IOM: Fix Health Care's Woes by Using States as Laboratories


The Bush administration needs to "immediately" start using states as laboratories to come up with solutions to save a health system in crises, according to a report by the National Academy of Sciences.

The report, issued by a panel of experts appointed by the academy's Institute of Medicine, urges that such solutions as universal health insurance and no-fault payment for medical malpractice be tried in some states.

"The cost of private insurance is increasing at an annual rate in excess of 12 percent," the report states. "Individuals are paying more out of pocket and receiving fewer benefits. One in seven Americans is uninsured, and the number of uninsured is on the rise."

Health and Human Services Secretary Tommy Thompson could conceivably start some of the proposed projects on his own. Others would need Congress's OK, as well as federal funding.The Bush administration seemed receptive to the report, with officials saying that it could become a blueprint for demonstrations. The report — "Fostering Rapid Advances in Health Care: Learning from System Demonstrations" — suggests that three to five states be used in a project that would expand Medicaid or the Children's Health Insurance Program.

Just what may be done, and how soon, are open questions. Members of the panel acknowledge that health care is not a top priority at the moment.

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