Prioritizing health-care reform components

Faced with a barrage of pressing issues, the Obama administration has placed health-care reform high on its agenda. The timing bodes well for change, according to Aaron E. Carroll, M.D., director of the Indiana University Center for Health Policy and Professionalism, associate professor of pediatrics at the IU School of Medicine and a pediatrician at Riley Hospital for Children.

"If the new administration wants to accomplish significant reform, they will need political capital, which they have now," says Dr. Carroll, who is a health services researcher and a Regenstrief Institute affiliated scientist.

"We have a government elected with a mandate for change and health care is an area that requires reform. Moreover, with the economy in its current state, with unemployment on the rise, and with health care costs on the ascent, more and more people will not be able to afford insurance or health care. Therefore, more will be in need of reform."

According to Dr. Carroll there are now more than 45 million people in America who have not had health insurance for the entire year; almost twice that number lack coverage for a portion of the year. Over the last few years, most of the newly uninsured are from the middle class. As unemployment rises, along with food, utilities and other prices, a growing number of people will be unable to afford health insurance, especially as it gets increasingly expensive.

"The combination of a sagging economy, increasing numbers of uninsured, and a disproportionately affected middle class makes this a critical junction," said Dr. Carroll.

But he says the public and their elected representatives need to be realistic. "It is impossible to improve access and improve quality and reduce costs at the exact same time. We need to prioritize. As we already spend much more on health care than any other country, and we are committed to spending even more to stimulate the economy, it seems rational to focus on access to health care and quality of care first."

Established as an independent objective source of health information, the IU Center for Health Policy and Professionalism translates research into practice in a timeframe that satisfies the needs of policymakers and other decision makers.

Last year, the center published the results of a national survey of physician opinion on national health insurance in the Annals of Internal Medicine. The largest survey of American physicians' opinions on health-care financing, it found that 59 percent of doctors support government legislation to establish national health insurance while only 32 percent oppose it. A similar survey conducted by the IU researchers in 2002 found 49 percent of physicians supporting national health insurance and 40 percent opposing it.

Source: Indiana University