As the nation continues its recovery from extraordinary economic turmoil -- in part through a sweeping stimulus package -- the opportunity to undertake comprehensive health care reform is now at hand. Judging by prior reform attempts, negotiations will be complicated, contentious and expensive.
Nevertheless, the troubled economy now presents a remarkable opportunity for success. If executed properly, addressing the nation's health policy challenges would be a key element of -- rather than an obstacle to -- economic recovery and personal financial security.
All stakeholders agree that America needs a more affordable, more inclusive and higher quality health care system. In 2008, health care spending in the United States reached $2.4 trillion, 17 percent of the gross domestic product, and -- according to one study -- could reach $3.1 trillion in 2012 and $4.3 trillion by 2016. Roughly 45 million people under the age of 65 -- 17 percent of the nonelderly population -- including close to 9 million children, did not have health insurance in 2007, based on Kaiser Family Foundation data. And a landmark health quality study from the New England Journal of Medicine reported surveyed participants received recommended care only 54.9 percent of the time.
A re-imagined health care system also will require a strong framework for the provision and delivery of health insurance. Previous reform proposals have recommended approaches that span the spectrum of ideas from a government-run single-payer system to a greater reliance on individual coverage from the private marketplace. But it is fair to suggest that the option that would be easiest to implement and must likely to succeed is one built upon the framework that already serves more than half of all Americans: the employer-sponsored benefits system.
This was the central premise of the American Benefits Council's health care reform proposal, "Condition Critical: Ten Prescriptions for Reforming Health Care Quality, Cost and Coverage."
Like other proposals developed by industry and interest groups, our plan establishes a set of key principles, or prescriptions, for reform:
- Build on what works -- the voluntary employer-based health care system
- Maintain a federal framework
- Improve the quality and efficiency of health care
- Provide clear, reliable information to make better health care decisions
- Make health coverage an individual obligation for all Americans
- Establish a minimum standard for quality, affordable health coverage
- Reform the individual insurance marketplace for those who do not have access to employer-based coverage
- Strengthen state safety-net health insurance programs
- Improve tax policy to make health coverage more affordable and accessible
- Enable employers and employees to develop retiree health care solutions
Unlike most other proposals, however, Condition Critical provides specific policy recommendations for achieving these goals. The time for articulating broad principles is behind us; lawmakers need specific input on what a 21st century health care system should look like as they begin the process now to draft legislation.
The most important prescription, however, does not appear on this list. It is the unspoken understanding that the most enduring legislative accomplishments in our nation's history are born out of bipartisanship. Health care reform almost certainly will require just such an open, consensus-based approach and a willingness to seek out and incorporate the best ideas from many parties.
If we remain committed to this approach, this time health care reform can succeed.
James A. Klein can be reached via e-mail at info@abcstaff.org.
