Neal Halfon, M.D., MPH, is professor of pediatrics, health services, and public policy and directs the UCLA Center for Healthier Children, Families and Communities. Halfon also directs the Blue Sky Health Initiative, whose core team contributed to this article.
The case for universal health-insurance coverage is becoming universally acknowledged. To make a real difference in health outcomes, cost, and system performance, we need to cover the whole person, with a full continuum of appropriate care, and ensure continuity over a person's entire life. Anything less will perpetuate inefficiencies and poorly coordinated coverage, which engender fragmented and poor-quality care. But universal coverage alone is not sufficient to reduce the remarkable 35-year difference in life expectancy across different classes of Americans. Universal coverage alone is also not likely to greatly improve the United States' ranking of 46th in life expectancy and 42nd in infant mortality among 192 nations.