The case for public funding and private delivery

Hastings Center Report

Volumn 38, Issue 1, 2008, Pages 23-33

  Degrazia, David ^a  

^a NONE

Author keywords

[No Author keywords available]

Indexed keywords

ARTICLE; COST BENEFIT ANALYSIS; ECONOMIC ASPECT; ECONOMICS; FINANCIAL MANAGEMENT; HEALTH CARE DELIVERY; HEALTH CARE POLICY; HEALTH INSURANCE; HUMAN; METHODOLOGY; ORGANIZATION AND MANAGEMENT; PATIENT; UNITED STATES;

COST-BENEFIT ANALYSIS; DELIVERY OF HEALTH CARE; ECONOMIC COMPETITION; FINANCING, GOVERNMENT; HEALTH CARE REFORM; HUMANS; MANAGED CARE PROGRAMS; MEDICALLY UNINSURED; SINGLE-PAYER SYSTEM; UNITED STATES;

EID: 39449095828     PISSN: 00930334     EISSN: None     Source Type: Journal    
DOI: None     Document Type: Article

References (66)

1. U.S. Census Bureau, Income, Poverty, and Health Insurance Coverage in the United States: 2005 (Washington, D.C.: Government Printing Office, 2006), 20.
2. Institute of Medicine, "Insuring America's Health: Principles and Recommendations" (Washington, D.C.: National Academies of Science, 2004), http://www.iom.edu/Object.File/Master/17/732/Uninsured6-EnglishFINAL.pdf.
3. Institute of Medicine, "Insuring America's Health: Principles and Recommendations," January 14, 2004, press release.
4. Institute of Medicine, Hidden Costs, Value Lost (Washington, D.C.: National Academies Press, 2003), 112.
5. J. Hadley and J. Holahan, "The Cost of Care for the Uninsured," Kaiser Commission on Medicaid and the Uninsured (May 10, 2004): 1-14;
6. J. Richmond and R. Fein, The Health Care Mess (Cambridge, Mass.: Harvard University Press, 2005), 233.
7. See G. Anderson et al., "Health Spending in the United States and the Rest of the Industrialized World," Health Affairs 24, no. 4 (2005): 903-914.
8. We have far outspent other countries for a long time. See G. Schieber, J.-P. Poullier, and L. Greenwald, "Health System Performance in OECD Countries: 1980-1992," Health Affairs 13, no. 4 (1994): 100-112;
9. and G. Anderson et al., "Health Spending and Outcomes: Trends in OECD Countries, 1960-1998," Health Affairs 19, no. 3 (2000): 150-57.
10. Alliance for Health Reform, "Health Care Coverage in America," updated March 2006; www.CoverTheUninsured.org.
11. See D. Cutler, Your Money or Your Life (New York: Oxford University Press, 2004), chapter 8;
12. and K. Donelan et al., "The Cost of Health System Change: Public Discontent in Five Nations," Health Affairs 18, no. 3 (1999): 206-216.
13. See Employee Benefit Research Institute, "2006 Health Confidence Survey: Dissatisfaction with Health Care System Doubles since 1998," EBRI Notes 27, no. 11 (2006) www.ebri.org,
14. and ABC News/ USA Today/Kaiser Family Foundation Health Care Poll, www.usatoday.com/news/health/2006-10-15-health-poll1.htm.
15. "New Leadership on Health Care: A Presidential Forum," sponsored by the Center for American Progress Action Fund; complete transcripts of the participants' talks are available at www.americanprogressaction.org/ events/healthforum/.
16. It is difficult to imagine genuine doubt that Americans care greatly about cost controls, patient freedom, and quality, but that they consider universal coverage a high priority might seem less obvious. On this point, see Washington Post-ABC Poll, The Washington Post, October 20, 2003;
17. American Hospital Association, "AHA National and Selected Statewide Surveys," www.hospitalconnect.com/aha/campaign2004/index.html;
18. and Kaiser Family Foundation, "Kaiser Health Poll Report: The Public Is Concerned about the Problem," December 2005, www.kff.org/spotlight/ uninsured/1.cfm.
19. On the importance to Americans of costs and quality, see Employee Benefit Research Institute, "2006 Health Confidence Survey."
20. See Schieber et al., "Health System Performance in OECD Countries"; K. Donelan et al., "All Payer, Single Payer, Managed Care, No Payer: Patients' Perspectives in Three Nations," Health Affairs 15, no. 2 (1996): 254-65;
21. K. Donelan et al., "The Cost of Health System Change"; Anderson et al., "Health Spending and Outcomes"; L. Brown, "Comparing Health Systems in Four Countries: Lessons for the United States," American Journal of Public Health 93 (2003): 52-56;
22. R. Blendon et al., "Common Concerns Amid Diverse Systems: Health Care Experiences in Five Countries," Health Affairs 22, no. 3 (2003): 106-121;
23. and K. Lasser et al., "Access to Care, Health Status, and Health Disparities in the United States and Canada," American Journal of Public Health 96 (2006): 1300-1307.
24. My overview has benefited from Richmond and Fein, The Health Care Mess, 235-37.
25. D. Palmisano, D. Emmons, and G. Wozniak, "Expanding Insurance Coverage through Tax Credits, Consumer Choice, and Market Enhancements," Journal of the American Medical Association 291 (2004): 2237-42.
26. Alliance for Health Reform, "Health Care Coverage in America."
27. J. Gruber, "The Massachusetts Health Care Resolution: A Local Start for Universal Access," Hastings Center Report 36, no. 5 (2006): 14-19.
28. Another reason this initiative will not achieve universal coverage is that the mandate is binding only for those who can afford insurance (ibid., p. 17).
29. For other difficulties, see S. Woolhandler and D. Himmelstein, "The New Massachusetts Health Reform: Half a Step Forward and Three Steps Back," Hastings Center Report 36, no. 5 (2006): 19-21.
30. See Richmond and Fein, The Health Care Mess, chapter 8.
31. Ibid, 252-57;
32. and Cutler, Your Money or Your Life, chapter 10.
33. Richmond and Fein, The Health Care Mess, 258.
34. E. Emanuel and V. Fuchs, "Health Care Vouchers - A Proposal for Universal Coverage," New England Journal of Medicine 352 (2005): 1255-60.
35. See D. Cutler and S. Reber, "Paying for Health Insurance: The Trade-Off Between Competition and Adverse Selection," Quarterly Journal of Economics 113 (1998): 433-66.
36. Cutler, Your Money or Your Life, 96-97.
37. Congressional Budget Office, Universal Health Insurance Coverage Using Medicare's Payment Rates, December 1991, http://www.cbo.gov/ftpdocs/76xx/ doc7652/91-CBO-039.pdf.
38. United States Government Accountability Office, Canadian Health Insurance: Lessons for the United States, June 1991, http://archive.gao.gov/ d38t12/144048.pdf.
39. See M. Angell, "Dr. Frist to the Rescue: How Not to Fix Medicare," The American Prospect, online article issued February 1, 2003, www.prospect.org/print/V14/2/angell-m.html;
40. and Physicians' Working Group for Single-Payer National Health Insurance, "Proposal of the Physicians' Working Group for Single-Payer National Health Insurance," Journal of the American Medical Association 290 (2003), 799.
41. See Physicians' Working Group for Single-Payer National Health Insurance, "Proposal of the Physicians' Working Group for Single-Payer National Health Insurance," 804.
42. See M. Barer et al., "Reminding Our Ps and Qs: Medical Cost Controls in Canada," Health Affairs 15, no. 2 (1996): 217-35;
43. Anderson et al., "Health Spending and Outcomes";
44. Brown, "Comparing Health Systems in Four Countries";
45. R. Deber, "Health Care Reform: Lessons from Canada," American Journal of Public Health 93, no. 1 (2003): 20-24;
46. Anderson et al., "Health Spending in the United States and the Rest of the Industrialized World."
47. See Blendon et al., "Common Concern Amid Diverse Systems";
48. P. Hussey et al., "How Does the Quality of Care Compare in Five Countries?" Health Affairs 23, no. 3 (2004): 89-99;
49. and Lasser et al., "Access to Care, Health Status, and Health Disparities in the United States and Canada."
50. S. Woolhandler, T. Campbell, and D. Himmelstein, "Costs of Health Care Administration in the United States and Canada," New England Journal of Medicine 349 (2003): 768-73.
51. H. Aaron, "The Costs of Health Care Administration in the United States and Canada - Questionable Answers to a Questionable Question," New England Journal of Medicine 349 (2003): 801-803.
52. N. Daniels, Seeking Fair Treatment (New York: Oxford University Press, 1995), chapter 8.
53. J. Hadley and J. Holahan, "Covering the Uninsured: How Much Would It Cost?" (Web exclusive) Health Affairs 22, no. 4 (2003): W3/250-W3/265.
54. Institute of Medicine, "Insuring America's Health," 6.
55. Richmond and Fein, The Health Care Mess, 243.
56. See Physicians' Working Group for Single-Payer National Health Insurance, "Proposal of the Physicians' Working Group for Single-Payer National Health Insurance,"
57. and Hadley and Holahan, "Covering the Uninsured."
58. P. Cotton, "Single-Payer Plan Gets Cautious Support," Journal of the American Medical Association 271 (1994): 731.
59. D. McCormick et al., "Single-Payer National Health Insurance: Physicians' Views," Archives of Internal Medicine 164 (2004): 300-304.
60. L. Fleck, "Rationing: Don't Give Up," Hastings Center Report 32, no. 2 (2002): 35-36.
61. S. Katz et al., "Phantoms in the Snow: Canadians' Use of Health Care Services in the United States," Health Affairs 21, no. 3 (2002): 19-31.
62. For a discussion citing many useful sources, see D. Callahan and A. Wasunna, Medicine and the Market (Baltimore, Md.: Johns Hopkins University Press, 2006), 236-46.
63. See also the works cited in notes 12 and 29.
64. D. Light, "Universal Health Care: Lessons from the British Experience," American Journal of Public Health 93 (2003), 29.
65. See especially the many fine articles by Steffie Woolhandler and David Himmelstein, including "Proposal of the Physicians' Working Group for Single-Payer National Health Insurance."
66. Any reader inclined to be skeptical may return to note 11.