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Medicare and Health Policy

Tuesday, September 22, 2009

Recent Changes in Dutch Health Insurance

Kieke Okma
Adjunct Associate Professor of Health Policy and Management, New York University

In 2006 the Netherlands implemented a new health insurance system that requires all citizens to buy health insurance from a regulated insurance company of their choice; insurers must accept all applicants; the government subsidizes children and low-income families. Recent Changes in Dutch Health Insurance analyzes the new Dutch system and considers whether it might serve as a model for the U.S. The working paper emphasizes some of the major differences between the Netherlands and the U.S., including the extensive role of the Dutch government in regulating the health sector and the egalitarian tradition in Dutch social policies.

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Posted on September 22, 2009  |  Write the first comment
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Monday, September 21, 2009

Designing Administrative Organizations for Health Reform

Paul N. Van de Water
Senior Fellow, Center on Budget and Policy Priorities

Many proposals for expanding health coverage involve the creation of organizations to produce information on comparative effectiveness, make coverage decisions, manage the marketplace for health insurance, or offer a public health insurance plan. Designing Administrative Organizations for Health Reform describes proposals to create new entities or agencies as part of a reformed health coverage system, catalogs the major types of federal executive agencies and non-governmental entities, and considers some of the issues involved in choosing an appropriate organizational design. It concludes that organizations that use governmental powers and funds and make public policy need to be accountable as well as effective.

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Posted on September 21, 2009  |  Write the first comment
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Friday, September 18, 2009

Re-Figuring Federalism: Nation and State in Health Reform's Next Round

Lawrence D. Brown
Professor of Public Health, Columbia University

Health reform must recognize the extensive role of states in U.S. health policy and reconcile national consistency with sub-national diversity. Re-Figuring Federalism: Nation and State in Health Reform's Next Round draws lessons both from federal-state relations in Medicaid and from the experiences of three other federal countries—Canada, Germany and Switzerland. It concludes that universal health coverage is compatible with a federal system, but that the federal government needs to establish central rules of the game.

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Posted on September 18, 2009  |  Write the first comment
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Thursday, September 17, 2009

Designing a Mixed Public and Private System for the Health Insurance Market

Bryan Dowd
Professor, University of Minnesota

Designing a Mixed Public and Private System for the Health Insurance Market considers design features of a health care reform proposal that would offer a government-run health insurance plan alongside competing private plans in a government-run insurance exchange. The Medicare program provides a practical guide to the problems and opportunities offered by such a mixed public and private system. Since both public and private plans have inherent advantages and disadvantages, both plans can be offered on a relatively level playing field. Among the items to be considered in creating a level playing field are the benefit package, advertising and consumer information, risk selection and risk adjustment, the choice environment, default enrollment, provider payment rates, and the administrative structure.

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Posted on September 17, 2009  |  Write the first comment
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Wednesday, September 16, 2009

Cost Containment and Coverage Expansion

Mark Merlis
Health Policy Consultant

Choices about covering the uninsured have implications for the feasibility of different approaches for controlling health care costs, and vice versa. In practice, some combinations may work together better than others and the interplay of different approaches to coverage expansion and cost containment is the focus of Cost Containment and Coverage Expansion. It begins with a brief review of whether coverage expansion and cost controls must go hand-in-hand. It then lays out the menus of commonly proposed coverage approaches and available cost control measures and considers how the two might go together.

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Posted on September 16, 2009  |  Write the first comment
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