Health Care Reform Resource Materials

League of Women Voters^®
of Orange-Durham-Chatham

Health Care Terminology. Article of Interest. Suggested Readings. Websites of Interest.

Health Care Terminology

Understanding the technical terms candidates use as they discuss health care reform proposals is critical to making informed decisions as we vote at both the state and national levels. A better understanding of what candidates really mean when they use these terms can also help us understand how their proposals fit with the League's position on health care. A brief list of some of the more frequently used terms follows. The information included here was drawn from the following websites, all of which are excellent resources for more in-depth reading and exploration of the many issues surrounding health care reform:
- Physicians for a National Health Program
- The Kaiser Family Foundation
- The National Conference of State Legislatures
- Understanding Health Policy, 4th Ed. By Thomas Bodenheimer and Kevin Grumbach. McGraw Hill, 2005.
- Universal Health Coverage: Includes all members of a geographic or political entity, regardless of an individual's health status, and provides everyone access to a basic level of health care services.
- National Health Insurance: This term is sometimes used interchangeably with universal coverage. A National Health Insurance program implies governmental guarantee that everyone has insurance for basic health care.
- Single Payer: Health care is paid for out of a single publicly administered trust fund (as opposed to our current multi-payer system in which costs are covered by a number of different entities). A single payer system addresses how health care is financed - individual proposals may differ in how health care is delivered (i.e. how patients choose providers, etc).
- Individual Mandate: Requires all adults who do not have employer sponsored insurance to purchase health insurance coverage or pay a penalty.
- Employer Mandate: Requires all employers of a certain size to provide health insurance for employees or pay a penalty.
- "Pay or Play" approach: this is a term used to describe states using their tax authority to require that employers of a certain size "play" by spending a certain amount of their payroll on health coverage for employees or "pay" a fee in the form of a tax (which might be used for state sponsored health programs).

Article of Interest

NB: Save this one and share it with others. It is one of the most important policy messages during this window of reform.
Health Affairs, June 10, 2008: How Many Are Underinsured?
Trends Among U.S. Adults, 2003 And 2007. Growing numbers of adults with insurance find that they are not adequately protected from the rising cost of health care. Authors: Cathy Schoen, Sara R. Collins, Jennifer L. Kriss, and Michelle M. Doty

Abstract

With health insurance moving toward greater patient cost sharing, this study finds a sharp increase in the number of underinsured people. Based on indicators of cost exposure relative to income, as of 2007 an estimated twenty-five million insured people ages 19-64 were underinsured -- a 60 percent increase since 2003. The rate of increase was steepest among those with incomes above 200 percent of poverty, where underinsurance rates nearly tripled. In total, 42 percent of U.S. adults were underinsured or uninsured. The underinsured report high levels of access problems and financial stress. The findings underscore the need for policy attention to benefit design, to assure care and affordability.
Study Results and Discussion

Suggested Readings

The Obama Administration's Options for Health Care Cost Control: Hope Versus Reality by Theodore Marmor, Ph.D., Jonathan Oberlander, PhD, and Joseph White, PhD.
Great Expectations -- The Obama Administration and Health Care Reform. Jon Oberlander's most recent assessment on the possibility of health care reform in the current administration.
The Politics of Paying for Health Reform: Zombies, Payroll Taxes, And the Holy Grail by Jon Oberlander published October 21, 2008 in Health Affairs.
Bills introduced by Verla Insko (2007-2008 Session)
The Politics Of Health Reform: Why Do Bad Things Happen To Good Plans?by Jonathan Oberlander, Health Affairs, 27 August 2003
The Political Life of Medicare (American Politics and Political Economy) by Jonathan Oberlander, (Paperback, June 2003)
The Path To Universal Health Care by Jonathan Oberlander and Theodore R. Marmor, Next Agenda, February 2, 2001
Adam Searing is editor of the Health Care Reports written for the NC Justice Center, a nonprofit anti-poverty organization, founded in 1996 to reduce and eliminate poverty in North Carolina. The Center houses a Publication Archives containing Searing's Health Care Reports and various other publications written by the Center. When on the archives page, you can search at the top of the page by either "health advocacy" or "NC Health Reports" to find a listing of health care publications of interest. Speedbumps on the Road to Affordable Coverage for All by Adam Searing, NC Health Report, November 2, 2006, is an example of the Health Care Reports you will find at this site.

Websites of Interest

Health Care Fact Sheets by the LWVUS Health Care Education Task Force.
Balanced Choice Health Care
Everybody In, Nobody Out
Expanded & Improved Medicare For All Bill HR 676
Families USA
Health Care for All NC
NC Mental Health Vote
Physicians for a National Health Program (PNHP)
The NC Justice Center's Health Care Webpage
Wisconsin Health Care Proposal

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