Public programs such as Medicare and Medicaid "should be considered building blocks in a system of seamless coverage for America's 47 million uninsured people," Commonwealth Fund President Karen Davis testified before members of the U.S. Senate Finance Committee on June 16.
In her invited testimony at a summit held by the Committee to begin planning for health system reform, Davis reviewed how Medicare and Medicaid have improved access to health care for many of our most vulnerable citizens. Noting that most Americans either have group health insurance through employers (55%) or are covered by Medicare or Medicaid (22%), she said that expanding this coverage will minimize disruptions and keep administrative costs low. Davis also pointed out that Medicare can be a leading force for change in the health care system, serving as a model for private insurers in public reporting, rewarding quality, requiring evidence-based care, and encouraging use of modern information technology.
Citing the "Building Blocks" framework for health reform that she devised along with her Fund colleagues, Davis explained how a mixed private–public system of universal coverage with seamless coordination across sources of coverage could achieve savings while ensuring access to care for all. The framework would include a structured choice of private plans and an enhanced Medicare-like plan, called Medicare Extra, which would be made available through a new national insurance connector.
"The question for the nation should not be 'public' or 'private,'" Davis told the senators, "but what creative mix will move us toward a more accessible, patient-centered, high performance health care system."
