 55-year-olds. The report -- the sixth and final in a series on the uninsured -- is meant as a guide for policymakers and does not recommend or reject any model. Despite incremental efforts at federal, state and local levels, "reforms over the past 20 years have made little progress in reducing overall uninsured rates," the report said. Up to 18,000 Americans die each year as a consequence of not having insurance, the IOM said. Some 43.6 million Americans were uninsured in 2002. Read more on the IOM Web site.
Meanwhile, a study by Harvard Medical School and Public Citizen said a national health system could save at least $286 billion annually by eliminating private carriers' high overhead and the administrative costs associated with a fragmented payment system. According to the study, the healthcare industry spent almost $400 billion overall on bureaucracy last year. Money saved through a single-payer system could be used to cover the uninsured, pay for seniors' out-of-pocket prescription drug costs and fund retraining for those who would lose jobs in a transformed industry, said Public Citizen, a consumer advocacy group. The new Medicare law represents a "huge increase in administrative waste and a big payoff for the AARP," said David Himmelstein, associate professor of medicine at Harvard and co-founder of Physicians for a National Health Program, an advocacy group pushing for a single-payer health system. The study will be published in Friday's International Journal of Health Services. -- by Tony Fong and Jeff Tieman