Health Care Reform 101: Goals
on August 15, 2009
I don't know about you, but I keep forgetting what health care reform was supposed to accomplish in the first place. I thought reigning in costs was the overarching goal of health care reform, but surprisingly little of the health care reform dialog really deals (in any obvious way) with cost issues.
Last week, I found myself Googling "goals for health care reform" to make sure I hadn't begun to lose my marbles. Turns out, a while back, President Obama outlined the basic principles for health care reform as follows:
- Reduce long-term growth of health care costs for business and government.
- Protect families from bankruptcy or debt because of health care costs.
- Guarantee choice of doctors and health plans.
- Invest in prevention and wellness.
- Improve patient safety and quality care.
- Assure affordable, quality health coverage for all Americans.
- Maintain coverage when you change or lose your job.
- End barriers to coverage for people with pre-existing medical conditions.
He did not, however, specify the details of how these goals were to be achieved. I suspect this is where the mass confusion really kicks in. If I have this right, we now have at least 10 different options for how to get from point A to point B:
Affordable Health Choices Act, Senate HELP Committee
America's Affordable Health Choices Act of 2009 (H.R. 3200), House Tri-Committee
Patients' Choice Act of 2009 (S. 1099 and H.R. 2520), Sens. Tom Coburn and Richard Burr Reps. Paul Ryan and Devin Nunes
National Health Care Act (H.R. 676), Rep. John Conyers U.S.
National Health Insurance Act (H.R. 15), Rep. John Dingell
Empowering Patients First Act (H.R. 3400), Rep. Tom Price (Republican Study Committee)
American Health Security Act of 2009 (S. 703), Sen. Bernie Sanders
AmeriCare Health Care Act of 2009 (H.R. 193), Rep. Pete Stark
Healthy Americans Act (S. 391), Sens. Ron Wyden and Bob Bennett
Crossing Our Lines: Working Together to Reform the U.S. Health System, Former Majority Leaders: Sens. Howard Baker, Tom Daschle, and Bob Dole
For comparisons of the above options, visit the Kaiser Family Foundation website. They have a section dedicated to information about health care reform. Details about each of the options can be explored using their Side-by-Side Comparison of Major Health Care Reform Proposals.
If you would like to contribute to a "wiki" to help make sense of the above information, please drop me a line at cthroop@open-health.us.
Comments
Basic principles
Cindy--I totally agree that often we lose sight of the goal when the sausage-making in the process begins. I wonder, however, whether part of the problem also is that not all goals are created equal. I mean of the ten goals, whoch are likely the "must haves" and which are the nice to haves. If we were to look and prioritize each, the legislative configurations that have the best chance of being signed into law will emerge.
A second way to look at it is not perhaps just from an Obama/legislative angle, but from each of the other relevant participants in healthcare and what THEIR priorities are going in. For example, the gov't sponsored plan is almost out the door now (some would argue it already is) as a direct result of the payers that are resisting it. By eliminating the one or two most likely proposals to see resistance, we can ALMOST get to a list of prioritized WANTS and likely SOLUTIONS that are viable. And since the normal patient/member is not exactly well-informed, I would argue that in some respects that may be the ONLY opinion we do not need to worry about since it will not drive the debate as much as be driven by it (see, e.g., the most recent discussion of death panels!)
OK, pretty damn complex problem but I think the core of any new plan would likely emerge from such an exercise. As much as I like Obama's vision, it is the vision of the many other participants that is key.
Too complicated? Perhaps. Just trying to think of ways to get to the sensible outcome and perhaps help shape the debate on the things that benefit the most stakeholders.
Visual explanation of healthcare reform
Thanks for pulling together Obama's reform principles and legislative proposals; it's really helpful.
Another resource: Ran Roam recently published a napkin-sketch explanation of healthcare reform that provides a simple, visual guide to the current discussion.
Thanks for the comments!
Kendall, Thanks for the comments! After identifying specific goals for health care reform, prioritizing them makes complete sense. And like you said, each stakeholder group has their own goals and priorities.
I agree that public perception is too often driven by silly things like “death panels.” At the same time, I think it is important to at least try to explain health care policy and practice issues to normal patients. Granted, not every patient is going to understand or care, but the government has an obligation to be transparent in how it plans to use taxpayer money.
I think the patient/consumer/taxpayer and health care providers are the two most important stakeholders in health care reform. From what I’ve seen, doctors are not involved nearly enough. Patients haven’t even been invited to the table.
Perhaps I am overly idealistic in my vision to make this information accessible to regular folks. On the other hand, if I have a graduate degree with a specialization in social policy and I can’t understand what’s going on, there is a problem!
Chris, Dan Roam’s “back of the napkin” visual explanation of health care reform is priceless! (http://www.slideshare.net/danroam/healthcare-napkins-all)