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Quality, Affordable Health Care for All
Date:10/15/2007

age. U.S. businesses' insurance costs make them less competitive globally and depress cash wages. The quality of care is unacceptably low. Authoritative studies document numerous prescription and treatment errors that cause unnecessary suffering, illness, injury and cost. Patients get only an estimated 55 percent of necessary and appropriate care. And access to care is deteriorating: 47 million Americans lack health insurance, and that number is rising.

-- The root causes of these problems lie deep within the structure of our health-care system. No one currently has an incentive to seek, or provide, quality, cost-efficient health care; our employer-based health insurance system lacks meaningful competition. Without controlling costs, we will never achieve affordable universal coverage.

Employees usually have no choice. Insurers demand all of an employer's business - to reduce per-employee overhead costs and avoid enrolling only the sickest workers. So employees have no choice of a plan (if they are offered health care at all). But employees, understandably, want to choose their doctors. Thus, to satisfy both employees and insurers, employers can offer only one plan that provides access to most doctors. The only way to reimburse any doctor an employee might choose is on a fee-for-service basis - a system with the worst incentives to drive up costs: the more services, the more fees.

Recommendations

-- The nation must replace employer-provided health insurance. Past employer efforts to provide affordable, quality health benefits have failed. The market is flawed, leaving those most in need without coverage and driving costs ever higher. A government-run, command-and-control system will not succeed; and devolving complex medical decisions from doctors to patients will not yield affordable care either. Instead, we must restructure the health-insurance market (and through it the health-delivery system) so that all Americans can afford and obtain
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SOURCE The Committee for Economic Development
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