What every citizen should know about Health Care Policy
Outline: Answers to 12 Basic Questions
Overview
1. What is the current three-level American health care system?
2. How did the current U.S. system come about?
3. Who are the five principal groups of players in the current system, and what are the motivations of each group?
4. What are the pros and cons of health care as an employment benefit?
5. Why is quality health care often expensive?
6. Can we separate good and bad methods of health care cost control?
7. What are the nine main criteria of quality for any future system
of quality health care for all?
8. Can the U.S. afford quality health care for all?
9. If quality health care for all is affordable, what are the real obstacles to progress toward that goal?
10. What are the pros and cons of "managed care?
11. To what extent can market forces be relied upon to achieve quality health care for all?
12. What are the chief current proposals to improve the American health care system, and what are their pros and cons7
Suggestions for further reading
OVERVIEW
Caveat Emptor—buyer beware—is again the watchword, as American health care policy continues in its long struggle for quality and affordability for all. But not only the buyer must beware, for caution signs have gone up for doctors, nurses, hospitals, other providers, drug manufacturers, insurance companies and managed care plans.
Little is firmly established in this complex system. Large health plans seem to be set one day and collapsing or shrinking the next. Physicians find their control of quality and pricing increasingly lost to intervening groups that deal with organizations paying for all or part of the services. Meanwhile some large suppliers such as drug companies operate with relative freedom to set the price of their products, adding significantly to the overall cost of medical care.
For many persons, "caveat emptor" has little meaning, for they have little money and no choice about their health care. And most important, national and state legislators who have the only effective power to control the health care system have, for the most part, failed to use that power effectively. Some believe the subject should be left to the private sector. Others who believe in a greater role for the government have often been unable to design adequate legislation or to find enough support.
This paper, which has been reviewed by health care and economics experts, reflects CQC*s work to date on this subject.* The paper seeks to clarify the subject*s most important aspects: the players, policies, programs, and problems that vex this volatile sector of American life.
*Note: CQC (Citizens for Quality Civilization, Inc.) is a nonpartisan think-and-action group, tax-exempt under IRS Section 501 (c)(3), composed of volunteers with professional or managerial backgrounds and records of civic and community service. Organized in 1990, CQC seeks to monitor significant national concerns. Since 1993, CQC has monitored health policy.
Copyright 1999, Citizens for Quality Civilization, Inc. (CQC). For additional copies of this paper, or to request permission to make copies, please contact CQC as indicated above.