Most proposals for reform advocate incremental change. They take as a given the existing methods of financing and seek to diminish the number of uninsured by patching and adding to them. Yet, none of these incremental changes would remedy the fundamental flaws that most experts see in these methods and would create additional problems. In contrast to incremental reform, advocates of major reform see it as the only way to provide coverage to all while slowing health care expenditure growth to a rate compatible with other demands on public and private budgets, and encourage the delivery of cost effective care by providing valid assessments of evidence-based interventions. There are multiple approaches to achieving major reform, yet common challenges confront each approach. Some of these challenges relate to operations of any system, such as defining the universal benefit package and determining how to structure private purchases of additional services or amenities to prevent undermining of the universal system. Other challenges relate to economics and financing, such as establishing effective cost control mechanisms including reimbursement methods that prevent adverse selection while encouraging efficiency. Still others relate to administration, such as ensuring a publicly accountable administrative structure that is relatively free of political interference. Finally, there are political considerations to be taken into account such as how to ensure that any new system is congruent with fundamental American values, such as equality of opportunity, individual choice, and use of the private market. The purpose of this project is to bring together individuals who have thought deeply and extensively about various aspects of health care reform from diverse perspectives: economic, medical, legal, and ethical. By working collaboratively and engaging other experts as needed, the project will critically study the theoretical, empirical, and practical aspects of creating a more efficient and equitable approach to financing health care in the U.S. The project will yield multiple papers, based on four workshops; a final report and preparation of a book; and the organization and hosting of a national conference on health care reform. Its success will be determined by the extent to which the project findings influence the debate over health care reform in the years to come.
Amount Awarded $495,972.00
Awarded on: 5/18/2007
Time frame: 6/1/2007 - 12/31/2011
Grant Number: 60436