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Having 50 Million Uninsured Americans Is Bad Enough, But…

October 2011

Sidney M. Wolfe, M.D.

The latest government data found that over 50 million people in this country lack health insurance. Combined with a poverty rate higher than it has been in 50 years, this is a recipe for disaster. But it gets worse.

The Institute of Medicine (IOM) of the National Academy of Sciences has just recommended that cost rather than medical need be the basis for defining the “essential benefits” that insurance policies must cover when the federal health reform law takes effect in 2014.

The inadequate coverage the IOM recommends would shift costs from corporate and government payers onto families already burdened by illness. Yet this strategy will not lower costs. Delaying care often creates even higher costs. Steadily rising co-payments and deductibles over the past two decades have failed to stem skyrocketing medical inflation. And nations that assure comprehensive coverage - with out-of-pocket costs a fraction of those in the U.S. - have experienced both slower cost growth and greater health gains than has our country.

Patients urgently need what people in these other nations already enjoy: universal and comprehensive coverage in a nonprofit system that prioritizes human need over corporate profit.

The IOM committee was riddled with conflicts of interest, many members having amassed personal wealth and career success through their involvement with health insurers and other for-profit health care firms. The committee’s recommendations were lauded by insurance industry leaders who have sought to undermine real health reform at every turn. As the Lancet medical journal noted in its Dec. 5, 2009, cover story: “Corporate influence renders the U.S. government incapable of making policy on the basis of evidence and the public interest.”