Sunday, June 2, 2013

Summing up the U.S. health reform debate

Jaan at DMCB sums up the U.S. health reform debate very nicely in just five points.
2. The conservative vs. liberal debate over how to reduce health care costs for the U.S. government is ultimately about transferring its insurance risk.  The conservatives want to transfer risk to patients in the form ofvouchers, while the liberals want to transfer risk to providers in the form of bundled payments and gain-sharing.  The liberals, so far, are handily winning the debate.

3. Risk is only half the health reform story.  The other half is quality. There is bipartisan consensus that a) U.S. health care quality could be better, and b) greater quality will mitigate insurance risk, resulting in fewer medical complications, emergency room visits and readmissions.
4. There is additional bipartisan consensus that a) insurance risk can be managed and b) quality can be increased when care is provided in large vertically integrated and regional provider systems.
I'm frustrated that I don't know enough about European health systems to have a strong opinion about whether moving to vertically integrated and regional provider systems would improve the quality of our system.  Also, I'm a bit more skeptical than he is about the possibility of a public option seriously entering the public debate in the next few years (although I am very curious to see how it fares in Vermont).  

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