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市場調査レポート
国民皆保険への道：米国の動向
Paving the Difficult Road to Universal Insurance Coverage: Spotlight on U.S. Innovators
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当商品の販売は、2011年12月21日を持ちまして終了しました。
Abstract
Introduction
The controversial issue of establishing universal health insurance has
recently reclaimed the spotlight in the United States. Various states, members
of Congress, President George W. Bush, and 2008 presidential hopefuls are
proposing plans to make health insurance more accessible to the approximately
47 million U.S. residents who do not have coverage.
Get the Answers You Need to Shape Your Strategy
- Massachusetts, Maine, and Vermont are leading the way in expanding
universal health care coverage. How have these states achieved consensus on
such a hot button issue? What are the key elements of these state health care
plans? What are the implications for other reform efforts?
- Other states have expressed considerable interest in Massachusetts'
groundbreaking universal coverage plan. Which states have viable programs on
the horizon? What have they learned from the Massachusetts planning and
implementation process that will help them develop their own successful new
universal coverage plans?
- As this fl urry of state health reform activity continues, proposals at
the federal level aim to complement state efforts or to set in motion sweeping
national reform. Which initiatives have gained national support? Which of the
universal coverage bills in Congress target drug pricing?
- Universal coverage proposals may threaten to take greater control over
drug prices. Would new initiatives give states the power to negotiate drug
prices with manufacturers? Are proposals requiring drug-price negotiation
likely to garner much support in the near future?
Scope
- Massachusetts: leading the way. Details on passage and implementation of
the plan, the mandate for individual coverage, employer responsibilities,
implications for other reform efforts, and future challenges.
- Maine: at the forefront of universal coverage. DirigoChoice plan details,
cost-containment reforms, Maine Quality Forum, implications for other reform
efforts, and future challenges.
- Vermont: implementation looming. Catamount Health plan details, employer
responsibilities, chronic care initiatives, implications for other reform
efforts, and future challenges.
- National solutions: universal coverage at the federal level. The Bush
administration proposal, Medicare for All, Healthy Americans Act, and
state/federal partnerships.
- Future perspectives: promise and problems. Value of compromise and
cooperation, potential pitfalls for state initiatives, cost-control issues,
and drug pricing.
Table of Contents
- Executive Summary
- Strategic Considerations
- Stakeholder Implications
- An Old Debate Takes on New Urgency
- Massachusetts Provides a Model
- Commonwealth Health Insurance Connector
- Defi ning Minimal Creditable Coverage
- Defi ning Affordability
- Commonwealth Care Health Insurance Program
- Medicaid Expansions and Restorations
- Commonwealth Choice Health Insurance Program
- Mandating Coverage for All
- Employer Responsibilities
- Learning from the Massachusetts Experience: Implications for Other
Reform Efforts
- Future Challenges
- Communication
- Affordability
- Primary Care Provider Shortage
- Employer Challenges
- Sustainability and Cost-Containment
- Maine and Vermont: Other Innovators at the Forefront
- Maine
- DirigoChoice
- Cost-Containment Reforms
- Maine Quality Forum
- Learning from the Maine Experience: Implications for Other Reform
Efforts
- Future Challenges for Maine
- Vermont
- Catamount Health Insurance Plan
- Employer Responsibilities
- Chronic Care Initiatives
- Learning from the Vermont Experience: Implications for Other Reform
Efforts
- Future Challenges for Vermont
- In Search of a National Solution: Universal Coverage Proposals at the
Federal Level
- Bush Administration Tax Reform Proposal
- Details of the Bush Proposal
- Problems with the Bush Proposal
- Starting a National Discussion
- Universal Coverage Bills in Congress
- Medicare for All
- Healthy Americans Act
- State/Federal Partnerships
- Future Perspectives
- Importance of Federal/State Partnerships
- Potential Pitfalls for State Initiatives
- A Key Issue: Addressing Costs
- Controlling Current Costs and Spending Growth
- Targeting Drug Prices
- Increasing Patient Cost-Sharing
- A Long Road Ahead
Tables
- 1. Health Insurance Coverage of the U.S. Population, 2002-2006
- 2. State Universal Coverage Bills, 2007
- 3. Key Elements of Massachusetts' Health Care Reform
- 4. Affordability Scale for Massachusetts Health Insurance Premiums Based
on Income Level, 2007
- 5. Coverage Options Offered by Commonwealth Choice Plans
- 6. Maine' s DirigoChoice Coverage Plan
- 7. Vermont' s Catamount Coverage Plan
- 8. Comparison of Key Elements of Universal Coverage Proposals at the
Federal Level, 2007
- 9. Key Elements of the Health Partnership Act and Health Partnership
Through Creative Federalism Act
Figures
- 1. 2006 Health Insurance Coverage: United States
- 2. U.S. National Health Expenditures per Capita and Corresponding Share of
Gross Domestic Product, 1960-2007
- 3. Status of State Initiatives for Health Care Reform
- 4. 2006 Health Insurance Coverage: Massachusetts
- 5. 2006 Health Insurance Coverage: Maine
- 6. 2006 Health Insurance Coverage: Vermont
- 7. Key State and Federal Health Insurance Expansion Activities, 2004-2006
- 8. U.S. National Health Expenditures, by Type of Service, 2005
Sidebars
- Ingredients for Health Care Reform: Key Opinion Leader Insights
- Universal Coverage Mandates: Key Opinion Leader Insights
- Factors Affecting the National Movement: Key Opinion Leader Insights
- All Eyes on California as Governor Schwarzenegger Pitches Universal
Coverage Plan
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