A key issue in the health reform debate is how best to provide affordable, high-quality health insurance for an estimated 36 million uninsured U.S.citizens.
One analysis suggests that 6 million Americans would ultimately meet eligibility requirements and would choose to enroll in a public plan.
In general, supporters believe that a public plan could bring new competition, choice, and accountability to the provision of health insurance. Administrative expenses could be lower than for private insurers, and there would be no need to generate returns for shareholders; as a result, dollars spent on health coverage would stretch further.
The version of the public plan passed by the U.S. House of Representatives would negotiate payment rates with doctors, hospitals, and other providers, and supporters hope those rates could be lower than those paid by private insurers. The public plan would also be required to develop innovative payment mechanisms that could ultimately hold down the rate of increase
in health costs.
Opponents of a public plan argue that it would present unfair competition to private health insurers. Some provider organizations worry that by driving down prices, a public plan would reduce their ability to provide high-quality care. Employer and insurer organizations add that in order to maintain their revenues, health care providers might “cost-shift” by raising charges to employer-based plans.
Finally, there are also growing questions, on the part of both supporters and opponents alike, about how viable or effective the latest redesigned version of the public plan is likely to be.
This Health Policy Brief lays out details of the public health insurance plan and explores the key arguments for and against it, and was published online on November 10, 2009 in Health Affairs.
Health Affairs/RWJF Health Policy Briefs
Series provides clear, accessible overviews of timely and important health policy topics. The briefs are geared to policy-makers, congressional staffers, and others who need short, jargon-free explanations of health policy basics.About the series
- About this grant
RWJF Scholar examines neighborhood-based death rates from opiate-based painkiller overdoses, compared with heroin overdose deaths.
RWJF Nurse Faculty Scholar Jennifer Bellot writes about losing her grandmother to complications from a medical error.
The County Health Rankings & Roadmaps can be put to use right away to help create a culture of health in your community.
Learn how The Robert Wood Johnson Foundation is dedicated to building a culture of health in Risa Lavizzo-Mourey's 2014 annual message.
As part of National Public Health Week, PHLR—a grantee of the Robert Wood Johnson Foundation—has been participating in the week by contribut...
A new paper reports on the proceedings of an unprecedented meeting that brought together diverse leaders from community colleges around the ...
Study: Banning Chocolate Milk in Elementary Schools Also Decreases Overall Sales, Increases Waste - CDC: Significant Drops in Five Major Di...
America is not getting good value for its health care dollar. These resources explore issues of cost and value of health care.
Developing small community homes as alternatives to nursing homes, this radical, new national model for skilled nursing care returns control...
Team members, grantees, and guests discuss breakthrough ideas that will allow us to move toward solving challenges in health care.
While the need to address disparities in care is well known, few strategies for reducing disparities have been studied systematically.
Empathy is the lifeblood of any system of health—it gives us all a shared stake in being healthy and helping others to thrive as well.