Insurer wants universal care
USA TODAY, December 4, 2002
By Julie Appleby
In a break with many other insurers, the head of Blue Shield of California is calling for universal health care, starting with Californians.
"Some of my peers in the industry may be disappointed with this approach," CEO Bruce Bodaken told the Commonwealth Club in San Francisco Tuesday. "We are willing to take these risks for a simple reason: The current system and its underlying economics are unsustainable."
Bodaken heads one of the state's leading health insurers, a not-for-profit entity with 2.6 million enrollees. His talk comes as health care costs are rising at their fastest clip in a decade, as more Americans fear losing coverage and as managed care is no longer seen as the answer to the problems.
Political interest in reforming health care has also revived: Former vice president Al Gore is calling for a single-payer system, several presidential hopefuls are touting their plans for universal coverage and the Bush administration is pushing tax credits and an expansion of community health clinics to help the uninsured.
Still, many lawmakers consider it politically dangerous to embrace a major overhaul. Voters in Oregon last month rejected a plan to give all state residents health care, paid for with tax increases.
Bodaken's plan is not an overhaul. Instead, he suggests building on the current system, by requiring employers to offer coverage or pay into a fund. In turn, individuals would also be required to buy coverage and those who can't afford it would get government subsidies.
State and federal health programs would be expanded to cover more low-income residents. Some kind of new tax would help pay for it all.
"Every one of us will have to participate and in some cases make a sacrifice for the good of the whole," says Bodaken, who sees such efforts starting in the states and eventually going national.
Critics say a plan like Bodaken's won't solve the system's many problems because it does not remove insurance companies from the equation.
"He's got the right diagnosis but the wrong treatment," says Quentin Young, national coordinator for Physicians for a National Health Program, a group that supports a single-payer-type plan similar to Medicare. "We need to end the profit-motivated distortions in our system."
Under a single-payer plan, insurance companies, essentially, would be out of business. Bodaken's plan, by contrast, could help insurers by requiring everyone to carry insurance. Observers say it is hard to evaluate the plan because many details are unclear. Still, many welcome the debate and say it is significant that a managed care insurer is calling for reform.
Karen Ignagni of the American Association of Health Plans says the industry wants universal coverage. "Universal coverage doesn't mean government takeover of the system," she says. "Our community wants to play a major role in working with Congress and the states."
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