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Why does health care cost so much more in America than in any other country in the world? One major reason is that our system is really a non-system. That is, in America we have many different payers, financing mechanisms, benefit designs, and structures. Every health plan has its own ways of doing things, and every health purchaser wants a customized benefit plan that meets its own specific goals.
On April 13, 2012, CHRT is sponsoring a symposium geared to health policy-makers, funders and researchers, to ask this question: can individuals from these three worlds do a better job of working together?
Well, the federal government has spoken about its intent with regard to defining essential benefits, and the answer is: leave it to the states. As Tim Jost notes in his latest blog post, there are some (probably, most) who assumed the Affordable Care Act would result in more uniformity in essential benefits across the country. But instead (no doubt bowing to a perceived political backlash at this time of difficult discourse in Washington, DC) the Obama administration decided to publish guidelines and establish broad parameters for essential benefits without going into the details.
Health care policy happens at many levels, but health care delivery: just one. Policy is made at the federal, state and local levels—but delivery is at the local level: in organized systems of care or with individual or teams of practitioners working with patients and families.
Mayor Bloomberg of New York made headlines when he decided to take on the soda industry (ok, I know, my New York roots are showing – pop for those of you from the Midwest!). Specifically, Mr. Bloomberg is seeking a federal waiver in the food stamp program (now called SNAP – supplemental nutrition assistance program) to ban the purchase of sugary beverages because of their contribution to diabetes and obesity.
Lately I’ve noticed a resurgence of the term “population health” in the health policy literature. It seems to me that the term is being used differently today than in the past, and I wonder how that might affect our ability to actually affect and improve population health.