Health Reform, Insurance Mandates, Role of Nonprofits Under Universal Coverage Highlighted in INQUIRY Journal

ROCHESTER, NY (05/23/2008)(readMedia)-- Opinion polls repeatedly show health care to be a major concern for Americans and proposals for expanding health insurance coverage are issues of debate in the U.S. presidential race. Two articles in the spring 2008 issue of INQUIRY add to this discussion of health reform. In “The View from Here,” INQUIRY Editor Alan C. Monheit examines health insurance mandates, and in our “Dialogue” feature, a panel of health industry experts looks at the role of nonprofits under universal coverage.

“Rehabilitation of Health Insurance Mandates” – In this column, Monheit outlines reasons for shifting from supply-side “fixes” to the market and re-considering “demand-side” initiatives---health insurance mandates---to make coverage more accessible to the uninsured. Compared to a voluntary approach, mandates have the potential to achieve universal coverage, to eliminate the problem of adverse selection and to assure greater equity in the delivery of health care. But, he notes, providing the required monetary subsidies to fund individual mandates is a concern. “Proposals for coverage expansions by the leading presidential candidates have been noticeably vague about the precise sources of financing,” Monheit writes. “Advocates of mandated insurance expansions may find themselves competing for a place in the social expenditure pecking order.” While there are compelling reasons to support insurance mandates, Monheit says “advocates should not turn a blind eye to the necessity of reliable and stable financing sources that are crucial to make the mandate both economically and politically acceptable.” Article available at http://www.inquiryjournal.org

“Nonprofit Health Care Organizations and Universal Health Care Coverage” – Moderated by Bruce McPherson, president and CEO of the Alliance for Advancing Nonprofit Health Care, this is a candid exchange among five panelists:

  • Terry Andrus, president and CEO of the East Alabama Medical Center
  • William Cox, president and CEO of the Alliance of Catholic Health Care in Sacramento, Calif.
  • Brad Gray, principal research associate at the Urban Institute
  • Cleve Killingsworth, president and CEO of Blue Cross Blue Shield of Massachusetts
  • Paula Steiner, senior vice president of marketing and sales at Blue Cross Blue Shield of Illinois.

The group touches on issues such as quality, competition, state/federal reforms and the future of tax exemptions for nonprofits in a system of universal coverage. Notes Andrus: “Whether we are talking about community benefits, quality, or costs, this is all part of the larger movement toward greater transparency. Over time, under universal coverage, questions may well be asked about whether nonprofit hospitals and systems should have the same tax treatments as nonprofit Blue Cross Blue Shield plans. We will need to have good answers.” Article available at http://www.inquiryjournal.org

Also in the spring issue is a group of papers from an agenda-setting conference on health care markets sponsored by the Agency for Healthcare Research and Quality (AHRQ):

  • “Overview---Health Care Markets: Concepts, Data, Measures, and Current Research Challenges,” by Michael Hagan and William Encinosa
  • “Research on the Hospital Market: Recent Advances and Continuing Data Needs,” by Richard C. Lindrooth
  • “Health Insurance and Labor Markets: Concepts, Open Questions, and Data Needs,” by Bowen Garrett and Michael Chernew
  • “The Market for Long-Term Care Services,” by David C. Grabowski
  • “Retail Pharmacy Market Structure and Performance” by John M. Brooks, William R. Doucette, Shaowei Wan, and Donald G. Klepser
  • “Data Needs for Policy Research on State-Level Health Insurance Markets,” by Kosali Simon

Other research papers in the spring issue:

  • “Managed Care and Hospital Cost Containment,” by R. Tamara Konetzka, Jingsan Zhu, Julie Sochalski, and Kevin G. Volpp
  • “Socioeconomic Disparities in Medical Provider Visits among Medicare Managed Care Enrollees,” by Jeannette Rogowski, Vicki A. Freedman, Steve L. Wickstrom, John Adams, and José J. Escarce

INQUIRY is a peer-reviewed scholarly publication. Now in its 45th year, it is published quarterly by Excellus Health Plan, Inc. Press releases and open access articles are available at http://www.inquiryjournal.org/news/press_release_20080522.html

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