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Who Has the Cure?

Who Has the Cure?: Hamilton Project Ideas on Health Care

Copyright Date: 2008
Pages: 277
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  • Book Info
    Who Has the Cure?
    Book Description:

    The Hamilton Project at the Brookings Institution was established to foster policy innovation from leading economic thinkers -ideas based on evidence and experience, not ideology and doctrine. The overall goal is to promote America's long-term economic growth, and economic security for American families. This important book brings The Hamilton Project's approach to one of the most critical issues facing Americans today -health care.

    InWho Has the Cure?a team of noted economists and policy analysts emphasizes the importance of universal health care -not just its value to individual and families, but also the overall economy. They examine in detail four policy alternatives for achieving universal health insurance coverage that would also improve efficiency in the health care industry.

    The contributors to this volume also evaluate proposales designed to make health care more affordable and effective. Among the possible strategies studied here are an expansion of preventive care, income-related cost sharing, and reform of Medicare's prescription drug benefit.

    eISBN: 978-0-8157-0199-6
    Subjects: Health Sciences

Table of Contents

  1. Front Matter
    (pp. i-iv)
  2. Table of Contents
    (pp. v-vi)
  3. Acknowledgments
    (pp. vii-viii)
  4. 1 Universal, Effective, and Affordable Health Insurance: An Economic Imperative
    (pp. 1-8)

    The Hamilton Project was founded to develop an economic strategy together with innovative policy ideas to promote three goals: growth, broad-based participation in growth, and economic security in a changing global economy. The Project’s proposals span a wide range of policy areas including education, income security, health, science and technology, tax policy, climate change, energy security, workforce training, and poverty reduction. The proposals have come from leading academics, practitioners, and policy analysts from across the nation, taking cutting-edge and evidence-based ideas from economists and others and bringing them to bear on policy debates in a relevant, accessible, and actionable way....

  5. 2 Achieving Universal Coverage through Medicare Part E(veryone)
    (pp. 9-48)

    Our starting premise is that any proposal to provide universal health coverage should be simple to explain so that members of the public can assess how any changes would affect them personally. Medicare Part E(veryone) is designed to be easy for the public to understand: it builds on the existing Medicare system and makes minimal changes to the rest of the health care system. Although we developed Part E as a self-contained program, policymakers could choose to combine it with a more ambitious restructuring of the health care system.

    Our proposal to add a Medicare Part E is simple: make...

  6. 3 Evolving beyond Traditional Employer-Sponsored Health Insurance
    (pp. 49-90)

    Access to adequate and dependable health insurance is one of the keys to economic security. When health coverage is uncertain or unaffordable, workers and their families face broad economic consequences and suffer personal anxiety. For most working-age families in the United States, health coverage is directly connected to the workplace. So the availability or absence of employment-based health insurance and the structure and cost of benefits when insurance is available affect basic employment decisions. Coverage, or the lack thereof, influences the choice between full-time or part-time employment and the decision whether to work in one company or another. Workers with...

  7. 4 A Comprehensive Cure: The Guaranteed Health Care Access Plan—A Voucher-Style Reform
    (pp. 91-120)

    The American health care system is a dysfunctional mess; its problems are well known. There are coverage problems: tens of millions are uninsured, others have poor coverage, and millions receive Medicaid, which looks comprehensive on paper but, because of extremely low reimbursement, is served by few providers. In addition, as costs rise, there has been—and will continue to be—a steady drop in employer-based insurance. There are cost problems: over the last thirty years, the rise in health care costs has exceeded the economy’s rate of growth by 2.1 percentage points each year (Catlin and others 2008; Kaiser Family...

  8. 5 Taking Massachusetts National: Incremental Universalism for the United States
    (pp. 121-142)

    The history of health care reform in the United States is littered with failed attempts at universal health care coverage. The most recent was the Clinton Health Security Act of 1993–94, which proposed an ambitious overhaul of the U.S. health care system; it was defeated soundly in Congress. There has been no serious national attempt at universal coverage since that time. For example, in 2004, Democratic presidential candidate John F. Kerry focused much more on lowering health insurance premiums than he did on broad expansions of coverage.

    All of this has changed recently, but this time the states are...

  9. 6 Mending the Medicare Prescription Drug Benefit: Improving Consumer Choices and Restructuring Purchasing
    (pp. 143-174)

    Prescription drugs play an increasingly central role in health care delivery, accounting for about 12 percent of personal health care spending in 2006.¹ They are critical in managing many chronic diseases and meeting other health needs of the elderly. Yet the original Medicare program, the main federal health care program for the elderly, did not cover most outpatient prescription drugs. In making this choice, Medicare simply followed the lead of the private health insurance plans that existed at its creation in the 1960s, when the clinical importance of drugs was much smaller than it is today.

    As a result, at...

  10. 7 The Promise of Progressive Cost Consciousness in Health Care Reform
    (pp. 175-226)

    In 1965 the average American received $995 worth of medical care (in today’s dollars).¹ Nearly half of this amount, $483, was paid out of pocket for deductibles, copayments, coinsurance, or for services and supplies not covered by insurance. Third parties, usually private insurance companies, paid the other half. In the decades that followed, health care was transformed as increased use of health care services, together with expensive new technologies and drugs, increased spending per capita to an estimated $6,640 in 2006. Yet even as national health care spending increased nearly sevenfold, the amount that consumers paid out of pocket did...

  11. 8 A Wellness Trust to Prioritize Disease Prevention
    (pp. 227-264)

    The health challenges faced at the beginning of the twenty-first century are different from and, in some ways, more daunting than those at the turn of the twentieth century. There were considerable gains made over the last century; for example, life expectancy has lengthened by thirty years and infant mortality has dropped by 90 percent (Centers for Disease Control and Prevention [CDC] 1999). Public health and medicine combined to reduce infectious disease. No longer are diseases like tuberculosis, influenza, and pneumonia the major killers that they were in 1900 (see figure 8-1). In addition, rapid scientific advances have largely converted...

  12. Contributors
    (pp. 265-268)
  13. Index
    (pp. 269-277)
  14. Back Matter
    (pp. 278-280)