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From the Editor |
Will New Leadership Address The Issue Of The Uninsured?
Over the past twenty-five years the politics of health insurance reform has grown more conservative, while the number of people without coverage has increased to about forty-three million people. Even during an era of great prosperity, leading to large budget surpluses, Congress has been reluctant to take substantial strides toward resolving this problem, leaving millions of working Americans and their children without adequate protection against the financial consequences of illness. Now, with the inauguration of a new president and the seating of the 107th Congress —albeit in the aftermath of a historically close election that has fueled partisan animosity—the federal government will have another opportunity to address this long-festering societal concern. In an effort to provide new data and analysis to the health policymakers who would take up this cause, Health Affairs has largely devoted this thematic issue to papers that address the subject of expanding insurance coverage.
While acknowledging the support of the Robert Wood Johnson Foundation (RWJF) for the publication of this issue of Health Affairs, I would also like to express our appreciation to this philanthropy, for it has been our major benefactor over our twenty years of publication. Without the support of the RWJF and other foundations (the California HealthCare, California Wellness, John A. Hartford, Henry J. Kaiser Family, and W.K. Kellogg Foundations; the Commonwealth Fund; and the Pew Charitable Trusts), Health Affairs would long since have ceased publication for lack of adequate funds. With foundation support, the journal becomes more affordable while remaining free of paid advertisements.
The RWJF’s grant award for the issue was a small part of an ambitious and multipronged effort the foundation has launched to increase the number of Americans with health coverage. As part of its $100 million-plus effort, the foundation is assisting federal, state, and local governments and a wide variety of private organizations in finding innovative ways to reduce the number of Americans without insurance coverage. Under the leadership of its chief executive officer, Steven A. Schroeder, the RWJF is funding programs to (1) simplify and increase enrollment in currently available private and public insurance options; (2) generate new proposals for public and private arrangements to expand coverage; and (3) raise the profile of the uninsured through further research, demonstrations, policy development, and communications. Asked why the foundation has launched this comprehensive effort, Schroeder said: "The reality that nearly forty-three million Americans are uninsured sadly constitutes a substantial health threat for too many individuals who lack coverage. Moreover, the status quo amounts to a moral tragedy for all of us. The foundation looks forward to the day when no American will need to delay life-saving care because of a lack of coverage."
Our lead papers reflect the policy approaches generally favored by Republicans (tax credits), Democrats (expanding public programs), and consensus builders (some combination of the two) to increase the number of individuals with health insurance. The issue also includes a wide variety of other insurance-related papers as well as a study of the use of prescription drugs by Medicare beneficiaries who take antihypertensive medications.
Along with his large circle of admirers, friends, and professional colleagues worldwide, we mourn the passing of Avedis Donabedian of the University of Michigan, a true pioneer in improving the measurement of quality health care. Only weeks before his recent death, Fitzhugh Mullan engaged Donabedian in a conversation that revealed his deep misgivings about how seriously the quality pursuit is being taken by U.S. medicine (p. 137).
Finally, we welcome as subscribers all of the 2,000 individual members of the Academy for Health Services Research and Health Policy. The academy’s president, David Helms, and its Board of Directors thought that the broader distribution of Health Affairs could serve as an effective link between health services research and health policy, and they will now provide it as a benefit of academy membership.
Founding Editor
Related Article
- Fitzhugh Mullan
A Founder of Quality Assessment Encounters A Troubled System Firsthand
Health Affairs, January/February 2001; 20(1): 137-141.
[Extract] [Full Text] [PDF]
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