Universal Health Care Shouldn’t Be Reduced, Lancet Says

Expansion of government-subsidized medical care improves health and should be maintained in times of economic crisis, according to a survey of research.

Programs such as Medicare for senior citizens and Medicaid for the poor in the U.S. and similar programs in other countries led to increased use of preventive, inpatient and outpatient services and better health status for previously uninsured populations, Peter Smith and Rodrigo Moreno-Serra of Imperial College London wrote in The Lancet medical journal today.

Their paper comes as U.S. President Barack Obama’s 2010 health-care overhaul faces attacks by the Republican party in an election year. The Republican nominee, Mitt Romney, has vowed to repeal the law and last week adopted a platform that advocates Medicare changes in which senior citizens are given financial support to purchase private insurance to stem the increase in public debt.

“The available evidence has shown that when Medicaid and Medicare were expanded, the beneficiaries saw an improvement in health status and suffered less financially,” Moreno-Serra said in a phone interview. “If countries rely more and more on private spending, this will be detrimental to health outcomes and financial security.”

Obama’s Patient Protection and Affordable Care Act requires people to obtain health insurance or face financial penalties, and, among other provisions, establishes subsidies to help people purchase policies on state-level exchanges and expands coverage of pre-existing conditions. The U.S. Supreme Court upheld the core of the law in June.

China, Thailand

The survey, funded by the New York-based Rockefeller Foundation, also cites examples in China and Thailand where the introduction of heavily subsidized health insurance programs have led to increased use of medical services.

In low-income countries, universal health care as a goal has also faced “powerful headwinds” since the financial crisis began in 2008, said Jeffrey Sachs, an economist at Columbia University, said in an article accompanying the paper.

Increased access to public health care, supported by donor aid, has resulted in sharp declines in deaths from malaria and child and maternal mortality in poor countries, he said.

“Cuts in aid at this point could undo the great progress of the past decade,” Sachs said. “Universal coverage for health is within our reach -- if we persevere.”

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