Harvard University Press
Total Cure
About this book
Proposals to reform the health care system typically focus on either increasing private insurance or expanding government-sponsored plans. Guaranteeing that everyone is insured, however, does not create a system with the quality of care patients want, the flexibility clinicians need, and the internal dynamics to continually improve the value of health care.
In Total Cure, Hal Luft presents a comprehensive new proposal, SecureChoice, which does all that while providing affordable health insurance for every American. SecureChoice is a plan that restructures payment for medical care, harnessing the flexibility and responsiveness of the market by aligning the incentives of clinicians, hospitals, and insurers with those of the patient. It uses the accountability of government to ensure transparency, competition, and equity.
SecureChoice has two major components. A universal pool covers the major risks of hospitalization and chronic illness, which account for almost two-thirds of all costs. Everyone would be in the pool, irrespective of employment, income, or health status. The second component emphasizes choice, flexibility, and responsibility. People will be able to choose any physician to serve as their “medical home,” to keep track of their health records, provide much of their care, and suggest referrals. Clinicians will have the information and incentives to continually enhance quality. SecureChoice also facilitates improvements in areas ranging from malpractice to pharmaceuticals and establishes new roles for key stakeholders such as health insurers.
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Topics
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Frontmatter
i -
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Contents
vii -
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Preface
ix -
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Tables and Figures
xiii -
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Abbreviations
xv -
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Introduction
1 -
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1 Build on What You’ve Got, but Recognize Real-World Constraints
13 -
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2 Overview of a Restructured Health Care System
32 -
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3 Covering the Cost of Care: Rethinking Health Insurance
59 -
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4 Organizing Care and Paying Providers
89 -
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5 Choices: Harnessing Data to Inform Decisions
117 -
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6 Financing SecureChoice
151 -
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7 Malpractice, Pharmaceuticals, Medical Education, and Prevention
178 -
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8 How SecureChoice Would Work for Patients and Physicians
202 -
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9 Getting There: Policy Choices, Implementation, and Transition
221 -
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Notes
251 -
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Glossary
299 -
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Index
309