Commission of Nation's Leading Health Care Experts Issues Reform Recommendations for Next President

Commonwealth Fund Commission on a High Performance Health System Says Health Insurance for All Is Essential But Not Enough

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Embargoed for release:
12:01 AM, EDT, Thursday,
November 15, 2007


November 15, 2007, Washington, DC—Ensuring that everyone in the United States has health insurance is essential, but it is not enough to drive the kind of reform the health system needs, according to a new report released today by the Commonwealth Fund Commission on a High Performance Health System.

Guaranteeing affordable health insurance for all, changing the way doctors and other health care providers are paid, better organizing and coordinating care delivery, investing in implementing an electronic information system in a reasonable period of time (aiming for five years), and establishing national goals and doing what it takes to reach them through strong national leadership should all be on the next President's health care agenda, says the report. Members of the commission are a diverse group of leading health policy experts from government, private industry, health care delivery organizations, academia, and professional associations.

"This report outlines how essential it is that we pursue improvements in health care quality and efficiency at the same time as we pursue universal coverage," said Dr. James Mongan, Commission Chair and CEO of Partners Health System. "We can not and should not hold either of these facets of reform hostage while we wait for the other to happen" The report, A High Performance Health System For the United States: An Ambitious Agenda for the Next President, outlines very specific strategies to contain costs and organize the U.S. health care delivery system to address how the U.S. health care system falls short by failing to provide health insurance to everyone, by delivering care that is highly variable in terms of quality, and by promoting inefficient health care spending.

Commissioners call for bold changes to the health care system in the next five years, including:

  • AFFORDABLE COVERAGE FOR ALL: Extending health insurance to all in a way that will allow people to seamlessly get coverage and not risk losing coverage when they change jobs, become widowed, or become ill.
  • ALIGNED INCENTIVES AND EFFECTIVE COST CONTROL: Slowing growing health care costs by rewarding doctors and hospitals for providing high quality, cost-effective care; moving away from fee-for-service to a model where providers share the accountability for the total care of their patients; and fix the payment disparity between primary and specialty care doctors.
  • ACCOUNTABLE COORDINATED CARE: Creating an organized health care system where doctors, hospitals and other health care services are linked together, virtually or literally, and it is easy for patients to navigate between their primary care doctor, specialist or hospital.
  • AIMING HIGHER FOR QUALITY AND EFFICIENCY: Investing in ways to help all doctors and health care systems practice evidence-based medicine and provide the highest quality care possible, and ultimately report their quality data to the public. This includes investment in health information technology like electronic medical records.
  • ACCOUNTABLE LEADERSHIP: Exploring the possibility of a national entity that would develop goals for the health care system, set national health care priorities, develop measurements for health system performance, and recommend policies and practices for achieving them.

"There is no question that health care is at the top of the nation's agenda in the Presidential election and will be a key issue for the next president," says Commonwealth Fund President Karen Davis. "These recommendations lay out how—in the next five years—we can move closer to a health system that gives all Americans the chance to lead longer, healthier and more productive lives."

This report follows the Commission's recent publication on how best to achieve universal coverage, A Roadmap to Health Insurance for All: Principles for Reform. Over the next year, the Commission will release several additional reports outlining specific health care reform strategies and analyzing existing reform plans from Capitol Hill and presidential candidates.

The Commonwealth Fund Commission on a High Performance Health System, formed in April 2005, seeks opportunities to change the delivery and financing of health care to improve system performance, and will identify public and private policies and practices that would lead to those improvements.

The Commission members are: James J. Mongan, M.D. (Chair), Partners HealthCare System, Inc., Maureen Bisognano, Institute for Healthcare Improvement, Christine K. Cassel, M.D., American Board of Internal Medicine and ABIM Foundation, Michael Chernew, Ph.D., Department of Health Care Policy, Harvard Medical School, Patricia Gabow, M.D., Denver Health, Robert Galvin, M.D., General Electric Company, Fernando A. Guerra, M.D., M.P.H., San Antonio Metropolitan Health District, George C. Halvorson, Kaiser Foundation Health Plan Inc., Robert M. Hayes, J.D., Medicare Rights Center, Glenn M. Hackbarth, J.D., Consultant, Cleve L. Killingsworth, Blue Cross Blue Shield of Massachusetts, Sheila T. Leatherman, School of Public Health, University of North Carolina, Gregory P. Poulsen, M.B.A., Intermountain Health Care Dallas L. Salisbury, Employee Benefit Research Institute, Sandra Shewry, State of California Department of Health Services, Glenn D. Steele, Jr., M.D., Ph.D., Geisinger Health System, Mary K. Wakefield, Ph.D., R.N., Center for Rural Health, University of North Dakota, Alan R. Weil, J.D., M.P.P., National Academy for State Health Policy Steve Wetzell, HR Policy Association.

Publication Details

Publication Date: November 15, 2007

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