To Control Costs Expand Managed Care and Managed Competition

摘要

The US health care financing and delivery system serves the public poorly. It costs far more than in any other country, does not produce better health outcomes, and leaves millions uninsured.1 A 2019 report estimated that approximately 25% of US health care spending is wasted.2 Health policy will be a dominant domestic issue during the pursuit of the Democratic presidential nomination and in the 2020 election. The extent and form of insurance coverage, such as Medicare for all, a single-payer health system, and other proposals, will be prominently discussed and debated. However, another important health issue, containment of costs, will probably be neglected. It has not been a focus of discussion in recent debates. Control of health care costs has major implications for the federal budget deficit; for the ability of state and local governments to fund education, infrastructure, and other essential services; and for the lives and financial security of most US families. All candidates, regardless of what health care system they support, have an obligation to address how costs can be controlled.