MANAGED CARE January 2003. ©MediMedia USA
Accommodating oneself to an idea whose time has come is either like riding a wave or riding a tiger's back. A push for universal health care was defeated in Oregon in November thanks, in part, to opponents spending $5.8 million to defeat it.That was about four times as much as proponents spent.
Backers of universal coverage vowed that the idea wouldn't die, and they were right.
Before he decided not to enter the 2004 presidential race, former Vice President Al Gore had come out for universal coverage. Massachusetts Sen. John Kerry, who is considered a frontrunner for the Democratic nomination (though he hasn't formally announced his candidacy), also likes the idea.
Now, some health plan executives support the proposal, apparently believing that universal coverage not only doesn't mean the end of managed care, but could be what saves it. The trick is to divorce universal care from the notion that only a single payer — the government — can provide such services.
"If we don't do something in a darn hurry about the uninsured, the whole health care system in this country is going to collapse and the government will step in," says Chuck Butler, vice president of Blue Cross Blue Shield of Montana.
He wants state legislators to increase taxes on cigarettes to ensure "basic coverage" for all residents.
Bruce Bodaken, CEO of Blue Shield of California, wants that state to adopt a universal care system that would, according to the New York Times, provide "an essential benefits package, designed by independent medical professionals, that would guarantee preventive care, physician services, hospital care, and prescription drugs" through private or public health insurers.
William McGuire, MD, CEO of UnitedHealth Group, the nation's largest for-profit insurer, has sent letters to each member of Congress, asking them to OK a plan to provide "essential health care for all Americans."
Such lobbying makes business sense.
"It would dramatically increase the size of the market and spread the risk better," says Todd B. Richter, a health care analyst with Banc of America Securities, about Bodaken's comments.
Also, addressing the problem of the uninsured will help to shore up the health care system.
Caution. Politicians may want to go further with an idea that hasn't been associated much with the managed care industry. Executives should always keep in mind that stealing the thunder of a populist movement means standing close to the lightning.