Health reform is not just about expanding coverage, but also laying out rules that will keep premiums down and prevent insurance industry abuses. It will end discrimination against people with pre-existing conditions and put our budget on a sounder path by reducing government overspending. It will make it possible for small businesses to get affordable insurance through the exchanges, and it will let young adults stay on their parents’ plans until they’re 26.
Until recently, quite a few health care policy makers still wanted to get back to some level of the entirely mythical “good old days” — when Marcus Welby-like physicians knew everything about their patients and made great, science-based decisions without interference from health plans or even scientific, performance-tracking databases. Today, however, buyers, patients and providers are beginning to understand that the world of unstructured care has created a real quality chasm that is expensive, dysfunctional and sometimes dangerous for far too many of them.
This new understanding has triggered different priorities for healthcare reform in different countries. In low-income nations, the emphasis is on improving the fundamentals of infrastructure and a skilled workforce. In richer ones, it is on enhancing efficiency and quality; acquiring advanced technologies; and developing innovative funding models. But, irrespective of whether they are poor or wealthy, all nations face the challenge of addressing the fact that a population’s health is not solely determined by its hospital system. It requires that the broader community tackles issues such as poverty, education, nutrition, housing and running water to create healthy communities.