Health care reform

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(This article is about political movements affecting the delivery of health care and health care systems. For more information about movements to improve health, see Health reform.)

Health care reform is a general rubric used for discussing major policy changes--for the most part, governmental policy changes--to any existing healthcare system in a given place. Health care reform typically attempts to:

Broaden the population covered by private or public health insurance
Expand the array of health care providers consumers may choose among
Improve the access to health care specialists
Improve the quality of health care
Decrease the cost of health care
Decrease the cost of health insurance

In the United Kingdom a massive programme of attempted reform of the British National Health Service has begun. In the United States, health care reform was a major concern of the Clinton administration headed up by First Lady Hillary Clinton; however, her complex proposal was not enacted into law. More recently, President George W. Bush signed into law the Medicare Prescription Drug, Improvement, and Modernization Act which included a prescription drug plan for elderly and disabled Americans.^[1] U.S. efforts to achieve universal coverage began with Theodore Roosevelt and continue to today.

As evidenced by the large variety of different health care systems seen across the world, there are several different pathways that a country could take when thinking about reform. Germany for instance, makes use of sickness funds, which citizens are obliged to join but are able to opt out (Belien 87). The Netherlands uses a similar system but the financial threshold for opting out is lower (Belien 89). The Swiss, on the other hand use more of a privately based health insurance system where citizens are risk-rated by age and sex, among other factors (Belien 90). The United States employs a system in which the government does not provide health insurance to all of its citizens.

When the health care expenditures per capita and GDP per capita for developed countries are graphed, a nearly linear relationship is revealed, with the United States the clear outlier^[2].