The Foundation commissioned a series of policy briefs to complement the Reform to Transform summit held in October. The papers are intended to spark conversation and provide useful background information for discussions and actions in Connecticut.
Addressing State Health Care Challenges through Regulation: Use of a Public Utility Model, John Pakutka and Megan Cole
The possibility of regulating the medical industry as a public utility is often dismissed as politically unfeasible, and in conflict with desires to maximize patient choice and physician independence, protect hospital financials, and minimize government interference.
However, what goes unrecognized is the extent to which the public utility model has historically shaped health law. Not only is such an approach compatible with our governing institutions and political culture; it is beginning to play an increasingly important role in many states.
The reason we have the highest health care costs in the world is that we have insisted on looking at health care as a commodity subject to the laws of supply and demand, rather than as a public good guaranteed by government.
From the point of view of classical economics, all of this concentration is bad for consumers, as limited supply will mean higher prices.
Enhancing the Value of Health Insurance by Making it Simpler, Victor G. Villagra, MD
Connecticut has an unmatched legacy of insurance expertise and is home to Access Health Connecticut, arguably the most successful marketplace in the country. The state is uniquely positioned to explore innovations that can enhance the value of health insurance by making it simpler.
Using Waivers to Improve Health Care Affordability and Access to Health Insurance in Connecticut, Robert W. Seifert, Rachel Gershon and Katharine London
Despite improvements in health insurance coverage in Connecticut over the past decade, the combination of insurance premiums and out-of-pocket costs at the point of service makes access to affordable health care difficult for some Connecticut residents. This brief considers how the state government might use program waivers as a policy tool to improve affordability and access for Connecticut residents. For more detail on waiver mechanics, see our companion brief, “How Waivers Work: ACA Section 1332 and Medicaid Section 1115.”
How Waivers Work: ACA Section 1332 and Medicaid Section 1115, Robert W. Seifert, Rachel Gershon and Katharine London
This brief outlines how Medicaid Section 1115 and ACA Section 1332 waivers work and what states should consider when designing these waivers. For consideration of how a particular state could use waivers to improve health care affordability and access, see our companion issue brief, “Using Waivers to Improve Health Care Affordability and Access to Coverage in Connecticut.”
The past fifty years have seen unprecedented medical progress, with new procedures and medicines available for most of the common causes of morbidity and mortality worldwide. However, despite this progress, it is widely acknowledged that the U.S. health care system delivers suboptimal quality.
Much of the evidence for what works is slow to be implemented in practice. At the same time, costs continue to rise with substantial variation by region in the total cost of care and use of resources. Health disparities remain despite improvements in insurance coverage and access to care ushered in by the Affordable Care Act (ACA).