RESEARCH General Health

HEALTH CARE
Idea of health-care reform appeals to many, though still a low priority

Melissa Mitchell, News Editor
(217) 333-5491; melissa@uiuc.edu

7/1/02

Photo by Bill Wiegand Community health professor Tom O'Rourke says the idea of health care reform hasn't lost its appeal among the American public, but as a public policy issue, it is unlikely to become a high priority item soon.

CHAMPAIGN, Ill. — Nearly a decade after the Clinton administration's unsuccessful efforts to reform the nation's health-care system, that system is still ailing – and failing many Americans.

According to data analyzed by Tom O'Rourke, professor of community health at the University of Illinois at Urbana-Champaign, and Nicholas Iammarino, professor of kinesiology at Rice University, an estimated 43 million Americans remain uninsured.

"An additional 13 percent of the under-65 population are underinsured – about 20 million people," the pair wrote in "The Future of Health Care Reform in the United States: Lessons From Abroad," an article published in the June issue of the British journal Expert Review of Pharmacoeconomics and Outcomes Research.

The idea of health care reform hasn't lost its appeal among the American public, according to O’Rourke. But, as a public policy issue, it is unlikely to become a high priority item anytime soon.

"Health-care reform still makes sense to most people, but the political climate is just not conducive to change at this time," O'Rourke said. And the players with the most at stake – not counting consumers – are unlikely to rally behind a new model, which O'Rourke says must be embraced before real change can occur.

"In order to get anything going," O’Rourke said, "you still will need the four big actors behind you: the purchasers, both public and private, that supply the funds; the insurers, who receive the funds from the purchasers and reimburse the providers; the providers (hospitals, physicians, nurses, nursing homes, pharmacies, etc.) that render the services; and the suppliers, such as the pharmaceutical and medical supply industries."

In the meantime, O'Rourke and Iammarino's analysis of data on other industrialized nations' health-care policies and systems indicates that "U.S. health care costs continue to be far higher and have risen more rapidly than other nations." In fact, they noted, "Of 29 industrial countries including the Group of Seven (G7) countries, the USA spends more on health care services than most industrialized countries in dollars and percent of GDP (Gross Domestic Product) while having the least access to care of any of the other 29 countries."

Among other key issues – or lessons from abroad – cited by the researchers:

There is no evidence to suggest that significantly higher health-care expenditures are associated with either better outcomes or improved health status. Savings from administration and inappropriate care are sufficient to provide coverage for those Americans currently uninsured.

U.S. health-care administrative costs are 60 percent higher than in Canada and 97 percent higher than in the United Kingdom.

"Universal access and cost control can occur within the parameter of a mixed private/public delivery system. It does not imply or require government ownership or operation."