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Panel Urges $6 Billion To Expand Health Coverage

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WASHINGTON--A blue-ribbon federal advisory panel on health care has called for a national system of schoolbased clinics and health-insurance policies based on school enrollment.

The panel, which was chaired by Deborah Steelman, a political adviser to President Bush during his 1988 election campaign, included the proposals in a plan recommending that the federal government spend at least $6 billion to provide medical insurance to the uninsured.

Other members of the 14-member Advisory Council on Social Security, whose recommendations are expected to play an important role in shaping Mr. Bush's platform on health issues during his re-election campaign, included lawyers, executives, academics, and union leaders.

In its report, issued last month, the panel estimated that if all its recommendations were carried out, an additional 20 million Americans would have health insurance. About 35 million Americans, one-third of whom are children, currently lack such insurance.

School-Related Efforts

To improve access to health care, the panel recommended that $3 billion be divided between two major initiatives. The first would provide more health care to young people through school-area clinics for children under age 12 and school-based insurance for children and young adults up to the age of 22.

These would be voluntary programs that would be subsidized for young people from families with incomes less than 185 percent of the federal poverty level, or $24,790 for a family of four, and would be available to others on a sliding-fee basis.

As proposed, the clinics would offer a full array of preventive services, including immunizations and dental care. For adults, the panel called for the creation of 250 new community-health centers in poor neighborhoods.

The panel also called on the federal government to spend an additional $3 billion to allow states, regions, and communities to test various health-care-delivery programs.

To pay for these programs, the panel recommended that taxes on alcohol and tobacco products be increased.

It also urged that: private insurers not be allowed to exclude certain individuals from coverage because of preexisting medical conditions; workers be allowed to carry their insurance policies from one job to another; health insurance become more available to small businesses; medical malpractice laws be reformed; and medical professionals evaluate the cost-effectiveness of treatments.

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