However, because of regulatory barriers and silos in our system, we have failed to adequately capitalize on these advances to benefit health care. Information technology has radically transformed major parts of our economy and improved our standard of living. ![]() Insurance design is only one part of the equation. Reasonable monthly out-of-pocket spending caps will help ensure that patients complete their treatment and avoid costly complications. Patients with serious diseases need to be protected from discriminatorily high cost-sharing. This is not right, this is not fair, and it must be corrected. However, health insurance benefit designs have begun to significantly discriminate against the sickest Americans – those with complex medical conditions such as cancer, arthritis, multiple sclerosis and HIV – by making them shoulder an unreasonable proportion of their health-care costs. Health insurance was created to help patients manage catastrophic events and unexpected expenses. Insurance should be there when people need it most, with benefits designed to keep care accessible and affordable. Government should provide regulatory flexibility that removes the barriers to these reforms and enables their adoption in publicly funded health programs. Health systems, employers and insurance plans are driving experimentation with new payment and delivery models. These reforms will ensure that we pay for innovation and quality care, managing health-care expenditures to produce the best outcomes at lower cost. Payment systems, including for prescription drugs, need to be based on value, performance and evidence based approaches that provide transparency on cost and patient outcomes. And we must make significant reforms to how we incentivize and pay for health care. We must evolve our health-care delivery system. ![]() ![]() So, what should we do? Here are some specific suggestions: And how do we lift the burden of cost that rests disproportionately on the sickest and most vulnerable in our population? How can we best invest in health? How can we reduce the burden of disease? How can we make patients healthier and keep them that way? And how will we address our rapidly aging population?Īlzheimer's and dementia, for example, are estimated to impact 16 million people at a cost to the health-care system of $1.1 trillion by 2050. Here are the fundamental questions we should be asking: To produce the right solutions, we must ask the tough questions, and not grasp at quick fixes just because they seem popular or convenient. We are not candidly and transparently confronting the challenges of our health-care system to ensure that high-quality care is accessible, affordable and delivers better value to all Americans. As gratified as I am by that progress, at the same time, I am daunted by the challenges that remain, and disappointed by our failure to adequately address the increasing inequality of health outcomes and the social and economic issues impacting health care in our communities today.
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