Executive Summary: US HEALTH

There is no doubt that the United State's systems for financing and delivering health care are imperfect. Governmental regulation and policy making have, at best, created useful institutions such as the National Institutes of Health, the Institute of Medicine, and Medicare. At worst, policymakers have created piecemeal, conflicting and shortsighted legislation. To create a starting point for discussing reform, we synthesized the above realities into a defined problem statement:

A balance has not been achieved between market-driven forces and regulation. Our society faces increasing demands, escalating costs, a growing number of un- and under-insured, and wide variations in the quality of care, all of which put into jeopardy the sustainability of the U.S. health care system. This issue is further complicated because health care is a complex, multi-dimensional industry with a large number of moving parts, competing interests, and related social issues.

Despite these shortcomings, our country's health system has achieved excellence in research, innovation and technological development. The overarching goal was to find the elusive point where regulation and market forces balance and where society's needs for health care begin to match its resources. We propose US HEALTH as a response to these tensions.

The heart of the US HEALTH proposal is an automatic enrollment system that creates universal coverage for all citizens and legal residents. This plan removes the current employer-based health insurance system, and is financed through a progressive federal income tax. It is administered by the states through contracts with private health plans, and preserves people's choice with the ability to "opt-out" into a private health plan or purchase supplemental coverage. The structure of US HEALTH includes significant cost sharing among those who can pay and provides subsidies for the uninsured and working poor pegged to the federal poverty level.

US HEALTH preserves the good features of our current healthcare system, such as innovation and Medicare. At the same time, we create a more transparent system that facilitates accountability and creates an infrastructure for informed cost and quality choices among all health care stakeholders.

US HEALTH appeals to many of the stakeholder groups that play in the health care arena. Employers have the option to be free from the administrative burden of health insurance while maintaining a right to provide opt-out or supplemental coverage as a competitive advantage. Individuals will be secure in the availability of the federally defined package while also maintaining personal choice. We maintain the impetus for biomedical innovation through private insurance market while simultaneously opening up their market to over 40 million new healthcare consumers. The plan appeals broadly to Democrats and Republicans by ensuring coverage yet preserving a competitive marketplace for both biomedical and insurance industries.

By providing a multi-phase implementation plan, we can ensure a relatively seamless rollover to the US HEALTH system and provide time for the necessary adjustments that will inevitably come from such a large undertaking. In the end, US HEALTH will achieve a radical shift in our healthcare system using a relatively incremental approach. It is a change that needs to be made and that the populace is demanding.

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