236692 Private Markets vs. Public Programs: What state private insurance market reform and managed care tell us about cost control and expanded coverage under the Patient Protection and Affordable Care Act?

Tuesday, November 1, 2011: 12:50 PM

Johnathon Samuel Ross, MD MPH , University of Toledo College of Medicine, Dept. of Internal Medicine, St. Vincent Mercy Medical Center, Toledo, OH
State-based experience with managed care and private health insurance market reform has not to date had a significant effect on cost control or coverage. Despite the failure of these reforms at the state level the Patient Protection and Affordable Care Act adopted many of the same insurance market reforms that have failed at the state level to significantly control costs or expand coverage.

Public program expansions have been more likely to provide health insurance at an affordable price per additional person covered than subsidies or tax credits for the purchase of individual private insurance policies. International experience suggests that national health insurance based on an improved and expanded Medicare for all Americans may be the better policy option to accomplish universal coverage and a high performance health care system at little or no added cost.

Learning Areas:
Advocacy for health and health education
Public health or related public policy
Systems thinking models (conceptual and theoretical models), applications related to public health

Learning Objectives:
Identify and compare existing reforms that states have tried that are also part of PPACA. Evaluate whether the reforms tried by the states are likely to control costs or expand coverage when applied at the national level by PPACA.

Keywords: Health Reform, Access to Health Care

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the author of the paper with prior publications on health reform and politics.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.