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4. Principles to Guide the Extension of Coverage
Pages 110-117

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From page 110...
... Any solution that brings coverage to those without insurance cannot simply plug the gaps in the current "non-system." At a minimum, it must reform many aspects of current health finance and will, inevitably, touch on aspects of health care delivery as well. Optimally, reforms to increase coverage will improve both health insur110
From page 111...
... VISION STATEMENT The Committee on the Consequences of Uninsurance envisions an approach to health insurance coverage that will promote better overall health for individuals, families, communities, and the nation by providing financial access for everyone to necessary, appropriate, and effective health services. Although insurance coverage is critical, it is not the only element of any plan to improve access to health care nationally.
From page 112...
... The Committee has documented the adverse impacts of being uninsured on the health and economic well-being of uninsured persons and their family members. Uninsured persons are less likely to get the timely and appropriate health care that they need.
From page 113...
... By "affordable," the Committee means that no one should be expected to make contributions to their health care coverage that are so costly that they cannot pay for the other basic necessities of life or afford to access health services. Because patient cost sharing at the point of service can deter use, no one should face a level of cost sharing so high that it would interfere with obtaining timely, necessary health services (Newhouse and The Insurance Experiment Group, 1993; IOM, 2002b)
From page 114...
... The sustainability of a given coverage strategy will depend, to a large extent, on the inflation rates for health care and health insurance and the ability to keep spending under control. During the past two years, high rates of increase in the cost of health insurance have contributed to employers shifting costs to employees,
From page 115...
... The revenue issue is beyond this Committee's charge and further discussion of it is limited. The Committee has reported previously the range and substantial amount of spending related to uninsurance, particularly by the public sector, and the dangers posed to the health care system by instability in public and private funding streams.
From page 116...
... To the extent that reform of the insurance system affects health care delivery, it should promote those aims. The best clinically relevant research evidence should play a role both in defining the features of benefit packages and in the daily delivery of care.
From page 117...
... PRINCIPLES TO GUIDE THE EXTENSION OF COVERAGE 117 The next chapter examines various prototypes of insurance systems that could achieve the Committee's vision of health insurance that will promote better overall health for individuals, families, communities, and the nation by providing financial access for everyone to necessary, appropriate, and effective health services. It will assess each model against the principles presented in this chapter.


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