Maybe I wrote in invisible ink
October 29, 2004 -- On October 20, the Columbia University School of Nursing issued a press release about its striking plan to provide universal health care coverage to all Americans at an estimated annual cost of about $2,000 per person. As of today, the only major press coverage of this important proposal of which the Center is aware is Laura Gilchrest's fair but short piece "Universal health care plan proposed," which was posted on the CBS Marketwatch web site just a few hours after the press release appeared.
As CBS Marketwatch reported, the nurses' proposal is outlined in a report called "Essential Health Care: Affordable for All?" which is published in the October/November 2004 issue of Nursing Economics. The CBS piece notes that the plan, which is based on a decade of experience by Columbia advanced practice nurses in New York, focuses on "providing incentives to prevent serious diseases as the best way to cut skyrocketing health care costs." The proposal would cover every American, including the 43 million now uninsured, for an annual per capita premium of $2,074, "including out-of-pocket expenses limited to $1,500 and excluding co-payments for prescription drugs;" it would cover generic drugs, and prescription drugs where there was no generic equivalent avaliable. The report did not advocate a payment strategy, but noted that the cost could be met through public or private funding, including employer subsidies or self-payment. The CBS article explains that the nurses' report blames rising costs "mainly on the overuse or inappropriate use of drugs and inadequate management of chronic diseases." The CBS piece appears to have been based entirely on the press release. It could have benefited from reaction quotes from scholars, policy experts, and government officials, as well as from more background, such as information on the particular expertise of advanced practice nurses in preventing and managing chronic disease in a cost-effective way.
However, we commend CBS and Ms. Gilchrest for covering the story at all, given that their report appears to be the only major mainstream press account to date--despite a press release that effectively presented the newsworthy elements of the plan, the fact that those behind the plan represent one of the nation's leading universities, and the prominence of health care coverage issues at the height of the current Presidential campaign. It is not a paucity of space in the nation's periodicals; without naming names, we think it is fair to say that a great deal of marginally important health news has been published in the last nine days. It is difficult to avoid the conclusion that the Columbia plan was largely ignored because of the professional status of those who created it and those who edit the journal in which it appeared. We can't help but envision the mental reaction of many editors and reporters as going something like this: "What's this? Universal coverage for $2K?! Wow! Who's behind this? Oh...what else have we got?"