Can America Get Everyone Covered?

ABC News asked a panel of experts five questions about what it would take to fix the U.S. health care system, and we'll post one question and answer every day this week.

The experts include physicians, academics and consumer advocates.

Below is the third batch of responses they've brought to this five-part series -- some surprising, some simple.

Question: How can we get everyone covered?

Dr. Alan Garber

Director, Center for Health Policy, Stanford University

I favor giving everyone a choice of many health plans, similar to the choices available to federal employees, and to provide subsidies that would enable lower-income Americans to purchase insurance. To create some health insurance choices that are truly affordable, we need to have a national discussion about what kinds of care everyone truly needs, and what kinds of care people should have to purchase directly or through supplemental insurance.

Dr. David Gratzer

Senior Fellow at the Manhattan Institute, and a licensed physician in the United States and Canada. Gratzer wrote "The Cure: How Capitalism Can Save American Health Care"

A third of the uninsured have incomes above $50,000 a year -- we need to make health insurance more attractive to these people by making it less expensive. No-frills health insurance plans (effectively banned in most states) would be important. We need to look at how we spend the billions of dollars already committed to the uninsured.

In Massachusetts, new reforms will focus this money on buying health insurance for the working poor -- an excellent idea.

Dr. Joanne Lynn

Physician and researcher with the Department of Health and Human Services' Office of Clinical Standards and Quality at the Centers for Medicare and Medicaid services

States are again working out ways to extend coverage to the poor, and coverage for prescription medications for the elderly has filled a major gap in their coverage. However, reversing the trend toward increasing numbers of working Americans who do not have health insurance will require reining in the rising costs so that businesses and public programs can afford to support workers and citizens. This is a major long-term endeavor on the part of all policymakers and leaders among provider groups.

Lisa McGiffert

Senior policy analyst at Consumers Union, publisher of Consumer Reports

First, we must make a national commitment to reach that goal by a specific time and recognize that there are many ways we can ensure that everyone has equal coverage.

Then we need to get started immediately, because it is going to take awhile to fix this mess.

States have always been the laboratories for trying out new programs and policies, and some have already started experimenting with various approaches. Some are trying an "individual mandate" that requires everyone who isn't covered to buy a policy. This approach presents some problems with making sure people can actually afford premiums, and it doesn't get at the problem of insurance companies making decisions instead of doctors and patients.

Making employers cover everyone is another option being proposed, but that misses people like the self-employed and may be a burden on very small businesses. There are also calls to create programs that cover everyone using models similar to Medicare, which has done a great job of efficiently providing hospital and physician benefits to a very large population.

One way Congress could help is to encourage and support state programs that commit to covering everyone by bending federal policies and financial barriers that get in the way of such efforts.

Debra Ness

President, National Partnership for Women and Families

We need to change the way we pay for health care and create incentives for better quality and more efficient use of resources. We are wasting billions of health care dollars on poor quality and unnecessary care, while millions go uninsured. We have the resources, but we aren't being smart about how we use them.

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