Health Policy Question
Background:
Health care in the United States is in a state of
crisis. The cost of health care continues to spiral ever higher,
while
access to and quality of health care fall. It is currently estimated
that over
40 million Americans do not have health insurance. In the U.S.,
we spend
far more on health care, as much as 14% of GNP and rising, than any
other
industrialized nation. But the U.S. ranks the lowest on health
quality
measures, including infant mortality and life expectancy. There
have many
attempts to reform the American health care system in the past to
control the
cost and/or to increase access. Presidents who have taken on this
issue
include Roosevelt (FDR), Johnson, Nixon, Ford, and most recently Bill
Clinton
in 1993.
The heart of the dilemma is that on one hand, we
want the
access and fairness denied to those without insurance in the current
system,
but on the other hand, do not want to give up the quality and ability
to choose
one's physicians available to those who can now afford it.
The presidential election of 2004 forced this issue again to center stage. Meanwhile, with the economic recovery appearing to falter, businesses increasingly cite the costs of providing health benefits to employees as one of their main challenges. Is it time to reconsider once again the fundamental structure of insurance and methods of health care payment and allocation? Or should more incremental measures be taken, such as reform to Medicare or prescription drug coverage? Or should the system be left as is?
Your Client:
Bill Frist of Tennessee, a physician and the
Republican
Majority Leader of the Senate, has asked you, a non-partisan health
policy task
force, to re-examine all options and prepare a report on the pros and
cons of
possible legislation to reform the health care system.
The Question:
What can be done to reduce the cost of health
care, increase
its availability, and in particular, to deal with the problem of the
growing
number of uninsured citizens?
Additional information to get started:
“Rising
Cost of
Health Benefits Cited as Factor in Slump of Jobs”, New York
Times,
January 17, 2004
"Academy of Sciences Calls for Universal
Health Care by 2010", New York Times, Janury 15, 2004
"Health Care Spending Increases for 6th
Year",
Washington Post, January 9, 2004
"Health Care Policy",
Ch. 8 in Public Policy: Politics, Analysis, and Alternatives by
Michael
Kraft and Scott Furlong, CQ Press, 2004.
Jonathan Oberlander, "The U.S. Health Care System: On a Road to Nowhere."
Patel and Rushevsky, Ch. 2: "Health Care Policy in the United States"
More Links:
Jonathan
Oberlander's Home Page - with many links to health policy
information
Study of several different plans for covering the uninsured
Detailed Study at the state level for California