Who’s got the cure? Four options for achieving universal coverage

On July 17, 2007, The Project held two panel roundtable discussions on four alternative policy proposals for achieving universal health care coverage in the United States and the merits and challenges of the various proposals. Following opening remarks by former U.S. Treasury Secretary and Hamilton Project Advisory Council member Robert E. Rubin, the first panel highlighted four new discussion papers on achieving universal coverage and the second panel explored the merits and challenges of the various proposals for achieving universal coverage.

Brookings Senior Fellow and Hamilton Project Director Jason Furman moderated the first panel that presented four new discussion papers on achieving universal coverage. Johns Hopkins University’s Gerard Anderson and Hugh Waters’ paper proposed Medicare Part E(veryone), which would allow people to keep their current employer-sponsored health care coverage while at the same time offering coverage to all individuals and employers through expansion of the Medicare program (with subsidies for low-income individuals). The second proposal by Stuart Butler of the Heritage Foundation would move beyond the traditional model of employer-sponsored health insurance by creating state-chartered insurance exchanges to offer portable health plans and by reforming the tax treatment of health care. Ezekiel Emanuel, of the National Institutes of Health, and Victor Fuchs, of Stanford University, offered a plan to give vouchers to every American to pay for basic health insurance. They argue the vouchers, which would be funded by a value-added tax, would provide portability and promote greater cost-effectiveness. Finally, Jonathan Gruber of the Massachusetts Institute of Technology examined the feasibility, costs, and benefits of extending nationwide the “Massachusetts model,” which provides universal coverage through a combination of individual mandates, subsidies to low- and moderate-income households, and alternative risk pools to purchase insurance.

Joanne Silberner, health policy correspondent for National Public Radio, moderated the second panel of experts from the business, labor, and policy communities, who explored the merits and challenges of the various proposals for achieving universal coverage. Panelists included former U.S. Treasury Secretary and Hamilton Project Advisory Council member Lawrence H. Summers, Brookings Senior Fellow and former Administrator for the Centers for Medicare and Medicaid Services (CMS) Mark B. McClellan, AFSCME International President Gerald W. McEntee, and Chairman and CEO of General Mills Stephen W. Sanger.