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A Not-So-Modest Proposal for the Health System

"The time is again ripe for foundation leadership," writes Karen Davis in her President's Message for the Fund's 2005 Annual Report. Citing instances when foundations have responded to voids in public policy and spurred reform, Davis explained the Fund's decision to establish the Commission on a High Performance Health System. The Commission has set out its vision for a health system that supports the following core values:

  1. Long, healthy, and productive lives
  2. The right care
  3. Coordinated care over time
  4. Safe care
  5. Patient-centered care
  6. Efficient, high-value care
  7. Universal participation
  8. Affordable care
  9. Equitable care
  10. Knowledge and capacity to improve performance

The Commission is currently at work tracking performance targets, developing policy options, and disseminating innovative approaches to improving the health system. Later this year, the Commission will issue its first national scorecard documenting the current state of U.S. health system performance on these key dimensions.

Davis points to a recent Fund survey that found surprising consensus among experts in health policy, financing, and delivery about the most promising strategies for health system reform. These include letting small businesses and individuals buy coverage through the program that insures federal employees; giving incentives to employers to expand coverage; rewarding more efficient and high-quality providers; and improving disease management and primary care case management.

"The Commission will examine these and other options available to a nation with our exceptional resources and capacity," writes Davis. "It is our hope that the Commission's work will be pivotal in moving the nation toward a high performance health system, one that offers better access, improved quality, and greater efficiency to all Americans."

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