by Marian Shostrom and Pat Snyder, LWVDV Health Care Issue Co-Chairs
In 1990, LWVUS undertook a two-year study of the funding and delivery of health care in the United States. Phase 1 studied the delivery and policy goals and Phase 2 focused on health care financing and administration. LWVUS announced its final health care position in April 1993. The 2016 Convention updated the position by concurrence to include behavioral health. The Meeting Basic Human Needs position also addresses access to health care.
The League has actively participated in the health care debate since 1993. LWV Education Fund was involved in a major citizen education effort in 1994. LWVUS joined other organizations to successfully urge Congress to pass bipartisan child health care legislation (CHIP) in 1997. The League opposed the Medicare Prescription Drug bill (signed by the President in 2003), because of provisions that undermined universal coverage in Medicare. The League has supported implementation of the Affordable Care Act (ACA) at the state level, and expansion of the Medicaid program under the ACA. The League has fought attempts to repeal the ACA and to limit provisions that provide health and reproductive services for women. Following the 2018 election, the League urged congressional leadership to pursue an agenda that ensures that the best health and health care are equally accessible and affordable to all in the 116th session of Congress (2019-2021).
The LWVUS publication Impact on Issues, 2020-2022 contains the complete background and wording of both of the relevant positions (the Health Care position is on p.129-134 and the Meeting Basic Human Needs position is on p. 136). The LWV California website includes them as separate webpages.
THE LEAGUE’S POSITION (SUMMARY)
- A basic level of quality health care at an affordable cost should be available to all U.S. residents.
- Other policy goals should include the equitable distribution of services, efficient and economical delivery of care, advancement of medical research and technology, and a reasonable total national expenditure level for health care.
- Prevention of disease
- Health promotion and education
- Primary care (including prenatal and reproductive health),
- Acute care
- Long-term care
- Mental health care (including mental illness and substance use disorder), including needed medications and supportive service that is integrated with, and achieves parity with, physical health care
Under any system of health care reform, consumers/patients should be permitted to purchase services or insurance coverage beyond the basic level.
- A national health insurance plan financed through general taxes (commonly known as the “single payer approach”) in place of individual insurance premiums
- Administration of the U.S. health care system either by:
- A combination of the private and public sectors, or
- A combination of federal, state, and/or regional government agencies
- A strictly private market-based model of financing the health care system
- The administration of the health care system solely by the private sector or the states
As the U.S. moves toward a national health insurance plan, an employer-based system of health care reform that provides universal access is acceptable to the League.
The League supports increased taxes to finance a basic level of health care for all U.S. residents, provided health care reforms contain effective cost control strategies.
- Allocating medical resources to underserved areas
- Providing for training health care professionals in needed fields of care
- Standardizing basic levels of service for publicly funded health care programs
- Requiring insurance plans to use community rating (no variation based on age, medical history, tobacco use, occupation, etc.) instead of experience rating (an applicant or group's medical history and claims experience is taken into consideration when premiums are determined).
- Establishing insurance pools for small businesses and organizations
The League believes that the ability of a patient to pay for services should not be a consideration in the allocation of health care resources.
