At almost $1.3 trillion this year, U.S. health care spending is sufficient to finance needed health services for all. Yet this goal is not coming closer. Health spending rises each year -- but the new money is used overwhelmingly to finance business as usual. It will be politically impossible to win and retain health care for all without incorporating the provisions that will make it durably affordable.
First, government should contain cost and assure universal coverage. Competition should be used to protect quality. Lacking a functioning free market, price competition does not contain cost. It undermines quality. Government responds by putting regulatory bandages on quality. But neither is well-suited to its current task. The challenge is to combine real competition by quality with both responsibility for managing budgets and patient choice of caregiver.
Second, hospitals should have budgets that are flexible for case mix and volume. They should make money by delivering efficient care, not by gaming volume or skimming.
Third, physicians should be responsible for managing budgets by making clinical-financial trade-offs, but their own incomes should not be affected by these decisions.
Fourth, prescription drug prices should be lowered through state or federal legislation. Private sales will rise in response to lower prices. And the cost of a drug benefit for seniors will drop substantially. Drug makers' revenues and profits will be safeguarded.
Fifth, state governments should identify and stabilize all needed hospitals, nursing homes, home health agencies, and other institutional caregivers.
Learning Objectives: Discuss requirements for achieving durably affordable health care for all
Keywords: Universal Health Care,
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.