New America on Health Policy

Recently, discussions around health care reform have begun in earnest among politicians and policymakers in Washington, D.C. and beyond. President Obama has spent the month of June hitting the trail and the airwaves making the case for reform,  and legislators are now aiming to pass a health care reform bill sometime this summer. With the possibility of comprehensive changes to health care on the horizon, it is important for leaders and policymakers—as well as citizens—to understand the full argument for… more

Our Vision for Health System Reform:

In these case studies for The Commonwealth Fund, Dr. Nichols and Tom Emswiler examine high-performing health care systems to see how they achieve better outcomes at lower cost. Both the Hill Physicians Medical Group, an association of physicians in individual practice, and the Baylor Health Care System, a highly integrated delivery system, have successfully standardized care, implemented electronic medical records, and improved clinical outcomes.

The ever-growing cost of health care is the largest threat to our nation's long-term fiscal future. One way of tackling this problem is by using Medicare-the nation's largest purchaser of health care-as a catalyst for widespread efficiencies in the private sector. Medicare must become a more value-based purchaser to make the Program sustainable over time and incent the private sector toward change. It is imperative that we act decisively and soon. Yet, we believe embarking on a Medicare-only reform effort

For the full text of the paper, please click here.

For a brief summary of the paper, please click here.

For Len Nichols' post on National Journal's Health Care Experts blog, please click here.  

About this paper:

"The Case for Health Reform: The Moral, Economic, & Quality Motives for Action" compiles the facts and figures that explain why health reform is a moral imperative, an economic necessity, and a necessary step toward ensuring our health system delivers high-quality care to us all.

Introduction The U.S. health care system is in crisis. Health care costs too much; we often get too little in exchange for our health care dollar; and tens of millions of Americans are uninsured.

One of the most pressing issues facing policymakers in the United State is rising health care costs. Cost growth is putting ongoing stress on the budgets of families, employers, and governments. The U.S. already spends $2.2 trillion a year - 16 percent of GDP - for health care. Nearly a third of this comes from the federal government.

Health expenditures are projected to nearly double to $4.3 trillion in a decade, at which point they will represent nearly one-fifth of the economy. According to the… more

As we enter the home stretch of a long presidential campaign, the good news is that both major candidates recognize that our health care system, especially the insurance marketplace, does not work well. The concept of selling health insurance across state lines has been included in health care proposals put forth by several Members of Congress and most recently in the campaign plan of Republican presidential nominee, Senator John McCain.

Allowing insurers to sell insurance across state lines… more

Every minute in the United States, an ambulance is turned away from a hospital because of a practice known as ambulance diversion. Diverting ambulances away from emergency departments (EDs) poses a serious threat to the health outcomes of both the insured and uninsured population. Ambulance diversions also indicate a struggling health system in need of comprehensive delivery system reforms.

An ambulance diversion occurs when a hospital ED cannot care for additional emergency patients.… more

The United States faces serious fiscal challenges. Large budget deficits have returned, and shifting demographics along with growing health care costs are putting intense pressure on the long-term federal budget outlook. Over time, sustained deficits will weaken the economy and adversely affect the American standard of living.

The United States faces a number of serious fiscal challenges. Budget deficits are back, the economy has weakened, Social Security is unsound, growing health care spending is putting immense pressure on the budget, tax policy is at a major crossroads, and borrowing is projected to reach unsustainable levels. Politicians will have to take concrete steps to confront these challenges, and some level of sacrifice will be required. The sooner decisions are made, the better-both because it will give the public… more

Although most Americans get health insurance through their employers, business leaders are increasingly united in their belief that rising health care costs threaten America’s competitiveness in the global economy. Business support for comprehensive health reform has been growing as a result.

The authors of this paper are longtime federal budget and policy experts who have been drawn together by a deep concern about the nation’s long-term fiscal outlook. Our group covers the ideological spectrum. We are affiliated with a diverse set of organizations. We have been meeting informally for over a year, under the auspices of The Brookings Institution and The Heritage Foundation, to define the dimensions and consequences of the looming federal budget problem, examine alternative solutions, and reach… more

In 2000, the Institute of Medicine (IOM) estimated that the “annualized economic cost of the diminished health and shorter lifespan of Americans who lack health insurance is between $65 and $130 billion for each year of health insurance forgone.”

After updating the IOM’s numbers to reflect growth in the economy and increases in the number of uninsured, we estimate that the poor health and shorter lifespan of the uninsured cost the U.S. economy between $102 billion and $204 billion in 2006.… more

In January 2007, Governor Arnold Schwarzenegger unveiled a comprehensive health care plan that aimed to provide quality, affordable health insurance to all Californians. Based on individual responsibility, the plan focused on prevention and wellness and emphasized a shared responsibility approach to financing.

After almost a year of negotiations between Governor Schwarzenegger and Democratic legislative leaders, compromise legislation with a framework and goals similar to the governor’s original proposal passed the State Assembly with a large majority. This compromise legislation, however,… more

Uncompensated care (UC) is health care that is delivered, but not paid for by either a patient or a third party payer. Most UC is delivered to the very ill during or after a visit to an emergency room. In 2004, UC was estimated to total $41 billion dollars.

This issue brief finds that individuals with incomes above 200% of the Federal Poverty Level (FPL) or $41,300 for a family of four and people living at or below the poverty… more

For reporters new to the health beat -- or for political or business reporters who need to delve into health policy now and then -- the topic can be daunting. Luckily, there are many, many resources on the web, useful whether you are in Washington or around the country... If you find yourself drowning in jargon and acronyms, it helps to take a breath and remember that health care is about people, and that it affects every one of us,… more

Our current health system is not sustainable. It leaves many Americans without access to quality, affordable health coverage, weakens the ability for U.S. businesses to compete internationally, and threatens the stability of our economy.

There are many ways that we could achieve a system of coverage for all Americans. However, in order to be economically and politically sustainable over time, any comprehensive reform plan must:

Lack of health insurance negatively affects the overall productivity of society, the stability of… more

Last week, the Bush administration released a proposal to

The proposal was issued in compliance with the "trigger" provision of the Medicare Modernization Act of 2003. This provision states that the President must present a plan when, for two consecutive years, the Medicare program's trustees estimate that funds taken from general revenues will exceed… more