Posted by CHPRE Staff
Publications
Friday, May 2nd, 2008
Abstract:
The United States appears headed toward another national debate about health system reform. Worry about access and health system deficiencies has reached critical mass, and polls indicate that health care leads the domestic agenda for the 2008 elections. This debate, like previous debates, will succeed or fail in Congress. We highlight key elements of recent sagas in health legislation and offer advice to the next president and Congress for improving the likelihood of a successful outcome in 2009–10: (1) make health reform a top legislative priority; (2) be leaders, not partisans; and (3) develop broad policy consensus but leave the policy details to Congress.
“The Long Road to Health Reform Requires Bi-Partisan Leadership,” Health Affairs (May/June 2008), with Christine Ferguson and Elizabeth Fowler.
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Posted by CHPRE Staff
Publications
Thursday, May 1st, 2008
Abstract:
Expanding insurance coverage is a critical step in health reform, but we argue that to be successful, reforms must also address the underlying problems of quality and cost. We identify five fundamental building blocks for a high-performance health system and urge action to create a national center for effectiveness research, develop models of accountable health care entities capable of providing integrated and coordinated care, develop payment models to reward high-value care, develop a national strategy for performance measurement, and pursue a multistakeholder approach to improving population health.
“Crossroads in Quality,” Health Affairs (May/June 2008), with Margaret O’Kane, Janet Corrigan, Sandra M. Foote, Sean R. Tunis, George J. Isham, Elliott S. Fisher, Jack C. Ebeler, James A. Block, Bruce E. Bradley, Christine K. Cassel, Debra L. Ness and John Tooker.
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Posted by CHPRE Staff
Publications
Thursday, May 1st, 2008
Summary:
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.
However, economists generally believe that it is workers — rather than employers — who pay for health care through lower wages. Although this proposition may hold true in the long run, employers face a variety of constraints that may make it difficult for them to fully shift health costs in the short run.
Health care costs would not burden firms if they could be shifted to consumers through higher prices. But with globalization and increased competition in international markets, this is not feasible. If employers cannot fully shift health costs onto workers or into prices, then how much they pay matters.
As a percentage of payroll, the employer cost of health benefits has exploded over the past few decades. In addition, employer health costs for manufacturing firms in the United States, $2.38 per worker per hour, were much higher than the foreign trade-weighted average of $0.96 per worker per hour in 2005. Employer health costs make the United States less competitive than it could otherwise be.
A new model for health care that…
- reforms the current insurance marketplace;
- provides income-based subsidies; and
- is individual, rather than employer-based,
…would enable us to finance our 21st-century health system in a more sustainable and competitive way.
“Employer Health Costs in a Global Economy,” New America Foundation (May 2008), with Sarah Axeen.
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