Health care reform efforts, especially those aiming to address the millions of uninsured Americans, are inherently complex. There are any number of policy choices that could contain costs, improve delivery, and save lives. These choices range from government oversight (insurance exchanges, a reformed Medicare Part D drug plan, and cost-control measures) to free market principles (deductibles, co-pays, Health Savings Accounts, and episode payments). Scholars and health care professionals who have exhaustively researched the issue acknowledge four core realities: one, health care spending is out of control; two, it is virtually impossible to correlate expenses with outcomes; three, there will never be a perfect universal system, anywhere; and four, without a significant level of reform, our national health care system will collapse.
The new members of the 119th Congress have an enormous opportunity to advance meaningful and long-overdue healthcare reform. Their first steps should include reversing the 2.8% Medicare cuts that began on Jan. 1, reforming the onerous prior authorization process, and tying physician Medicare reimbursements to quality of care metrics. They should also pass a fair and equitable employer mandate that sets required contributions as a percentage of payroll rather than the Finance Committee’s “free-rider” provision, which would discourage firms from hiring workers who qualify for insurance subsidies.
Major societal reforms are unlikely to succeed unless they resonate with the people most directly affected by them. If they fail to do so, they will quickly lose support. In that context, improving subjective measures of happiness should become a central objective of any serious healthcare reform effort.