title: Assessing health reform's impact on four key groups of Americans.
abstract: Health reform can be assessed from the perspective of four groups that collectively include most Americans. For those who are now in Medicaid or who are uninsured, reform will be a major gain. For those who obtain health insurance in the individual and small-group markets, reform should bring improvements. For those who have health insurance from midsize- and large-group insurers, reform will bring little change. Finally, for Medicare beneficiaries, reform promises to bring positive change. However, financing future health spending overall, and Medicare spending in particular, poses a formidable challenge. Although not a panacea, all-payer rate setting, in which a federal or state agency establishes standard payment rates for each class of payer, may be the only feasible alternative, at least in the short run.
authors.affiliation: Division of Health Policy Research and Education, Harvard University, Boston, MA, USA. newhouse@hcp.med.harvard.edu
authors.forename: Joseph P
authors.initials: JP
authors.lastname: Newhouse
mesh_terms: D014487:Centers for Medicare and Medicaid Services, U.S.; D002662:Child Health Services / Q000191:economics / Q000331:legislation & jurisprudence; D002675:Child, Preschool; D005380:Financing, Government; D019983:Guideline Adherence / Q000592:standards; D006264:Health Benefit Plans, Employee / Q000191:economics / Q000331:legislation & jurisprudence; D018166:Health Care Reform; D006297:Health Services Accessibility / Q000191:economics* / Q000331:legislation & jurisprudence; D006801:Humans; D019458:Insurance Coverage / Q000191:economics*; D008404:Massachusetts; D008484:Medicaid / Q000331:legislation & jurisprudence; D006278:Medicare / Q000706:statistics & numerical data; D010344:Patient Advocacy / Q000331:legislation & jurisprudence*; D013221:State Health Plans / Q000191:economics / Q000331:legislation & jurisprudence; D014481:United States