At the heart of Barack Obama’s presidential campaign was a promise to transform the health sector in the United States by bringing down costs, improving quality, and broadening coverage so that all Americans, starting with children, will have health insurance. The outlines of the specific policies he has offered to achieve those goals would lead to a fundamental shift in the way that the U.S. health sector is organized.
Many of the proposals that have been offered, both from the White House and in Congress, have a distinctly European flavor. For years, influential pundits and policymakers have said that European health care systems have been able to achieve what America finds so difficult: namely, providing universal coverage with high-quality care delivered at a low cost.
As a result of these perceptions, Mr. Obama and congressional leaders are looking to import many elements of these European health systems to the U.S. Some of the leading ideas include: a legal requirement that all employers provide health insurance to employees (somewhat analagous to the French system of largely employer-provided insurance); a big expansion of health care directly provided by the government (taking the U.S. in the direction of Canada, Italy, and Britain); and measures aimed specifically at keeping costs under control (akin to Britain’s “comparative effectiveness” agency, the National Institute for Health and Clinical Excellence or NICE).
Many of those who are taking the lead in advancing these initiatives have visited with government leaders and policy experts in these countries, but few have any experience in actually living with the health care systems they praise so highly. What has been missing so far are the voices of those familiar with the realities of European and Canadian systems – the physicians and policy experts who work within and study these systems on a daily basis.
For this reason, International Policy Network and the Galen Institute are co-sponsoring this conference on Lessons from Abroad for Health Reform in the U.S., to bring some of these voices to America. This short booklet is a summary of the presentations prepared for delivery at the conference in Washington, D.C., on March 9, 2009.