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The 2010 U.S. health care reform: approaching and avoiding how other countries finance health care

Published online by Cambridge University Press:  12 October 2012

Joseph White
Joseph White*
Affiliation:
Luxenberg Family Professor of Public Policy, Department of Political Science, Case Western Reserve University, Cleveland, Ohio, USA
*
*Correspondence to: Professor Joseph White, Department of Political Science, Case Western Reserve University, Mather House 111, 11201 Euclid Avenue, Cleveland, OH 44106-7109, USA. Email: Joseph.white@case.edu
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Abstract

This article describes and analyzes the U.S. health care legislation of 2010 by asking how far it was designed to move the U.S. system in the direction of practices in all other rich democracies. The enacted U.S. reform could be described, extremely roughly, as Japanese pooling with Swiss and American problems at American prices. Its policies are distinctive, yet nevertheless somewhat similar to examples in other rich democracies, on two important dimensions: how risks are pooled and the amount of funds redistributed to subsidize care for people with lower incomes. Policies about compelling people to contribute to a finance system would be further from international norms, as would the degree to which coverage is set by clear and common substantive standards – that is, standardization of benefits. The reform would do least, however, to move the United States toward international practices for controlling spending. This in turn is a major reason why the results would include less standard benefits and incomplete coverage. In short, the United States would remain an outlier on coverage less because of a failure to make an effort to redistribute – a lack of solidarity – than due to a failure to control costs.

Type
Articles
Information
Health Economics, Policy and Law , Volume 8 , Issue 3 , July 2013 , pp. 289 - 315
Copyright
Copyright © Cambridge University Press 2012 

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