A fully public health care paradigm in the vein of Medicare For All remains a long shot in the current political climate. But two industry veterans, including a former head of CMS, lay out some policies in Health Affairs that could win bipartisan support and spur a refresh of the nation's health care apparatus.
Up first: Reduce the out-of-pocket expenses for more Americans and place a hard cap on rising insurance rates by curtailing hospital pricing, suggest Donald Berwick, M.D., former CMS administrator as well as president emeritus and senior fellow at the Institute for Healthcare Improvement, and Robert Kocher, M.D., senior fellow at the Leonard D. Schaeffer Center for Health Policy and Economics and adjunct professor of medicine at Stanford University.
The proposals seek to address a trifecta of ailments plaguing American health care today: the high costs of insurance, a lack of access to care and ongoing quality issues tied to poor outcomes.
"We are alarmed by the bluntness of high deductibles, co-insurance, and copayments, since these approaches, alleged to give patients 'skin in the game,' are regressive and disproportionately penalize people with chronic diseases," Berwick and Kocher write.
The authors caution that the rapid rise of hospital costs in recent years puts the entire health care system on unsustainable footing. From 2007 to 2014, hospital prices jumped 42%. Berwick and Kocher suggest a hard cap on all hospital prices of 120% of going Medicare rates.
Another solution could be to reduce the number of years that expensive biologic pharmaceuticals maintain market exclusivity to allow for greater generic competition. The authors also support the Trump administration's approach to control drug pricing by tying costs to the international market.
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