JAMA Forum: A Tale of 2 Health Plans
Consider 2 plans for health coverage.
In plan No. 1 (the ACA), the approach is to help everyone under the age of 65 years who doesn’t have insurance coverage. Everyone who is really poor is offered Medicaid. Everyone else will be put into a regulated market.
In plan No. 2 (the Romney plan for Medicare), the approach is to change the way everyone over the age of 65 years gets health insurance. Everyone who is really poor is offered Medicaid. They—along with everyone else—will also be put into a regulated market.
The differences between the end points of the ACA and the Romney plan for Medicare are shockingly similar. With enough tweaks and some serious efforts at compromise, one could be accepted in exchange for the other. The powers of both competitive bidding and regulatory reform could be used.
We could stop demonizing the other side for trying to “end America” by seeking results that aren’t much different from our own.
I’m not optimistic. It’s an election year. And despite protestations that good policy is the goal, it seems far too often that politicians care more about winning elections than about Americans winning a better health care system.
See on newsatjama.jama.com
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