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Opinion Leaders Say Uninsured Rate Could Be Halved in a Decade

Sometimes, it seems as if there's no way to begin to address the problem of the growing number of Americans lacking health insurance, much less resolve it. But health care opinion leaders are much more encouraging.

Respondents to The Commonwealth Fund's latest Health Care Opinion Leaders Survey say the proportion of uninsured Americans can and should be cut to 8 percent in 10 years, less than half the current rate. And they have some specific ideas on how to do so.

Most say employer-sponsored coverage should continue to cover about two-thirds of individuals under age 65. A wide majority say an option similar to the Federal Employees Health Benefits Program would be the best way to help small employers and the self-employed obtain affordable coverage. About four-fifths favor incentives for employers to provide insurance that meets minimum standards and tax credits or other subsidies to help low-wage workers enroll in employer plans. Other popular policy options include requiring employers who don't provide benefits to pay into a fund that would; allowing employers to buy into Medicaid or the Children's Health Insurance Program for their employees; and employer mandates to help finance benefits. Neither Association Health Plans nor Health Savings Accounts were nearly as popular options.

You may recall that we launched our online survey in January, asking a range of widely recognized experts in health care practice and policy to identify the five most important issues for Congress' health policy agenda over the next five years, as well as to name their top five priority solutions for addressing the issues of rising health care costs and improving quality, next steps in Medicare reform, and how to best cover the uninsured. This time around, we wanted to focus on insurance issues in some detail.

I'm encouraged that health care leaders are optimistic about our ability to find solutions to the crisis of millions of Americans without health insurance coverage. There also appears to be a great deal of consensus among leaders across health care sectors—academia, health care delivery, business and insurance, as well as government, labor and consumer groups—about actions we can take that will reduce the numbers of uninsured.

You can see the results of our second survey here, as well as read commentaries from Charles N. Kahn III, president of the Federation of American Hospitals, "Coalition Building and Political Reality" and Michael Rodgers, interim president and CEO of the Catholic Health Association, "Finding Common Ground." You can also learn more about the survey's methodology.

As with our first survey, we expect some of our results to be a prime topic for lively debate, even criticism. And that's fine; the goal is to offer a forum for such professional discussion and present a wide range of points of view on crucial issues. So as part of that ongoing effort to keep the debate going, we invite you to take the survey yourself; we'll post the results at a later date. We also invite your comments on this survey and suggestions for topics to be addressed in the future.




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March 2005