Hostname: page-component-cd9895bd7-jn8rn Total loading time: 0 Render date: 2024-12-26T05:02:30.513Z Has data issue: false hasContentIssue false
  • English
  • Français

The 2010 U.S. health care reform: approaching and avoiding how other countries finance health care

Published online by Cambridge University Press:  12 October 2012

Joseph White
Joseph White*
Affiliation:
Luxenberg Family Professor of Public Policy, Department of Political Science, Case Western Reserve University, Cleveland, Ohio, USA
*
*Correspondence to: Professor Joseph White, Department of Political Science, Case Western Reserve University, Mather House 111, 11201 Euclid Avenue, Cleveland, OH 44106-7109, USA. Email: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

This article describes and analyzes the U.S. health care legislation of 2010 by asking how far it was designed to move the U.S. system in the direction of practices in all other rich democracies. The enacted U.S. reform could be described, extremely roughly, as Japanese pooling with Swiss and American problems at American prices. Its policies are distinctive, yet nevertheless somewhat similar to examples in other rich democracies, on two important dimensions: how risks are pooled and the amount of funds redistributed to subsidize care for people with lower incomes. Policies about compelling people to contribute to a finance system would be further from international norms, as would the degree to which coverage is set by clear and common substantive standards – that is, standardization of benefits. The reform would do least, however, to move the United States toward international practices for controlling spending. This in turn is a major reason why the results would include less standard benefits and incomplete coverage. In short, the United States would remain an outlier on coverage less because of a failure to make an effort to redistribute – a lack of solidarity – than due to a failure to control costs.

Type
Articles
Information
Health Economics, Policy and Law , Volume 8 , Issue 3 , July 2013 , pp. 289 - 315
Copyright
Copyright © Cambridge University Press 2012 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Alliance for Health Reform (2008), ‘Putting the Brakes on Health Care Costs: Would the Candidates’ Plans Work? Are There Better Solutions?’ Transcript of Briefing, http://www.allhealth.org/briefingmaterials/Transcript-June3,2008-1240.pdf [3 June 2008].Google Scholar
Angrisano, C., Farrell, D., Kocher, B., Laboissiere, M.Parker, S. (2007), Accounting for the Cost of Health Care in the United States, San Francisco: McKinsey Global Institute.Google Scholar
Antos, J., Wilensky, G.Kuttner, H. (2008), ‘The Obama plan: more regulation, unsustainable spending’, Health Affairs, 27(6): w462–w471.Google Scholar
Armstrong, D.Wayne, A. (2009a), ‘A second opinion’, CQ Weekly, April 6: 768–773.Google Scholar
Armstrong, D.Wayne, A. (2009b), ‘Majority forced by its own to go slow’, CQ Weekly, July 27: 1778–1780.Google Scholar
Bernstein, J. (2009), ‘Public Perspectives on Health Delivery System Reforms’, Changes in Health Care Financing & Organization Policy Brief, Robert Wood Johnson Foundation, http://www.rwjf.org/files/research/62209hcfopublicperspectivesbrief.pdf [22 June 2009].Google Scholar
Buchmueller, T., Glied, S. A., Royalty, A.Swartz, K. (2008), ‘Cost and coverage: implications of the McCain plan to restructure health insurance’, Health Affairs, 27(6): w472–w481.Google Scholar
Carman, K. L., Maurer, M., Yegian, J. M., Dardess, P., McGee, J., Evers, M.Marlo, K. D. (2010), ‘Evidence that consumers are skeptical about evidence-based health care’, Health Affairs, 29(7): 1400–1410.CrossRefGoogle ScholarPubMed
Cohn, J. (2010), ‘How they did it’, The New Republic, June 10: 14–25.Google Scholar
Colombo, F., Zurn, P.Oxley, H. (2006), OECD Reviews of Health Systems: Switzerland, Paris: OECD and WHO.Google Scholar
Commonwealth Fund (2010), ‘Health Reform Resource Center: What's In the Affordable Care Act?’ http://www.commonwealthfund.org/Health-Reform/Health-Reform-Resource.aspxGoogle Scholar
Congressional Budget Office (CBO) (2008), ‘Key Issues in Analyzing Major Health Insurance Proposals’, http://cbo.gov/ftpdocs/99xx/doc9924/12-18-KeyIssues.pdfGoogle Scholar
CBO (2010), ‘H.R. 4872, Reconciliation Act of 2010 (Final Health Care Legislation’, http://cbo.gov/doc.cfm?index=11379&zzz=40823Google Scholar
Congressional Research Service (2010), ‘The PPACA Penalty Provision and the Internal Revenue Service’, Memo to the Hon. Tom Coburn (April 30), http://coburn.senate.gov/public/index.cfm?a=Files.Serve&File_id=2ec1e180-afbf-4a48-ba12-8dea812ac30a [29 October 2011].Google Scholar
Crivelli, L. (2010), ‘Swiss are Back to (Quasi-) Universal Coverage’, Health Policy Monitor Survey 15. http://www.hpm.org/en/Surveys/USI_-_Switzerland/15/Swiss_are_back_to_(quasi-)_universal_coverage.html?p_c:256=256&content_id=251&search.x=65&search.y=6&search=start+search&p_i=83&a=sh&language=enGoogle Scholar
Cutler, D. (2010), ‘How health care reform must bend the cost curve’, Health Affairs, 29(6): 1131–1135.Google Scholar
Davis, K. (2010), A New Era in American Health Care: Realizing the Potential of Reform, New York: The Commonwealth Fund.Google Scholar
Democratic National Convention Committee (2008), Renewing America's Promise: The 2008 Democratic National Platform, www.democrats.org/about/party-platform [8 July 2012].Google Scholar
DeNavas-Walt, C., Proctor, B. D.Smith, J. C. (2010), Income, Poverty, and Health Insurance Coverage in the United States: 2009, Washington, DC: U.S. Government Printing Office, U.S. Census Bureau, Current Population Reports, P60-238.Google Scholar
Eibner, C., Girosi, F., Price, C. C., Cordova, A., Hussey, P. S., Beckman, A.McGlynn, E. A. (2010), Establishing State Health Insurance Exchanges: Implications for Health Insurance Enrollment, Spending, and Small Businesses, Santa Monica, CA: Rand Corporation.Google Scholar
Emanuel, E. (2008), Healthcare Guaranteed: a Simple, Secure Solution for America, New York: Public Affairs.Google Scholar
Employee Benefit Research Institute (2009a), ‘Chapter 20: Health Benefits Overview’, in Fundamentals of Employee Benefit Programs, http://www.ebri.org/pdf/publications/books/fundamentals/2009/20_Hlth-Bens-Ovrvu_HEALTH_Funds-2009_EBRI.pdfGoogle Scholar
Employee Benefit Research Institute (2009b), ‘Chapter 28: Non-discrimination and Health Benefits’, in Fundamentals of Employee Benefit Programs, http://www.ebri.org/pdf/publications/books/fundamentals/2009/28_Nondiscrim_HEALTH_Funds-2009_EBRI.pdfGoogle Scholar
Fukawa, T. (2002), ‘Public Health Insurance in Japan’, World Bank Institute, http://Unpan1.un.org/intradoc/groups/publicdocuments/APCITY/UNPAN020063.pdfGoogle Scholar
Ginsburg, P. B. (2008), ‘High and Rising Health Care Costs: Demystifying U.S. Health Care spending’, The Robert Wood Johnson Foundation Research Synthesis Report No. 16, Princeton, NJ.Google Scholar
Greenstein, R., Kogan, R., Van de Water, P. (2011), ‘Democrats Offer Significant Concessions’, Center on Budget and Policy Priorities (October 28), http://www.cbpp.org/files/10-28-11bud.pdf [29 October 2011].Google Scholar
Gruber, J. (2009), ‘Cadillac tax isn't a tax: it's a plan to finance real health care reform’, Washington Post, http://www.washingtonpost.com/wp-dyn/content/article/2009/12/27/AR2009122701714.html [28 December 2009].Google Scholar
Hacker, J. (2009), ‘Healthy competition – the why and how of “public plan choice” ’, New England Journal of Medicine, 360(22): 2269–2271.CrossRefGoogle Scholar
Hacker, J. (2010a), ‘The road to somewhere: why health reform happened’, Perspectives on Politics, 8(3): 861–876.CrossRefGoogle Scholar
Hacker, J. (2010b), ‘Health Care Reform 2015’, Democracy, A Journal of Ideas 18 (Fall), http://www.democracyjournal.org/article.php?ID=6772Google Scholar
Health Policy Brief: Essential Health Benefits (2011), Health Affairs, April 25, http://www.healthaffairs.org/healthpolicybriefs/brief.php?brief_id=68 [5 July 2012].Google Scholar
Holahan, J. (2009), ‘Statement to Committee on Ways and Means, United States House of Representatives, Hearing on “Health Reform in the 21st Century: Proposals to Reform the Health System” ’, http://www.urban.org/UploadedPDF/901265_JHolahanCongTestimonyJune242009.pdf [2 October 2012].Google Scholar
Holtz-Eakin, D.Ramlet, M. J. (2010), ‘Health care reform is likely to widen federal deficits, not reduce them’, Health Affairs, 29(6): 1136–1141.Google Scholar
Jost, T. S. (2009), ‘The Experience of Switzerland and the Netherlands With Individual Health Insurance Mandates: A Model for the United States?’, http://law.wlu.edu/deptimages/Faculty/Jost%20The%20Experience%20of%20Switzerland%20and%20the%20Netherlands.pdfGoogle Scholar
Jost, T. S. (2010), ‘Implementing Health Reform: Grandfathered Plans’, Health Affairs Blog, http://healthaffairs.org/blog/2010/06/15/Implementing-health-reform-grandfathered-plans/ [15 June 2010].Google Scholar
Jost, T. S., White, J. (2010), ‘Cutting Health Care Spending: What is the Cost Of an Excise Tax That Keeps People From Going to the Doctor?’ Institute for America's Future, http://www.ourfuture.org/files/Jost-White_Excise_Tax.pdf [13 January 2010].Google Scholar
Kaiser Commission on Medicaid and the Uninsured (2010a), ‘Medicaid and Managed Care: Key Data, Trends, and Issues’, http://www.kff.org/medicaid/upload/8046.pdfGoogle Scholar
Kaiser Commission on Medicaid and the Uninsured (2010b), ‘Medicaid Beneficiaries and Access to Care’, http://kff.org/medicaid/upload/8000-02.pdfGoogle Scholar
Kaiser Family Foundation (2010a), ‘Focus on Health Reform: Medicaid and Children's Health Insurance Program Provisions in the New Health Reform Law’, http://kff.org/healthreform/upload/7952.03.pdfGoogle Scholar
Kaiser Family Foundation (2010b), ‘Focus on Health Reform: Explaining Health Reform: Benefits and Cost-Sharing for Adult Medicaid Beneficiaries’, http://kff.org/healthreform/upload/8092.pdfGoogle Scholar
Kaiser Family Foundation (2010c), ‘Focus on Health Reform: Summary of the New Health Reform Law’, http://kff.org/healthreform/upload/8061.pdfGoogle Scholar
Kaiser Family Foundation (2010d), ‘The Uninsured: A Primer. Supplemental Data Tables (Dec)’, http://kff.org/uninsured/upload/7451-06_Data_Tables.pdfGoogle Scholar
Kaiser Family Foundation Health Reform Source (2011), ‘Health Reform Subsidy Calculator’, http://healthreform.kff.org/subsidycalculator.aspxGoogle Scholar
Keehan, S. P., Sisko, A. M., Truffer, C. J., Poisal, J. A., Cuckler, G. A., Madison, A. J., Lizonitz, J. M.Smith, S. D. (2011), ‘National health spending through 2020: economic recovery and reform drive faster spending growth’, Health Affairs, 30(8): 1594–1605.Google Scholar
Kirsch, R. (2012), Fighting for Our Health: the Epic Battle to Make Health Care a Right in the United States, Albany, NY: Rockefeller Institute Press.Google Scholar
Liptak, A. (2012), ‘Supreme Court Upholds Health Care Law, 5-4, in Victory for Obama’, New York Times, 28 June, http://www.nytimes.com/2012/06/29/us/supreme-court-lets-health-law-largely-stand.html?_r=1&pagewanted=all [4 July 2012].Google Scholar
Marmor, T.Oberlander, J. (2011), ‘The patchwork: health reform, American style’, Social Science and Medicine, 72(2): 125–128.Google Scholar
Marmor, T., Oberlander, J.White, J. (2009), ‘The Obama administration's options for health care cost control: hope vs. reality’, Annals of Internal Medicine, 150(7): 485–489.Google Scholar
Matsuda, R. (2009), ‘A new rule for setting premium rates’, Health Policy Monitor. http://www.hpm.org/en/Surveys/Ritsumeikan_University_-_Japan/13/A_New_Rule_for_Setting_Premium_Rates.html?search.x=66&p_i=83&search.y=12&sortOrder=sortAsc&a=sh&lastSortBy=sortCountry&p_c:256=256&p_c:263=263&content_id=251&sortBy=sortCountry&search=start+search&lastSortOrder=sortAsc&language=en&pageOffset=0 [2 October 2012].Google Scholar
McDonough, J. E. (2011), Inside National Health Reform, Berkeley and New York: University of California Press and the Milbank Fund.Google Scholar
McDonough, J. E. (2012), ‘The road ahead for the affordable care act’, New England Journal of Medicine, 367(3): 199–201.Google Scholar
Newhouse, J. P. (2010), ‘Assessing health reform's impact on four key groups of Americans’, Health Affairs, 29(10): 1714–1724.Google Scholar
Newport, F. (2010), ‘U.S. Still Split on Whether Gov't Should Ensure Healthcare’, The Gallup Poll, http://www.gallup.com/poll/144839/split-whether-gov-ensure-healthcare.aspx [18 November 2010].Google Scholar
Oberlander, J. (2010), ‘Long time coming: why health reform finally passed’, Health Affairs, 29(6): 1112–1116.CrossRefGoogle ScholarPubMed
Oberlander, J. (2011), ‘Throwing darts: Americans’ elusive search for health care cost control’, Journal of Health Politics, Policy and Law, 36(3): 477–484.Google Scholar
Oberlander, J.White, J. (2009a), ‘Public attitudes toward health care spending aren't the problem: prices are’, Health Affairs, 28(5): 1285–1293.Google Scholar
Okma, K. G. H. (2009), Recent Changes in Dutch Health Insurance: Individual Mandate or Social Insurance?, Washington DC, (January), National Academy of Social Insurance.Google Scholar
Okma, K. G. H. (2011), ‘Obama's health reform in European perspective’, Journal of Health Politics, Policy and Law, 36(3): 577–579.Google Scholar
Organization for Economic Cooperation and Development (2010), ‘OECD Health Data 2010: Frequently Requested Data (June)’, http://www.oecd.org/document/16/0,3343,en_2649_37407_2085200_1_1_1_37407,00.htmlGoogle Scholar
Orszag, P. R.Ellis, P. (2007), ‘The challenge of rising health care costs: a view from the congressional budget office’, New England Journal of Medicine, 357: 1793–1795.Google Scholar
Pauly, M. V. (2008), ‘Blending better ingredients for health reform’, Health Affairs, 27(6): W482–W491.Google Scholar
Pear, R. (2012), ‘Next health law battle: insurance exchanges’, New York Times 8 July, p. 14.Google Scholar
Radnofsky, L., Mathews, A. W.McWhirter, C. (2012), ‘Some states balk at Medicaid expansion’, Wall Street Journal, July 2.Google Scholar
Rampell, C. (2009), ‘Economists’ letter to Obama on health care reform’, New York Times, Economix website, http://economix.blogs.nytimes.com/2009/11/17/economists-letter-to-obama-on-health-care-reform/ [17 November 2009].Google Scholar
Sack, K. (2010), ‘As Medicaid payments shrink, patients are abandoned’, New York Times, http://www.nytimes.com/2010/03/16/health/policy/16medicaid.html?pagewanted=all [15 March 2010].Google Scholar
Schlesinger, R. (2012), ‘Geithner says fiscal debate began, will end with Simpson Bowles’, U.S. News Online, http://www.usnews.com/opinion/blogs/robert-schlesinger/2012/06/14/yah-yah-yah [14 June 2012].Google Scholar
Schoen, C., Stremekis, K., Collins, S., Davis, K. (2009), ‘Progressive or regressive? A second look at the tax exemption for employer-sponsored health insurance premiums’, Commonwealth Fund Issue Brief, May. http://www.commonwealthfund.org/~/media/Files/Publications/Issue%20Brief/2009/May/Progressive%20or%20Regressive%20A%20Second%20Look%20at%20the%20Tax%20Exemption/PDF_1269_Schoen_progressive_or_regressive_ESI.pdfGoogle Scholar
Singhai, S., Stueland, J., Ungerman, D. (2011), ‘How US health care reform will affect employee benefits’, McKinsey Quarterly. http://www.mckinseyquarterly.com/How_US_health_care_reform_will_affect_employee_ benefits_2813Google Scholar
Sommers, B., Swartz, K.Epstein, A. (2011), ‘Policy makers should prepare for major uncertainties in Medicaid enrollment, costs, and needs for physicians under health reform’, Health Affairs, 30(11): 1–7.Google Scholar
Supreme Court of the United States (2012), National Federation of Independent Business v. Sebelius, http://www.supremecourt.gov/opinions/11pdf/11-393c3a2.pdf [4 July 2012].Google Scholar
Tuohy, C. H. (2011), ‘American health reform in comparative perspective: big bang, blueprint, or mosaic?’, Journal of Health Politics, Policy and Law, 36(3): 571–576.Google Scholar
Ulmer, C., Ball, J., McGlynn, E., Hamdounia, S. B. (eds) (2011), Essential Health Benefits: Balancing Coverage and Costs. Institute of Medicine Report (Uncorrected Proofs), Washington, DC: National Academies Press.Google Scholar
U.S. Census Bureau (2010), ‘2005–2009 American Community Survey 5-Year Estimates, Table B17024’, http://factfinder2.census.gov/faces/tableservices/jsf/pages/productview.xhtml?pid=ACS_10_1YR_B17024&prodType=table [2 October 2012].Google Scholar
Van de Water, P. (2010), ‘Changes to Excise Tax on High-Cost Health Plans Address Criticisms, Retain Long-Term Benefits’, Center on Budget and Policy Priorities Report, Washington, DC.Google Scholar
Weil, A. (2012a), ‘The Curtain Rises on the Fourth Act: States’ Evolving Responses to the Affordable Care Act’, http://healthaffairs.org/blog/2012/05/31/the-curtain-rises-on-the-fourth-act-states-evolving-responses-to-the-affordable-care-act/print/ [8 July 2012].Google Scholar
Weil, A. (2012b), ‘Decision Time For States On The Affordable Care Act’, http://healthaffairs.org/blog/2012/07/02/decision-time-for-states-on-the-affordable-care-act/ [4 July 2012].Google Scholar
White, J. (1995a), Competing Solutions: American Health Care Proposals and International Experience, Washington, DC: The Brookings Institution.Google Scholar
White, J. (1995b), ‘Budgeting and Health Policymaking’, in T. E. Mann and N. J. Ornstein (eds), Intensive Care: How Congress Shapes Health Care Policy, Washington, DC: Brookings Institution, 53–78.Google Scholar
White, J. (2001), ‘National Health Care/Insurance Systems’, in N. J. Smelser (eds), International Encyclopedia of the Social and Behavioral Sciences, 4th ed., vol. 15, Oxford: Elsevier, 10301–10305.Google Scholar
White, J. (2009a), ‘Gap and parallel insurance in health care systems with mandatory contributions to a single funding pool for core medical and hospital benefits for all citizens in any given geographic area’, Journal of Health Politics, Policy and Law, 34(4): 543–583.Google Scholar
White, J. (2009b), ‘The United States: Risks for Americans and Lessons for Abroad’, in T. R. Marmor, R. Freeman and K. G. H. Okma (eds), Comparative Studies and the Politics of Modern Medical Care, New Haven: Yale University Press, 24–60.Google Scholar
White, J. (2011a), ‘Muddling through the muddled middle’, Journal of Health Politics, Policy and Law, 36(3): 443–448.Google Scholar
White, J. (2011b), ‘Prices, volume and the perverse effects of the variations crusade’, Journal of Health Politics, Policy and Law, 36(4): 775–790.Google Scholar
Woolhandler, S.Himmelstein, D. U. (2002), ‘Paying for National Health Insurance and not getting it’, Health Affairs, 21(4): 88–98.Google Scholar