Statement on Health Care Reform
February 23, 1994
The Friends Committee on National Legislation seeks comprehensive reforms in our health care system, so that all people in this society will be able to receive high-quality, comprehensive health care services.
Our commitment to universal health care arises from our basic belief that all persons have right to live in dignity, and that our society should order itself and its resources to assure the exercise of this basic right. Health care is one important resource for the preservation of life and dignity.
With guidance from our Quaker constituency, many of whom are involved in health care professions, the Friends Committee on National Legislation has identified specific concerns as challenges to be addressed within any comprehensive reform package. We believe that the future of this nation’s health care system will help to define the future of our true "national security" - the physical and mental well-being of this nation’s people and communities. Specifically, we seek the following principles in any health care reform proposal:
- Comprehensiveness. A comprehensive health care system must offer adequate services to keep a population healthy. A comprehensive system should address not only treatment, but also, prevention of illness and injury. The services should emphasize primary care, public health and health education. In deciding which services to include in a health care plan, plan designers should place high priority on health care assistance that enables the population to preserve and to live in health and dignity.
- Availability. A comprehensive health care plan must reach different kinds of populations in different places. It must work well in rural areas, as well as in inner cities. It must be truly available to people with no money and people with little money. It must serve all residents, regardless of employment status or citizenship.
- Diversity. A comprehensive health care plan must recognize the diverse nature of the populations of the United States. Our needs and expectations vary among many different age groups, cultures, ethnicities, languages, income levels and regions. The differences among our communities manifest themselves in different health needs. Poverty, for example, is not only a barrier to health care - it can also be a cause of poor health. Decisions about the operation and oversight of health care plans must be made by groups that adequately represent the diversity of the population served by the plans.
- Local Accountability. A comprehensive health care plan should be designed to improve the health of the population. To accomplish this, local or regional boards or commissions should be charged with the responsibility of conducting local health assessments, and should be authorized to make adjustments in the national or "standard" health care plan to respond to local health needs. Within agreed national standards, decentralized control will help to: 1) accommodate diverse needs within the larger system; 2) encourage close attention to causes of illness in the local area - even when the causes are primarily environmental, occupational, social or income-related; and 3) focus attention on the appropriate and equitable use of expensive technologies and facilities in the local area; and 4) result, ultimately, in a stronger and healthier citizenry.
- Distribution of Health Care Resources. In order to provide adequate health care in underserved areas (including many rural and inner city areas), special attention to the distribution of health care resources is needed. These underserved areas need health care facilities and technology, doctors and health care professionals, transportation and support system.
- Cost. If this nation is to sustain a comprehensive health care plan, it must be affordable – both to the nation and to individual participants. To be sustainable, the health care system should be financed through a progressive tax. A "flat tax", such as the one that finances the Social Security System, will place an undue (and perhaps unsupportable) burden on low-income workers, and will further diminish the progressivity – and therefore the fairness – of the federal tax system. Employer-dependent tax schemes tend to create unsupportable burdens for the smaller employers; such financing structures would have to be supplemented by revenues from another source (presumably) to support health care for unemployed persons.
The nation has a strong public health interest in providing free or very low cost health care to individuals and families with low or no incomes. Unless the reformed health care system serves people at all income levels, the system will not be able to realize sufficient savings to maintain itself. The costs associated with unhealthy populations and with uninsured care will overburden any less-than-universal system, and will drive costs out of reach once again.
The Friends Committee on National Legislation will continue to provide educational materials and workshops on these concerns and on Congress’s progress toward universal health care. We will also continue to labor with congress members and their staffs to insure that these critical principles are included in proposals that move forward in the national debate.