In the meantime, the per capita cost of health care in the U.S. is double that of any other industrialized country, about 20 million people will remain uncovered even when Obama’s new law takes effect and the U.S. ranks 28th among developed countries in infant mortality and 16th in female life expectancy.
Bredesen wants to base reform on rigorously researching best practices, raising quality, measuring performance, telling consumers how providers rate and letting them choose which provider group they want to sign up with.
He envisions the creation of “systems of care” — the Mayo Clinic is a model — which would offer all standard plan services and take responsibility for keeping patients healthy, not just performing (and charging for) individual procedures.
Key to the program, he told me, is to “create a world of limited resources” for health care — the only way to put market forces into play in a field where costs are now “open-ended.”
“An economy does not work in a garden of Eden,” he said.
Congress would set the level of the GDP the basic program could cost and vouchers would be apportioned accordingly. Provider groups would have an incentive to keep costs down.
People seeking services not covered by the basic plan could buy them with their own money.
Bredesen thinks it will take 15 years to get his plan fully up and running — perhaps from 2016 to 2030 — but at the end of the process, “the result is the health care system we’ve been seeking — universal, fair, high quality, reasonable in its cost, honestly paid for, uniquely American.”
Instead of wrangling incessantly over the GOP demands to “repeal and replace” Obamacare and Obama’s offer to merely “tweak” it, Congress ought to reform the reform — and call Bredesen in to help.