Across the globe, healthcare reformers are increasingly recognizing that a system-wide approach is needed. They are focusing on quality by improving how the system works and by helping individuals take more responsibility for their own health. They are also addressing the root causes of poor health, such as reducing poverty and providing housing, education, nutrition and running water. These efforts are a response to mounting dissatisfaction with the old quality agenda, which has been unaffordable and dysfunctional for far too long.
Health reforms that secure demonstrable, attainable benefits are essential. But, if they are to succeed, they must also include well-designed evaluation. This can depoliticize the process, and help identify the reasons why a reform fails to improve care or even produce negative effects. Linear cause-and-effect logic (let us do reform X, and we will see benefit Y) rarely holds.
The House and Senate bills both provide a firm foundation for reform. They set out commonsense rules of the road to hold insurance companies accountable and to keep their premium increases in check, while preventing discrimination against those with preexisting conditions. They strengthen consumer protections and curb fraud, waste and abuse by imposing tough new requirements for providers and instituting new penalties. They also help families afford coverage by making subsidies available to all households, while ensuring that young people can stay on their parents’ plans. This will ensure that all Americans can be confident that they have affordable access to the medical services they need.