Universal Coverage – A Call for Action

Joseph S. Perkins
President, AARP
“Universal Coverage – A Call for Action”
National Coalition on Health Care Leadership Summit
The Carter Center, Atlanta, Georgia
January 26, 2000

The most enduring lesson we’ve learned in AARP’s 41 years is this: The foundations for a healthy and fulfilling old age must be laid early in life. We have learned, too, that these foundations must be supported by wise social policy and strong supporting structures.

Another lesson we’ve learned is that, among the truths of the human experience, perhaps the most difficult for people to understand – and to accept – are those related to aging. I can think of few other benevolent explanations for our failure as a society to place health care at the top of our personal and public priorities.

I can think of a few explanations that are not so benevolent -but I won’t go there today.

The most basic truth of the human experience is that aging is a process that begins at birth. Yes, aging begins at birth, not at age 50, or at age 65. Aging is a lifelong continuum. We can never escape the consequences of our experiences at prior stages in life. In no area is this more evident than our health. Health care denied in earlier years often leads to health problems later in life. Period.

To put it in terms of today’s policy debate, the health care we provide our children and our younger adults today will have a tremendous effect on the care we will have to provide for the elderly of tomorrow.

The quality of health care we provide today will also have a tremendous effect on the cost of providing that care tomorrow – the cost to our taxpayers, the cost to our families – the cost to our nation. And, the quality of health care we provide our younger generations today will have a direct effect on the overall quality of life for tomorrow’s older Americans.

Accordingly, AARP deplores the fact that – in the United States of America, in the year 2000, nearly 44-and-a-half million people have no health insurance at all – and the number is rising – at a time when we have the strongest economy we’ve had in 30 years!

We know the uninsured are less likely to seek medical treatment when they need it, are less likely to get routine medical check ups, and are less likely to have the tests and the screenings that can often lead to early detection. This leads, in many cases, to more expensive treatment down the road.

Fortunately, because of Medicare, nearly 99 percent of Americans over age 65 enjoy basic health insurance coverage. But for the reasons I mentioned, among many, AARP has adopted the principle that all Americans have a right to health care services when they need them.

Further, we’ve adopted the principle that all Americans have a right to reasonable access to health care coverage that provides adequate protection against health care costs. We’ve also adopted the principle that all Americans have a right to high-quality health care.

You may have seen the television commercial on behalf of a chain of automobile repair shops. It ran for years. A veteran character actor implored us to get that noise checked out – so that the problem which might require an inexpensive repair now – would not turn out to require an expensive repair later. He bid us farewell by saying, “It’s up to you. You can pay me now. Or… you can pay me later.”

For me, that sums it up as simply as possible. It’s up to us. We can get serious about coming up with a way to pay for health coverage for those 44-and-a-half million people now.

Or, we can let our children and our grandchildren pay for the consequences later. As a parent and a grandparent, that is a prospect I deplore.

I’m hearing more and more from AARP members who feel the same way. They worry more about what their children and grandchildren are going to face, than they worry about themselves. This is a fact our elected leaders and candidates had better face up to. The older voter today is concerned not only with issues that affect them directly, such as prescription drugs and long-term care. Not by a long shot.

Today’s older voter cares deeply about issues of concern to Americans of all ages. Why? Because their loved ones are of all ages.

AARP has long advocated comprehensive reform of the U.S. health care system. We need a system that ensures universal access to needed health care services and health care coverage for all Americans, including those with disabilities or existing health problems.

There should be a minimum benefit package to which all are entitled, and there should be strong and coordinated quality assurance programs. Government, employers, and individuals should share the responsibility to participate in health care financing. But our present method of financing health care should be replaced by fairer, and more progressive financing approaches.

Burdensome cost-sharing requirements such as high deductibles and coinsurance requirements should be avoided because they disproportionately burden the poor, and those with chronic and severe health problems.

The American people, through our federal and state governments, should subsidize the cost of health care coverage for individuals with lower incomes and should fully finance health care coverage for the poor.

This is the minimum level of social responsibility members of a free society should accept, in my view. And, any system should preserve the dignity of the individual, regardless of his or her income level.

Until we achieve comprehensive national reform, AARP supports incremental steps to improve access to affordable coverage. We are pleased to see that, in many states, the pace of legislative activity targeted at health care reform has increased.

But that’s just a beginning. Comprehensive health care reform at the national level remains AARP’s goal.

As a first step in this critical election year, we must pledge to not allow the matter of the 44-and-a-half million uninsured to slide off the radar screen in the election campaigns.

There are a lot of people counting on us. We can’t let them down.