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Universal Coverage Results Are In

Healthcare Power Poll members say universal coverage doubtful any time soon

Healthcare  |  July 10, 2019 6:00am  |  By Joel Lee

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Look at any of the polls in the run-up to the 2020 election and you can see that healthcare remains the top item on the nation’s To-Do list. Lots of work to be done in controlling cost, in encouraging healthy lifestyles, in improving quality and in choosing the best way to manage this sprawling sector of the economy. But at the very top of the To-Do list is finding a way to offer healthcare to everyone in a way that is affordable.

The Healthcare Power Poll panel of the 1,000 most influential leaders in the industry is not enthused about the near-term prospects for universal coverage. Only 21% of the panel felt that universal coverage would happen by 2025. And for the purposes of this question we defined universal coverage as affordable coverage for 95% of the US population. Just under two-thirds of respondents thought that level of coverage would be achieved before 2030. A surprising 15% of the sample predicted it would take more than 20 years or might never happen.

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We also wondered what vehicle would be used to take the next big step forward in coverage. About 40% of the responders predicted that a public option would be the next important mechanism for expanding coverage. (34% favored a national public option through the ACA and 6% leaned toward a state offered public option). The next most predicted approaches were in a dead heat at 13% —split between a Medicare option for people 55 and older and an increase in subsidies under the Affordable Care Act. Only 11% predicted that Medicaid expansion would be the next significant push. Fully 23% thought the next big jump in coverage would use some other still-to-be-described vehicle.

We wondered how these leaders viewed universal access from a philosophical point of view. A full 36% saw healthcare as a basic human right. Another 34% favored universal coverage as a societal good but not a human right. Just about 15% view it as a consumer good that should be subsidized for the poor within reasonable limits of government’s ability to pay. Just a touch more than 1 in 10 responders thought that the statement "universal healthcare is a prudent investment in national productivity" most closely matched their thinking.