Experts call for health cover in U.S., cite study
Wed Feb 20, 2008 8
HONG KONG (Reuters) -
Experts called for universal health insurance in the United States, citing a study in Taiwan that showed it increased life expectancy and closed the gap between those who were most healthy and least healthy.
In a commentary published in the Annals of Internal Medicine, the experts said Taiwan's experience lent "credence to the argument that the United States should join other industrialized nations in ensuring universal health insurance coverage".
"Our failure to introduce national health insurance undermines access to care for millions and is a major factor in health outcome disparities and highly preventable deaths in the United States," wrote Karen Davis, of The Commonwealth Fund, and Andrew Huang, of Duke University Medical Centre.
Their call accompanied an article in the same journal on a 10-year study in Taiwan that showed that universal health insurance raised life expectancy.
However, the Taiwan researchers considered the improvements to be modest and called for more aggressive disease prevention programs to reduce lifestyle-related illnesses, such as cancer.
"Two risk behaviors among men in Taiwan, smoking and betel quid chewing, remained high after the introduction of national health insurance," the Taiwan researchers wrote.
"Every second middle-aged man is a smoker and every fourth is a chewer ... which could account for the large increases in lung and oral cancer in the lower socioeconomic groups and the relatively small reduction in health disparities."
Taiwan introduced universal health insurance in 1995, which extended insurance coverage from 57 percent of the population to everyone. Co-payments are required, however: 10 percent for inpatient and 20 percent for outpatient care, although these are waived for the very poor, veterans and indigenous groups.
National health expenditure rose modestly, from 5.1 percent of gross national product before 1995 to 6.2 percent in 2005.
Visits to the doctor and use of medication increased substantially after 1995, especially among the elderly and poor.
The most obvious positive correlation was life expectancy for men, which increased to 74.22 years from 71.83 years after universal health insurance.
There was a reduction in deaths from cardiovascular and infectious diseases, and from accidents, but deaths from cancer and diabetes rose.
(Reporting by Tan Ee Lyn; Editing by Alex Richardson)