What's the Best Way to Pay for Americans' Health Care?

ByABC News
October 18, 2006, 1:48 PM

Oct. 19, 2006 — -- ABC News has 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 fourth batch of responses they've brought to this five-part series -- some surprising, some simple.

Dr. Alan Garber
Director, Center for Health Policy, Stanford University

The funds for health insurance will have to come from both public and private sources. It is unlikely that we can avoid using general federal revenues for a chunk of the costs, which means that we will have to find ways to control Medicare expenses as part of any plan.

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"

I'm unconvinced that employer-based health insurance will last -- only 58 percent of companies now offer coverage, a 20-year low. But if we move away from this idea, we'll need to help people pool risk -- not easy. Still, private health insurance is a better bet than nationalized health care.

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

The U.S. has three major arenas for enhanced coverage, and the ways to pay for improvement differ:

For those who have no coverage at all, the approach may well involve state initiatives to extend coverage, managing costs so that businesses can cover workers and their families, and assuring backup plans for citizens who have no other access to coverage.

For the elderly who have medical care coverage but no long-term care coverage, CMS and others have encouraged younger people to buy long-term care insurance and to attend to the issues of retirement income and security, though broader initiatives may prove to be needed.

For family caregivers upon whom so much of the care of disabled and elderly persons depends, the society will probably need to consider strategies to make continued high levels of service possible as the numbers of persons needing care rises dramatically and the numbers of potential caregivers shrinks.