Health Care: How Can We Reduce Costs and Still Get the Care We Need - Issue Guide (downloadable PDF)

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Healthcare, a top domestic policy agenda in Congress and across the country since the passage of the Affordable Care Act in 2010, is a bellwether issue leading up to the 2016 presidential election. Public deliberation on the topic can provide the public voice necessary for policy makers to make sound decisions and this guide is designed to stimulate those types of discussions.

The guide presents three options for addressing this complex public issue, which were researched and compiled by the Kettering Foundation, a nonpartisan research institute that studies the public’s role in democracy. It provides an alternative means for moving forward in order to avoid polarizing rhetoric. They are as follows:

  • As a Nation and as Individuals, We Need to Live within Our Means: raise Medicare eligibility age to 67 and base it on financial need, make greater use of hospice care, have employees take on a greater portion of the costs, and encourage more doctors to go into primary care;
  • Make the Healthcare System More Transparent, Efficient, and Accountable: the US healthcare system suffers from a lack of design, making it impossible for citizens to make good decisions – it needs transparency on cost/price, regulations and/or incentives to instill financial discipline and end greed and abuse; and
  • Take Responsibility for Lowering Healthcare Costs by Focusing on Wellness: Unhealthy behaviors drive up healthcare costs by an estimated $147 billion a year – collective and individual efforts to improve healthy behaviors can lower those costs.

Each option is rooted in a shared concern and proposes several distinct strategies for addressing the problem. This guide does not favor any one option over another. Download your guide today for use in your classroom, research or policy organization or community to help citizens and those interested in policy better understand today’s public policy challenges. It also includes some of the strategic facts needed to understand the context of the topic such as:

  • Other technically advanced countries spent 33% to 66% less per person and 12% less of their economies on healthcare
  • The US ranked last among 26 other high income countries in infant mortality and life expectancy
  • Despite spending far more on healthcare, we trail other countries in life expectancy and have higher rates of obesity, diabetes, heart diseases, and other ailments

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Published Date: 
Thursday, April 16, 2015
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First of all thank you for any help you can provide the PEOPLE of the United States in lowering the costs of healthcare.
We will all need healthcare at some point in time (we all get old) .... So this represents a major, across the board redistribution of wealth.
The already shrinking middle class will soon not be able to pass on any material inheritance to their loved ones.
It will all go to pay their hospital bills.
Hospital Bills are among the leading causes of bankruptcy in the US.
$5,000.00 or $6,000.00 per night just for a bed is ridiculous! But that is just what is happening.
Some of this may be just plain greed, but much of it is to cover the cost of malpractice type liability insurance.

We MUST limit the amount of this expenditure that the hospitals can pass on to their patients.
As a painter or carpenter, I could not pass on the cost of a one hundred million dollar insurance policy to my customers ;
so why do we accept it from the hospitals?
If hospitals will not operate under these new, fairer conditions then we must nationalize the hospitals.
Like the State Hospitals of old , but better run (with an emphasis on transparency -- that should be part of every government agency).
This seems only logical since this is a life and death matter.
We would not trust private sector police forces to keep order and administer fair and impartial enforcement of the law.
The fire departments used to be private (and linked to their respective insurance companies) and that did not work well either.