AFSCME Information Highway

Source: Wynand P.M.M. van de Ven, and Frederik Schut, Health Affairs, May/June 2008 Vol. 27 no. 3
(subscription required)

From Commonwealth Fund summary:
In 2006, the Netherlands launched a sweeping national health care initiative to provide universal health care coverage for its population. According to the authors of "Universal Mandatory Health Insurance in the Netherlands: A Model for the United States?" (Health Affairs, May/June 2008), it is a model that may be of particular interest to policymakers in the United States. Not a single-payer system--a policy approach often considered a nonstarter in U.S. policy circles--the Dutch approach combines mandatory universal health insurance with competition among private health insurers.

Posted by Info Center at 5:22 PM in Health Reform | Permalink

Source: Brian Smedley and Beatrice Alvarez -The Opportunity Agenda, Rea Pañares, Cheryl Fish-Parcham, and Sara Adland - Families USA, Commonwealth Fund, April 2008

Millions of people in the United States--principally racial and ethnic minorities, immigrants, and those who lack proficiency in English--face barriers to high-quality health care. Such problems are largely due to high numbers of uninsured individuals among these groups, though it persists even when they are insured. By expanding health insurance coverage and addressing issues of access to care, quality of care, patient empowerment, infrastructural reforms, and social and community-level determinants of health, states have the potential to achieve equity. This report seeks to identify state policies that promote equitable health care access and quality and to evaluate existing laws, regulations, or reform proposals in five states--Massachusetts, Washington, Illinois, Pennsylvania, and California. These states' initiatives, all of which move toward universal health insurance coverage, also address other innovative strategies such as improving health care provider diversity, distribution, and cultural competence.

Posted by Info Center at 5:21 PM in Health Reform | Permalink

Source: Cathy Schoen, Karen Davis, Sara R. Collins, Commonwealth Fund, May 13, 2008

The upcoming presidential election and ongoing primary races have brought health care reform squarely back into the spotlight. Despite a handful of statewide reform initiatives, the nation is losing ground on coverage and families are feeling the strain on their wallets and their health. But while the need for universal coverage is clear, there is a lack of consensus on how to provide and finance such an expansion.

In their study, "Building Blocks for Reform: Achieving Universal Coverage with Private and Public Group Health Insurance" (Health Affairs, May/June 2008) (subscription required), The Commonwealth Fund's Cathy Schoen, Karen Davis, and Sara R. Collins present a new health reform framework, built on the current U.S. mixed private-public system, that "provides a pathway to universal coverage with a minimal increase in total national spending and relatively modest net federal budget costs." The authors estimate the plan would insure 44 million of the estimated 48 million Americans currently lacking health coverage.

See also:
The Building Blocks of Health Reform: Achieving Universal Coverage and Health System Savings

HEALTH REFORM REVISITED - a series of articles
(subscription required)
Health Affairs, Vol. 27 no. 3, May 2008

Posted by Info Center at 5:19 PM in Health Reform | Permalink

Source: Congressional Budget Office and Joint Committee on Taxation

From the summary:
According to the Congressional Budget Office and Joint Committee on Taxation, the bipartisan universal health coverage plan that is being sponsored by Sens. Ron Wyden (D-Ore.) and Robert Bennett (R-Utah) "could be fully operational by 2012 and become 'budget-neutral' by 2014," meaning that it "would bring in as much revenue as it costs to implement," the Associated Press reports.

See also:
CBO/JCT analysis

Posted by Info Center at 10:46 AM in Health Reform | Permalink

Source: Marie Gottschalk, Dissent, Spring 2008

...Organized labor has enormous potential to be the pivotal player in raising these economic and moral questions and anchoring a reform coalition that fundamentally reshapes the health care debate. For well over a century now, labor has been instrumental in the development of the U.S. health system. It established some of the first prepaid group practices and health maintenance organizations, was the leading voice for national health insurance up until the mid-1970s, and was decisive in the establishment of Medicare and in the expansion of other major social programs, like Social Security and the Great Society. The employment-based system of health benefits is largely the product of a collective-bargaining regime established during and immediately after the Second World War. That system is under siege today. Without unions to act as a brake, today's downward spiral in health benefits for union and nonunion workers would be even faster. Divided and hemorrhaging members, organized labor still has formidable resources to influence the course of health care reform.

At one pole is Andrew Stern, president of the Service Employees International Union (SEIU), the nation's largest union, and arguably the best known labor leader today. He stridently contends that health care reform must be pitched primarily as an economic competitiveness issue, not a moral one. Stern also has indicated that the single-payer approach, for all its virtues, is a political nonstarter. At the other pole is the growing number of national unions, locals, labor councils, and rank-and-file members pledged to the single-payer solution. Somewhere in between is the AFL-CIO, the nation's largest labor federation, which in March 2007 endorsed the idea of "Medicare for All" but carefully avoided mentioning the "s" word, that is, single-payer.

Posted by William at 9:38 AM in Health Reform | Permalink

Source: Tanya Alteras, Sharon Silow-Carroll, and Greg Moody, Commonwealth Fund, April 28, 2008

Massachusetts' passage of health care reform legislation in April 2006 heralded an exciting new era in state health policy. The reform plan is the most comprehensive effort by a state to achieve near-universal coverage, and arguably the most controversial, given its inclusion of an individual mandate. On the second anniversary of its passage (and 18 months since implementation began), States in Action examines the law's impact on the state's residents and its health care system.

Posted by Info Center at 3:36 PM in Health Reform | Permalink

Source: AFL-CIO

A new survey released March 25 by the AFL-CIO finds that an astounding 95 percent of those who responded say that the nation's healthcare system needs to be completely rebuilt or fundamentally changed. Nearly 27,000 people--including 1,600 AFT members--completed the online survey, and more than 7,000 submitted personal and often painful stories about their own healthcare woes.

Results

Survey questionnaire

Posted by William at 3:05 PM in Health Reform | Permalink

Source: Physicians for a National Health Plan

From press release:

Reflecting a shift in thinking over the past five years among U.S. physicians, a new study shows a solid majority of doctors -- 59 percent -- now supports national health insurance.

Such plans typically involve a single, federally administered social insurance fund that that guarantees health care coverage for everyone, much like Medicare currently does for seniors. The plans typically eliminate or substantially reduce the role of private insurance companies in the health care financing system, but still allow patients to go the doctors of their choice.

A study published in today's Annals of Internal Medicine, a leading medical journal, reports that a survey conducted last year of 2,193 physicians across the United States showed 59 percent of them "support government legislation to establish national health insurance," while 32 percent oppose it and 9 percent are neutral.

The findings reflect a leap of 10 percentage points in physician support for national health insurance (NHI) since 2002, when a similar survey was conducted. At that time, 49 percent of all physician respondents said they supported NHI and 40 percent opposed it.

Full report (PDF; 93 KB)

Posted by William at 11:08 AM in Health Reform | Permalink

Source: Harvard School of Public Health

A recent survey by the Harvard School of Public Health (HSPH) and Harris Interactive, as part of their ongoing series, Debating Health: Election 2008, finds that Americans are generally split on the issue of whether the United States has the best health care system in the world (45% believe the U.S. has the best system; 39% believe other countries have better systems; 15% don't know or refused to answer) and that there is a significant divide along party lines. Nearly seven-in-ten Republicans (68%) believe the U.S. health care system is the best in the world, compared to just three in ten (32%) Democrats and four in ten (40%) Independents who feel the same way.

This poll was conducted during a period of debate over the comparative merits of the U.S. health care system and the health care systems in other countries. President Bush and other prominent political figures have claimed that the U.S. has the best system in the world. At the same time, the World Health Organization and other organizations have ranked the U.S. below many other countries in their comparisons, while Michael Moore presented a similarly negative assessment of the U.S. health system in a popular format with his film Sicko.

So how might this issue impact how Americans vote in the upcoming presidential election? When asked if they would be more likely to support or oppose a presidential candidate who advocates making the U.S. health care system more like health systems in other countries, specifically Canada, France, and Great Britain, only one in five (19%) Republicans say they would be more likely to support such a candidate. This is compared to more than half (56%) of Democrats and more than a third of Independents (37%) who say they would be more likely to support such a candidate.

Americans' views on the U.S. health care system (Word; 340 KB)

Posted by Info Center at 8:43 AM in Health Care | Health Reform | Permalink

Source: U.S. House of Representatives, Committee on Oversight and Government Reform, March 2008

From the press release:
Although Medicaid is the largest health care program operated by the states, the Administration has failed to provide any estimates of the state-specific impacts of its regulations. After several unsuccessful attempts by the Committee to obtain these important state estimates from CMS, the Committee requested an analysis from Medicaid State Directors on the impact of the CMS regulations on their state.

The report finds that the state estimates of the fiscal impact of the CMS regulations are significantly higher than the $15 billion impact projected by the Administration for next five years. States estimated that the regulations would reduce federal payments to them by nearly $50 billion over the next five years, more than three times the Administration's estimate.

The large discrepancy between the state estimates and the CMS estimates is evidence that the regulations are likely to have a much larger fiscal and programmatic impact on state Medicaid programs and state budgets than people realize.

▪ Summaries of State Responses
▪ Interactive Map
▪ Response from Center for Medicaid and State Operations

Posted by Info Center at 2:34 PM in Health Care | Health Reform | State & Local Finance | Permalink

Source: Todd Tucker and Mary Bottari, Public Citizen, Global Trade Watch, February 2008

From the press release:
Public Citizen today identified changes needed to World Trade Organization (WTO) rules and the investment provisions of the North American Free Trade Agreement (NAFTA) to implement a dozen of the presidential candidates' key health and climate policy proposals.

The changes were detailed in a report, "Presidential Candidates' Key Proposals on Health Care and Climate Will Require WTO Modifications, Overreach of WTO Highlighted by Potential Conflicts with Candidates' Non-Trade Proposals."
...
Although they have nothing to do with trade, key health care cost containment proposals on the creation of health insurance risk pooling mechanisms, reduction of pharmaceutical prices and electronic medical record-keeping, a proposal to expand coverage by requiring large employers to provide health insurance and a proposal to establish tax credits for small employers as an incentive to provide health insurance fall within WTO jurisdiction. In addition, proposals that address climate policy, such as increasing Corporate Average Fuel Efficiency (CAFE) standards, banning incandescent light bulbs, establishing new regulation of coal-fired electric plants and establishing national renewable portfolio standards (RPS), green procurement proposals and green industry subsidies come under the jurisdiction of existing U.S. WTO commitments.

Posted by Info Center at 1:24 PM in Environment | Health Reform | Politics | Trade | Permalink

Source: Harvard School of Public Health, Press release, February 14, 2008

During the course of the presidential nomination campaign, some candidates' health care plans have been described as 'socialized medicine'. Historically, the phrase socialized medicine has been used to attack health reform proposals in the U.S. However, a new poll by the Harvard Opinion Research Program at the Harvard School of Public Health (HSPH) and Harris Interactive finds that Americans are split on whether a socialized medical system would be better or worse than the current system. Among those who say they have at least some understanding of the phrase (82%), a plurality (45%) says such a system would be better while 39 percent say it would be worse. Twelve percent say they do not know and four percent say about the same.

The poll shows striking differences by party identification. Seventy percent of Republicans say that socialized medicine would be worse than our current system. The same percentage of Democrats (70%) say that a socialized medical system would be better than our current system. Independents are more evenly split with 43% saying socialized medicine would be better and 38% worse.
▪ Americans' Views on Socialized Medicine

Posted by Info Center at 1:14 PM in Health Care | Health Reform | Permalink

Source: Aaron McKethan, Terry Savela, and Wesley Joines, The Lewin Group, January 2008

In recent years, health system stakeholders have experimented with a wide range of efforts to stimulate quality improvement, often combined with efforts to contain costs. In this report, the authors explore strategies that public and private purchasers are using to improve care quality, focusing specifically on the role that states play as employers providing health benefits for public employees and retirees. Examples of innovations used by state public employee health plans include: promoting provider adherence to clinical guidelines and best practices, publicly disseminating provider performance information, implementing performance-based incentives, developing coordinated care interventions, and taking part in multi-payer quality collaborations. This report can be used by public employee health plans and other large purchasers making strategic decisions about how to develop or coordinate quality improvement initiatives.

Posted by Info Center at 2:50 PM in Health Reform | Public Sector | Permalink

Source: Kaiser Family Foundation Commission on Medicaid and the Uninsured, January 28, 2008

From press release:
New reports released today by the Kaiser Family Foundation's Commission on Medicaid and the Uninsured (KCMU) describe aggressive efforts by states in the past year and a half to expand coverage to low-income children and their families, but the actions may be curtailed as a deteriorating economic climate and new limits on federal assistance take effect.

A downturn in the economy, the federal failure to reauthorize the State Children's Health Insurance Program (SCHIP) and new federal rules affecting Medicaid and SCHIP eligibility all suggest that the recent period of aggressive expansion of coverage by states may be over. This is the conclusion based on a series of new studies by the KCMU, including a 50-state survey of eligibility and enrollment rules in Medicaid and SCHIP for children and families, interviews with Medicaid directors in ten states representing all regions of the country, and recent studies of enrollment in Medicaid and SCHIP.

● Health Coverage for Children and Families in Medicaid and SCHIP: State Efforts Face New Hurdles
● Current Issues in Medicaid: A Mid-FY2008 Update Based on a Discussion with Leading Medicaid Directors
● SCHIP Enrollment in June 2007: An Update on Current Enrollment and SCHIP Policy Directions
● Medicaid Enrollment in 50 States: December 2006 Update
● State Children's Health Insurance Program (SCHIP): Reauthorization History

Posted by Info Center at 5:07 PM in Health Care | Health Reform | Permalink

Source: Katherine K. Shea, Sara R. Collins, and Karen Davis, Commonwealth Fund, January 2008

From the overview:
The 13th Commonwealth Fund/Modern Healthcare Health Care Opinion Leaders Survey asked a diverse group of experts for their perspective on the health care reform proposals of the 2008 presidential candidates. Survey participants strongly support reform proposals that applied a mixed private-public market approach. Additional favored policy strategies for reform include a requirement for individuals to obtain health insurance, new private market regulations, and a requirement for employers to provide coverage or contribute to a coverage fund. Alternatively, respondents think proposals that focus on tax incentives to purchase individual private health insurance are not an effective method for controlling the rising costs of health care or achieving universal coverage. Health care opinion leaders call for the next president to simultaneously address universal coverage and quality, efficiency, and cost containment policies to move our health care system toward high performance.

Related commentaries:
● Reform Is No 'Either-Or': We Must Fix the Payment System Along with Access
Darrell Kirch, M.D, president and chief executive officer of the Association of American Medical Colleges
● Tough Choices Ahead: Candidates Ignore Pain of Needed Cuts to Health Costs
Dallas L. Salisbury, president and CEO of the Employee Benefit Research Institute and a member of The Commonwealth Fund Commission on a High Performance Health System

Related resources:
● Data Brief
● Chartpack
● Tables
● Methodology

Posted by Info Center at 4:43 PM in Health Reform | Politics | Permalink

Source: Jill Eden, Ben Wheatley, Barbara McNeil, and Harold Sox, Institute of Medicine/National Academies Press, 2008
(scroll down)

From press release:
Solutions to some of the nation's most pressing health problems hinge on the ability to identify which diagnostic, treatment, and prevention services work best for various patients and circumstances. Spending on ineffective care contributes to rising health costs and insurance premiums. Variations in how health care providers treat the same conditions reflect uncertainty and disagreement about what the standards for clinical practice should be. Patients and insurers cannot always be confident that health professionals are delivering the most effective care.

A new report from the Institute of Medicine offers a blueprint for a national program to assess the effectiveness of clinical services and to provide credible, unbiased information about what really works in health care. The report recommends that Congress direct the U.S. Department of Health and Human Services to establish a program with the authority, expertise, and resources necessary to set priorities for evaluating clinical services and to conduct systematic reviews of the evidence. This program would also be responsible for developing and promoting rigorous standards for clinical practice guidelines, which could help minimize the use of questionable services and target services to the patients most likely to benefit, said the committee that wrote the report.
● Report Brief
● Report Summary

Posted by Info Center at 4:29 PM in Health Reform | Permalink

Source: Robert J. Blendon, Drew E. Altman, Claudia Deane, John M. Benson, Mollyann Brodie, and Tami Buhr, New England Journal of Medicine, Vol. 358 no. 4, January 24, 2008

For the first time since 1928, neither the Democratic nor the Republican party has an incumbent president or vice president among the candidates in its field, so both primaries are particularly open to all challengers and very competitive. In this article, we report findings from public opinion polls that assessed how health care issues might affect voters' choices in the 2008 presidential primaries.

This article examines the role of health care in the 2008 presidential primary elections in two ways. First, it draws on data from multiple opinion surveys to better understand how Republicans and Democrats differ in their values, beliefs, and attitudes with regard to health care and health care policy. Second, it focuses particularly on voters who say they are going to participate in the early Democratic and Republican primaries and caucuses, looking at differences in their health care preferences and the extent to which the health care issue is affecting their vote.

Finally, we explore how the differences in views and desires concerning health care among Republicans and Democrats are reflected in the kinds of proposals being put forward by the major candidates, and we assess the ways in which these divisions might affect the general-election campaign.
See also:
The Amazing Noncollapsing U.S. Health Care System -- Is Reform Finally at Hand?

Posted by Info Center at 1:32 PM in Elections | Health Reform | Politics | Permalink

Source: Commonwealth Fund, January 15, 2008

Eighty-one percent of Americans believe that in order to help reach the goal of health insurance for all, employers should either provide health insurance to their workers or contribute to the cost of their coverage, according to survey data released today by The Commonwealth Fund. Nearly nine of 10 (88%) Democrats, nearly three-quarters (73%) of Republicans, and nearly four of five (79%) Independents would support such an employer "play or pay" requirement.

In addition, the survey, conducted between June and October of 2007, found that a wide majority of Democratic (67%), Republican (66%), and Independent (70%) voters believe that health insurance costs should be shared by individuals, employers and the government. Further, a majority of the public was strongly or somewhat in favor of requiring individuals to have health insurance coverage--with government help for those who cannot afford it. Sixty-eight percent of Americans favor such a proposal, with 80 percent of Democrats in support, and more than half of Republicans (52%) and two-thirds of Independents (68%) in favor, according to a report on the survey findings, The Public's Views on Health Care Reform in the 2008 Presidential Election.
+ Issue Brief
+ Chartpack

Related Articles:
Envisioning the Future: The 2008 Presidential Candidates' Health Care Reform Proposals
Sara R. Collins and Jennifer L. Kriss, Commonwealth Fund, January 2008

Posted by Info Center at 2:42 PM in Health Reform | Permalink

Source: Linda J. Blumberg, John Holahan, Urban Institute, January 29, 2008

In this brief we conclude that, absent a single payer system, it is not possible to achieve universal coverage without an individual mandate. The evidence is strong that voluntary measures alone would leave large numbers of people uninsured. Voluntary measures would tend to enroll disproportionate numbers of individuals with higher cost health problems, creating high premiums and instability in the insurance pools in which they are enrolled, unless further significant government subsidization is provided. The government would also have difficulty redirecting current spending on the uninsured to offset some of the cost associated with a new program without universal coverage.

Posted by Info Center at 5:11 PM in Health Reform | Permalink

Source: Jessica P. Vistnes and Barbara S. Schone, Health Affairs, Vol. 27 no. 1, 2008
(subscription required)

Using data from the Medical Expenditure Panel Surveys for 1997 and 2005, spanning the eight-year period after enactment of the State Children's Health Insurance Program (SCHIP), we examine whether the composition of insurance coverage has changed for working families. Public coverage has played an increasingly important role for working families with children. For families without access to job-based insurance, roughly two-thirds of single-parent and over half of two-parent families with children had at least one family member covered by public insurance in 2005. Among families with access to job-based insurance, nearly half of minority single-parent families had at least one family member with public coverage.

Posted by Info Center at 5:14 PM in Health Reform | Permalink

Source: Debra J. Lipson, James M. Verdier, and Lynn Quincy, Mathematica Policy Research, Inc., December 2007

In this evaluation of Maine's health reform plan, researchers examine interim indicators of progress after two years of program implementation. Since enacting comprehensive health care reform in 2003, the effort has helped expand coverage for low- and moderate-income individuals. Yet by late 2006, the initiatives had enrolled less than 10 percent of previously uninsured residents.

Researchers identify both the successes and challenges of the program. They also consider how Maine's experiences could serve as a lesson for other states which are exploring initiatives to expand access and provide affordable insurance.

Posted by Info Center at 5:05 PM in Health Reform | Permalink

Source: The Commonwealth Fund

U.S. health spending is projected to increase from 16 percent of GDP in 2006 to 20 percent in 2016--from $2 trillion to $4 trillion. Meanwhile, the number of uninsured Americans continues to rise. In this report prepared for The Commonwealth Fund Commission on a High Performance Health System, the authors examine 15 federal policy options that have the potential to lower health spending relative to projected trends. They include policies that would: produce and use better information for health care decision-making, promote health and enhance disease prevention, align financial incentives with quality and efficiency, and correct price signals in health care markets. Combining policies would capture the synergistic benefits of individual changes. If implemented along with universal health insurance, a combination of selected options could save $1.5 trillion in national health expenditures over 10 years, while also improving value in terms of access, quality, and health care outcomes.

Posted by Info Center at 11:37 AM in Health Reform | Permalink

Source: New Labor Forum, Fall 2007
By Jacob Hacker

America's $2.2-trillion-a-year medical complex is enormously wasteful, ill-targeted, inefficient, and unfair. The best medical care is extremely good, but the Rube Goldberg system through which that care is financed is extremely bad--and crumbling. One out of three non-elderly Americans spend some time without health insurance every two years, and the majority of those remain uninsured for more than nine months. Meanwhile, runaway health costs have become an increasingly grave threat, not just to the security of family finances, but also to corporate America's bottom line. The United States spends much more as a share of its economy on health care than any other nation, and yet all this spending has failed to buy Americans the one thing that health insurance is supposed to provide: health security.

Posted by Info Center at 2:07 PM in Health Reform | Permalink

Source: Annals of Internal Medicine

From press release (American College of Physicians):
In a new evidence-based paper, the American College of Physicians (ACP) analyzes health care in the United States and 12 other industrialized countries and identifies lessons that could be applied to the particular political and social culture of the United States to achieve a high performing health care system, including achieving universal health insurance coverage for all Americans.
...
In the paper, "Achieving a High Performance Health Care System with Universal Access: What the USA Can Learn from Other Countries," published on the Web site of ACP's flagship journal, Annals of Internal Medicine, ACP notes that spending on health care in the United States is the highest in the world and has been rising at a faster pace than spending in the rest of the economy. Yet an estimated 47 million Americans - nearly 16 percent of the population - lack health insurance protection. Even among those with health insurance coverage, wide variations exist in terms of cost, utilization, quality, and access to health care services.

Posted by Info Center at 10:53 AM in Health Care | Health Reform | Permalink

Source: Commonwealth Fund

From press release:
Health insurance reform plans that build on a mix of private and public health insurance, where costs are shared among government, employers, and enrollees would have great potential to move the system to high performance and would be the most practical to implement according to a new report released today by The Commonwealth Fund Commission on a High Performance Health System. Commissioners are a diverse group of leading health policy experts from government, private industry, health care delivery organizations, academia, and professional associations.

Affordable, comprehensive health insurance coverage for all Americans is essential to achieving a high performance health system, say the report authors, because coverage helps to ensure access to essential preventive services; improve overall health; cut down on inefficiencies like duplicate medical tests; reduce administrative costs; and eliminate costly uncompensated care for uninsured and underinsured families.

However, the way coverage reform plans are designed will be critical to their success and ability to offer all participants access to high-quality, efficient, and equitable health care, according to the analysis, A Roadmap to Health Insurance for All: Principles for Reform, prepared for the Commission by Sara Collins, Assistant Vice President at The Commonwealth Fund and colleagues. The report is the first of three major policy reports the Commission will issue this Fall.

Full Report (PDF; 487 KB)

Posted by Info Center at 9:14 AM in Health Care | Health Reform | Permalink

Source: New England Journal of Medicine

The 2008 presidential election will not resolve the debate over health care reform, but the results will go a long way toward determining the future of U.S. health policy. It would be a mistake, however, to read the candidates' plans too literally. A plan offered during the primaries usually looks different in key respects from the plan that a newly elected president takes to Congress, to say nothing of any legislation that Congress actually passes. Still, it is clear that there is a wide partisan gap on health care reform that reflects ideological divisions over the roles that government and market forces should play in the health care system. And the further U.S. health policy moves from incrementalism, the more that partisan divide is likely to be exposed.

Posted by Info Center at 11:34 AM in Health Care | Health Reform | Permalink

Source: Commonwealth Fund

Ensuring that everyone in the United States has health insurance is essential, but it is not enough to drive the kind of reform the health system needs, according to a new report released today by the Commonwealth Fund Commission on a High Performance Health System.

Guaranteeing affordable health insurance for all, changing the way doctors and other health care providers are paid, better organizing and coordinating care delivery, investing in implementing an electronic information system in a reasonable period of time (aiming for five years), and establishing national goals and doing what it takes to reach them through strong national leadership should all be on the next President's health care agenda, says the report. Members of the commission are a diverse group of leading health policy experts from government, private industry, health care delivery organizations, academia, and professional associations.

Full Report (PDF; 187 KB)

Posted by Info Center at 3:21 PM in Health Care | Health Reform | Permalink

Source: Jon R. Gabel, Heidi Whitmore, and Jeremy Pickreign, Health Affairs Web Exclusive, Vol. 27 no. 1, November 14, 2007

Based on a 2007 survey of 1,056 randomly selected Massachusetts firms, this paper presents findings about employers' attitudes about, knowledge of, and responses to recently enacted reform legislation. A majority of Massachusetts employers agree that all employers bear some responsibility for providing health benefits, firms not offering benefits should be required to pay a "fair share" contribution up to $295 annually per employee, and employers with ten or fewer employees should not be exempt from this requirement. Only 24 percent of employers with 3-50 workers are familiar with the Connector purchasing pool. About 3 percent of Massachusetts small employers intend to drop coverage, similar to national figures.

Posted by Info Center at 12:12 PM in Health Reform | Permalink

Source: Phillip Longman, Washington Monthly, Vol. 39 no. 10, October 2007

What I'm proposing is this: Take the existing, ad hoc system we use for treating the uninsured and turn it into a real integrated system. Specifically, mandate that everyone in America buy health insurance (with subsidies to those who can't afford the premiums), and then contract with assorted St. Elsewheres to serve the resulting pool of newly insured patients. The organizing blueprint of this new system would come from the one truly successful national health care system we currently have: the VA.

Posted by Info Center at 5:13 PM in Health Reform | Permalink

Source: Health Business Daily, October 16, 2007

States have intensified efforts to address the growing number of uninsured in recent months, with some moving closer to passing various measures that would provide or mandate health coverage. Insurers in some states are supportive of the measures, while others oppose such reforms or choose not to comment on the efforts.

Posted by Info Center at 11:14 AM in Health Reform | Permalink

Source: Paul Starr, American Prospect, Vol. 18 no. 10, October 2007

Did Hillary doom health reform in 1993? It's time to get the facts straight about the Clinton plan and why compromise failed. Here's the real story, from the Prospect co-editor who was a White House senior health policy advisor at the time.

Posted by Info Center at 1:22 PM in Health Reform | Permalink

Source: Linda J. Blumberg, Urban Institute, October 2007

Nearly 40 percent of a low-income family's earnings will need to be spent on health insurance if a Bush administration proposal to use the tax system to subsidize coverage is enacted, a new Urban Institute analysis has found.

After receiving the proposed tax subsidy, a two-parent, two-child family with an annual household income of approximately $32,000 would pay 39 percent of its income on family coverage. Insuring this family's children through the State Children's Health Insurance Program (SCHIP) would have no cost to the family.

Posted by Info Center at 2:14 PM in Health Reform | Permalink

Source: Paul Fronstin and Dallas Salisbury, Employee Benefit Research Institute, Issue Brief no. 309, September 2007

From the press release:
Proposals to change the tax treatment of health insurance could mean the end of employment-based coverage as it now exists in the United States, according to a study released today by the nonpartisan Employee Benefit Research Institute (EBRI).

Currently, the vast majority of U.S. residents with health insurance receive coverage through an employer. The most recent data show that about 62 percent of workers and their dependents (161.7 million individuals under age 65) had some form of employment-based health benefits, while about 7 percent (17.7 million) bought insurance directly from an insurer, and 18 percent (46.5 million) were uninsured.

Of the various options to change the way health benefits are taxed, the EBRI report identifies the proposed "tax cap" on the health insurance exclusion that workers currently receive as most likely to cause the end of employment-based health benefits. This change would be likely to prompt younger and healthier workers to drop out of the employment-based system, causing adverse selection in the remaining pool of older and less healthy workers, thereby resulting in a so-called "death spiral" that makes employment-based group health insurance unsustainable.

Posted by Info Center at 12:37 PM in Health Reform | Taxation | Permalink

Source: Leighton Ku, Center on Budget and Policy Priorities, September 27, 2007

As leading health policy experts have explained, under the fragmented U.S. health insurance system, virtually any effort to cover more of the uninsured -- including efforts that rely on tax deductions or credits for the purchase of health insurance in the private market, as well as public program expansions -- will result in some "crowd-out" (in the substitution of one type of health insurance for another) or in more heavily subsidizing people who are already insured, rather than in extending coverage to those who are uninsured. For example, an analysis of the Administration's health tax proposals from last year by the noted health economist Jonathan Gruber estimated that 77 percent of the benefits would go to people who already are insured.

Posted by Info Center at 12:50 PM in Health Reform | Permalink

Source: GAO, GAO-07-1155SP, September 7, 2007

The discussion sessions focused on three interrelated topics: cost and personal responsibility; coverage of the uninsured; and quality, standards, and outcomes. The keynote speech focused on related policy challenges. The following are highlights from these discussions and the participant poll. The proceedings are not intended to reflect the views of GAO.

Posted by Info Center at 2:49 PM in Health Care | Health Reform | Permalink

Source: Center for Children and Families, Georgetown University Health Policy Institute, July 20, 2007

In a report released this spring, the Center for Children and Families (CCF) conducted a nationwide review of state efforts to provide health care coverage to uninsured children. The report, titled "States Moving Forward," focused on legislation adopted between January 2006 and mid- April 2007, as well as on proposals under serious consideration as of mid-April 2007. In this update, CCF reports on the status of these proposals as of July 20, 2007.

See also:
Getting to the Finish Line: a monthly report on federal and state policy issues affecting children's health
Moving Backward: New Federally Imposed Limits On States' Ability to Cover Children

Posted by Info Center at 11:55 AM in Children | Health Reform | Permalink

Source: Sharon K. Long and Mindy Cohen, The Urban Institute, 2007

This report is meant to provide a snapshot of Massachusetts' adult population prior to the implementation of new health reform legislation in the state. Using survey responses obtained in Fall 2006 as the Bay State began implementing a landmark effort to bring near-universal health coverage to its population, this report serves as the baseline for an on-going study of the effects of the reform efforts on Massachusetts' working-aged adult population. We focus on the overall adult population aged 18 to 64 years old in Massachusetts, as well as those targeted by specific elements of the state's reform efforts, including uninsured adults and adults with family income less than 100% of the federal poverty level (FPL), between 100% and 300% FPL, and between 300% and 500% FPL. We describe their insurance coverage and health care experiences in the period prior to the full implementation of the major health reform provisions. The goal of this report is to provide information to support Massachusetts' efforts to implement the health care reforms. In subsequent work, we will document changes in insurance coverage and health care experiences as Massachusetts fully implements its health reform initiative.

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Posted by Info Center at 3:36 PM in Health Reform | Permalink

Source: Jacob S. Hacker, New England Journal of Medicine, Vol. 357 no. 8, August 23, 2007

It is certainly true that Sicko is not a careful accounting of the pros and cons of the U.S. insurance system. But the basic truth of Moore's indictment is undeniable. A recent survey by Consumer Reports found that nearly half of adults younger than 65 -- most of them insured -- say they are "somewhat" or "completely" unprepared to cope with a costly medical emergency in the coming year. A substantial share of the more than 1 million personal bankruptcies in the United States each year -- perhaps as many as half -- are due in part to medical costs and crises. In no other rich country are people even remotely as likely to report having trouble with paying medical bills or going without care because of the cost. These problems are long-standing -- yes, "dating back to the 1980s" -- and worsening. And they are largely due to our reliance on employment-based, voluntary private health insurance.

Posted by Info Center at 1:47 PM in Health Reform | Permalink