Expanding the scope of health reform: application in the United States.
Since the demise of the Clinton national health plan in the early 1990s, a number of states in the US have continued to pursue health reform. The reforms reflect the on-going debate in the US and throughout the world over market-minimizing versus market-maximizing strategies to improve healthcare systems. This paper describes the limits of this debate and supports a broader view that focuses on how health policy can improve population health. Performance measures and indicators traditionally used to evaluate market minimizing/maximizing strategies for reforming healthcare are redefined for evaluating strategies to improve health. Differences in the two views are illustrated by describing state reforms in the US using the market-minimizing/maximizing framework and evaluating the reforms based on the health-related framework.
D000208:Acute Disease; D002908:Chronic Disease; D003362:Cost-Benefit Analysis; D004465:Economic Competition; D017598:Efficiency, Organizational; D018166:Health Care Reform / Q000191:economics / Q000331:legislation & jurisprudence* / Q000379:methods; D019981:Health Care Sector; D006291:Health Policy; D006293:Health Promotion / Q000191:economics; D006297:Health Services Accessibility / Q000331:legislation & jurisprudence; D006302:Health Services Research; D006304:Health Status; D006801:Humans; D019458:Insurance Coverage / Q000331:legislation & jurisprudence*; D008134:Long-Term Care; D018854:Managed Competition / Q000331:legislation & jurisprudence; D012935:Social Justice; D013221:State Health Plans / Q000191:economics / Q000331:legislation & jurisprudence*; D016896:Treatment Outcome; D014481:United States; D019472:Universal Health Insurance / Q000331:legislation & jurisprudence