How the Primary Candidates Would Reform Healthcare

Neil Chesanow

Disclosures

May 25, 2016

In This Article

The Health Policy We Deserve?

According to health policy expert Tom Miller, none of the candidates' plans for reforming healthcare in America address the hard questions that would make true reform possible. He says some of those questions are[37]:

  • Who gets to make the initial decisions in healthcare? Who controls the money up front and then attaches strings on how others might receive it?

  • What do we want the healthcare system to do, and how do we measure its performance?

  • How should we re-balance health spending commitments to match them better to the resources we have to meet them, along with other competing to needs and preferences?

  • How far can, and should, we go in climbing the steepening slope toward near-universal coverage?

"Having worked with politicians on these things, especially on healthcare, for a long time, I can tell you that most of them—Republicans and Democrats alike—simply don't understand what they're doing," Merrill Matthews told Medscape.

"We get the health policy we want rather than the health policy we deserve," Miller reflects. "People would rather hear simple answers to the wrong questions and wonder why they get results they don't like. The candidates vary in the degree of engagement, sophistication, and interest in health policy issues. But even those who seem to be more engaged and interested are repeating a number of the wrong approaches that have helped make the situation worse rather than better."

"Whatever might be a better remedy does not appear to be on the horizon at the moment,” Miller concludes. "We are going to have to have some more negative experience before finding out that what we wish may not be possible. If we took more direct control of and engagement in some of these health policy decisions ourselves, we might end up with better results."

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