WASHINGTON — Because the growing number of Americans without health insurance results in unnecessary sickness and death, weakens the nation's economy and undermines the entire health care system, the federal government must begin working now to expand coverage to all Americans by 2010, the Institute of Medicine said Wednesday.
The nonpartisan organization, which advises the government on health issues, declined to endorse a specific strategy for health care reform. But its new report, "Insuring America's Health: Principles and Recommendations," called on President Bush, Congress and the Democratic presidential contenders to reject piecemeal proposals.
For The Record
Los Angeles Times Friday January 16, 2004 Home Edition Main News Part A Page 2 National Desk 1 inches; 36 words Type of Material: Correction
Health-care spending -- An article in Thursday's Section A about an Institute of Medicine report on the uninsured incorrectly stated that U.S. spending for health care in 2002 totaled $1.55 billion. Actual spending was $1.55 trillion.
After three years of intensive research and five previous reports on the costs of insurance, the institute concluded that "small steps are inadequate," said Mary Sue Coleman, president of the University of Michigan and co-chair of the committee that wrote the report. "It is time to insure America's health."
The Democratic candidates have released proposals that range from incremental expansions of Medicaid, the government's health care program for the poor, to national health insurance. And Bush is expected next week to renew his call for tax credits to help those without health insurance purchase it.
Earlier this week, the administration dismissed calls for universal coverage.
"It's not realistic," Health and Human Services Secretary Tommy G. Thompson told reporters. "I don't think, administratively or legislatively, it's feasible."
More than 43 million Americans had no health insurance at any time in 2002, according to the Census Bureau. That year's increase in the share of uninsured Americans, from 14.6% in 2001 to 15.2%, was the largest in a decade.
Calling 43 million "a big, big number," former Sen. Bob Dole, the Republican presidential candidate in 1996, strongly endorsed the institute's report.
Dole called on lawmakers from both parties to cooperate on the issue and encouraged voters to demand specific coverage plans from both Bush and the Democratic presidential nominee.
In spite of "the scope of the problem and the [limited resources] of our federal government," Dole said, "I think we have what it takes to get it done. All we lack is the will to get it done."
"There are two major obstacles," said Dr. Arthur L. Kellermann, co-chair of the institute's committee and head of emergency medicine at Emory University. "First is the knee-jerk response that we can't afford" universal health coverage.
