Considering the trade-offs of health care reform approaches

October 21, 2019

Dear Changemakers,

If you’re having trouble sorting through the different approaches to health care reform—Medicare for All, universal coverage, a public option—that have been front and center in debates among the 2020 Democratic presidential hopefuls, you’re not alone. The Urban Institute’s recent analysis of eight health care reforms, funded by the Commonwealth Fund, can be your guide to understanding the complicated trade-offs of different plans and their potential effects on health insurance coverage and spending.

The analysis, produced by an Urban Institute Health Policy Center team led by fellows Linda Blumberg and John Holahan, concluded the following:

  • Although one widely cited single-payer approach would leave no one uninsured and would largely eliminate consumers’ out-of-pocket medical costs, it would lead to higher overall health spending and significant increases in the federal budget.
  • Other versions of the single-payer approach could be constructed with lower federal and system-wide costs.
  • Near-universal coverage and improved affordability are attainable within the existing public-private health care system at a more moderate cost nationally.

NPR’s former Marketplace health reporter Dan Gorenstein and his team have a new health care podcast, Tradeoffs. Their launch episode focused on Urban’s Blumberg and Holahan and the microsimulation model they use to analyze health reform options: “A team of economists and coders has built one of the most influential machines in health care —a machine almost no one has ever heard of. Their latest analysis may shake up the Democratic debate over how to fix our health care system.”

If you want to better understand what is behind the candidates’ one-liners, check out Urban’s From Incremental to Comprehensive Health Reform: How Various Reform Options Compare on Coverage and Costs and Tradeoffs’s podcast episode.

Warmly,
Sarah