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Medicare and Health Policy

Friday, December 18, 2009

The Heart of Power: Health and Politics in the Oval Office

A Book Review by Philip Caper, M.D.

In many ways, the new book by David Blumenthal and James Morone is a fine dissertation on the role of the presidency and a succession of American presidents, stretching back to FDR, in the formulation of health care policy in the United States. But it does not address a central question. What are the barriers to reform of the American health-care system? Why has it been so difficult for American politicians to create a statutory right to health care for Americans - a right that every other affluent democracy created years ago?

To read a PDF of the full review, click here.

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Posted on December 18, 2009  |  Write the first comment
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
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
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
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