Former CMS Head Vladeck Calls for Universal Health Care

Providing health coverage to all the uninsured in the United States would cost "only a fraction" of the $1.6 trillion the nation will spend on health care this year, Bruce Vladeck, former administrator of CMS, then known as the Health Care Financing Administration, said on March 18 at a forum sponsored by the American Public Health Association, Reuters Health reports. Vladeck, now teaching at the Mount Sinai School of Medicine, said that so many uninsured people in the United States -- about 41 million in 2001 -- hurts "not only those without coverage" but also the nation's economy "as a whole, in sometimes unexpected ways." According to Vladeck, between one-third and one-half of all personal bankruptcy filings are associated with high health care costs. Dr. Harvey Fineberg, president of the Institute of Medicine, said while the uninsured receive "some care," it is "inadequate" compared to the care available to those with health insurance. Further, Fineberg said that the uninsured often receive care "too late," are sicker and die sooner than the insured and that uninsured children often have developmental problems "that are common and correctable" if they receive proper preventive care. Vladeck said, "[W]e think we need to be comfortable with ways to contain the costs" before implementing universal coverage but doing so is "holding the uninsured hostage to our inability to address costs or address inefficiencies" (Rovner, Reuters Health, 3/19).