Abstract
Introduction
The controversial issue of establishing universal health insurance has
recently reclaimed the spotlight in the United States. Various states, members
of Congress, President George W. Bush, and 2008 presidential hopefuls are
proposing plans to make health insurance more accessible to the approximately
47 million U.S. residents who do not have coverage.
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- Massachusetts, Maine, and Vermont are leading the way in expanding
universal health care coverage. How have these states achieved consensus on
such a hot button issue? What are the key elements of these state health care
plans? What are the implications for other reform efforts?
- Other states have expressed considerable interest in Massachusetts'
groundbreaking universal coverage plan. Which states have viable programs on
the horizon? What have they learned from the Massachusetts planning and
implementation process that will help them develop their own successful new
universal coverage plans?
- As this fl urry of state health reform activity continues, proposals at
the federal level aim to complement state efforts or to set in motion sweeping
national reform. Which initiatives have gained national support? Which of the
universal coverage bills in Congress target drug pricing?
- Universal coverage proposals may threaten to take greater control over
drug prices. Would new initiatives give states the power to negotiate drug
prices with manufacturers? Are proposals requiring drug-price negotiation
likely to garner much support in the near future?
Scope
- Massachusetts: leading the way. Details on passage and implementation of
the plan, the mandate for individual coverage, employer responsibilities,
implications for other reform efforts, and future challenges.
- Maine: at the forefront of universal coverage. DirigoChoice plan details,
cost-containment reforms, Maine Quality Forum, implications for other reform
efforts, and future challenges.
- Vermont: implementation looming. Catamount Health plan details, employer
responsibilities, chronic care initiatives, implications for other reform
efforts, and future challenges.
- National solutions: universal coverage at the federal level. The Bush
administration proposal, Medicare for All, Healthy Americans Act, and
state/federal partnerships.
- Future perspectives: promise and problems. Value of compromise and
cooperation, potential pitfalls for state initiatives, cost-control issues,
and drug pricing.
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