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Health-care reform reactions at Stanford

UPDATE 03-23-10: Another faculty member, Alan Garber, has weighed in.

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Much has been said about the historic passage of health reform, but I was curious what some of Stanford's own economists and experts thought of the legislation. Here's what a few had to say.

Laurence Baker, PhD, health economist:

The bill would address some of the serious challenges facing our health care system. Helping 30 or so million people who would have been uninsured get coverage is a useful and important step. The changes to the insurance system in the bill would remove some of the uncertainty facing people who fear losing or being denied coverage when they get sick. But the bill leaves other important issues unaddressed. Health care cost growth will continue and will require further work to address. Those issues still await us, and dealing with them promises to be even more contentious. Paying the bill for this reform also looks challenging given the difficult politics of Medicare funding.

Alain Enthoven, PhD, professor emeritus with the Graduate School of Business:

It is a very positive achievement that this country has made a commitment to insure the uninsured. Millions of Americans without health security is a national shame. But I regret that the Congress chose the most costly way of doing it. The legislation does nothing significant to bend the curve of health expenditure growth, so that problem remains to be addressed. This year, health spending is draining the federal budget by some $1.2 trillion and that is growing substantially faster than the GDP. And we are paying for it with borrowed money. We still need to reform the health care financing and delivery system to replace the incentives to increase costs with serious incentives to improve value for money and to slow expenditure growth.

Alan Garber, MD, PhD, health economist and director of the Center for Health Policy/Center for Primary Care and Outcomes Research:

Like most people I've spoken with, I didn't get everything I wanted in the health reform bill. It's fair to say nobody did. Its passage has been a political high-wire act. But in cataloging its shortcomings - particularly the way that efforts toward controlling health expenditures were pared back - it's too easy to overlook its very real accomplishments. The expansion in health insurance coverage is massive and genuinely helps the most vulnerable Americans. And the legislation also establishes a foundation for future improvements. For example, the creation of health insurance exchanges can lead to greater price and quality transparency, and can foster more competition in health insurance markets. Comparative effectiveness research can inform the design of payments and make better, vitally important information available to doctors and patients. The Independent Payment Advisory Board, which many provider organizations oppose, has the potential to stimulate modernization of Medicare and ultimately to enable health programs to serve the public better. It will take months, and in some cases years, to fully implement the proposed legislation, so any predictions of its long-term success are speculative. But it puts in place many of the right elements.

Philip Pizzo, MD, medical school dean (excerpted from the Dean's Newsletter):

Sunday, March 21st witnessed a historic vote in the Congress for health care reform. While a couple of months ago I personally felt that the current legislation fell short of expectations, the prospect of no progress at all was more than daunting. Thus, I am happy to see at least a beginning of healthcare reform underway. I am also pleased that a number of physician groups offered their support for the House Reconciliation Bill... I am well aware that individual members have varying concerns about the current legislation. But it is a beginning, although with lots more to do before we get to the end. At least that is something to be grateful for!

Previously: Health-care reform reactions

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