The Commonwealth Fund created a commission to make recommendations for a high performance health system for the United States. Here’s the summary:
This report from the Commonwealth Fund Commission on a High Performance Health System offers recommendations for a comprehensive set of insurance, payment, and system reforms that could guarantee affordable coverage or all by 2012, improve health outcomes, and slow health spending growth by 3 trillion by 2020-if enacted now to start in 2010. Central to the Commission’s strategy is establishing a national insurance exchange that offers a choice of private plans and a new public plan, with reforms to make coverage affordable, ensure access, and lower administrative costs. Building on this foundation, the report recommends policies to change the way the nation pays for care, invest in information systems to improve quality and safety, and promote health. By stimulating competition and delivery system changes aimed at providing more effective and efficient care, the policies could yield higher value and substantial savings for families, businesses, and the public sector.
They preface the report by saying:
With the economy in crisis and health costs increasing faster than incomes, a growing number of adults and children are losing access to care and coverage, placing them at health and financial risk if they become sick. Despite high levels of spending, the U.S. health system falls short of producing the quality and outcomes that should be possible, considering the available resources, medical science, and centers of excellence. To move quickly in a more positive direction, the Commonwealth Fund Commission on a High Performance Health System presents The Path to a High Performance U.S. Health System: A 2020 Vision and the Policies to Pave the Way. This report provides Commission recommendations for an integrated set of policy actions to expand health insurance to all; change the way we pay, invest in, and organize care to achieve better outcomes; and substantially slow the growth in projected national health spending. It is urgent to start now. It will take leadership and bold steps over the next decade to move toward a health system that achieves better access, quality, and value in return for our investment. As discussed in the Commission’s 2007 report, A High Performance Health System for the United States: An Ambitious Agenda for the Next President, providing universal coverage is essential, but equally critical are policies that change the way we pay for and deliver care with a focus on health, disease prevention, prudent use of resources, and innovation to aim higher. The strategic policies offered in this report present a framework for comprehensive policies in which insurance, payment, and system reforms interact to provide a catalyst for dynamic change. To illustrate the potential of positive action, we provide estimates of the impact of policies that follow this strategic approach. The analysis indicates it would be possible to reduce projected spending by a cumulative $3 trillion by 2020, achieve universal coverage, and improve outcomes-if we start now. The Commission offers these recommendations knowing that the path ahead is clearly visible, but daunting. However, the human and economic costs if we fail to act are worse. Thus, the Commission urges that leadership, political will, and resolve be sum- moned now to overcome resistance to change and proceed forward.
Writing for the New England Journal of Medicine, Karen Davis, Ph.D., discusses the report:
Indicating that health care reform is integral to his policy agenda, President Barack Obama as moved swiftly to incorporate elements of reform into his economic recovery bill and signed reauthorization of the State Children’s Health Insurance Program (SCHIP). Enactment of comprehensive reform, however, is likely to hinge on the development of a plan that is affordable to families, employers, and taxpayers. It will need to combine expanded health insurance coverage with investments designed to improve care and slow spending growth if it is to be sound and sustainable in the long term.
The Commonwealth Fund Commission on a High Performance Health System, in its new report, The Path to a High Performance U.S. Health System (Path proposal), has endorsed a set of health care policies that would produce savings or the system: the creation of a national health insurance exchange with a choice of private plans and a new public-plan option; investment in systemic changes, such as accelerated adoption of health information technology and health insurance benefits that are based on evidence of the comparative effectiveness of treatment options; realignment of incentives for health care providers under Medicare and the public plan to encourage accountability for patient outcomes and prudent use of resources; and public health measures, including increasing taxes on harmful products as a way of combating smoking and obesity. All these policies would require ubstantial changes in the financing and delivery of health care, and all would be politically difficult to accomplish. Estimates of the effect of this proposal on the trajectory of health care spending and coverage were prepared with the use of a health-benefits-simulation model and assumptions derived from the literature.
You can download the Executive Summary of the report and the New England Journal of Medicine article, both as PDFs.
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