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Summary: The Health Security Proposal

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The proposal was going to provide a new way to fund and deliver healthcare. The Health Security proposal goal was to control cost through competition with a key provision in the proposal known as managed care or competition. This would allow states and employers to work together to make different plans available in return, providing competition among the different providers of the healthcare plans The proposal was also going have large employers pay for healthcare while, small employers would have subsidies provided by the government. The proposal also offered other cost controls and insurance reforms.
Many Americans did not like the Health Security proposal because they felt with managed care they would have limited input about what physician …show more content…
The proposal was dead and so was the idea of managed care. The debate of healthcare continued and there were new initiatives introduced to control cost and improve quality of care. According to Wang, “improving healthcare quality includes many methods. Pay-for-performance (P4P) and public reporting (PR), of hospital quality data have become two strategies to improve the quality in healthcare”. P4P & PR are new payment methods for care based on value not volume. While, the Health Security proposal did have a report card to monitor the quality of the plans it did not have any metrics to monitor the quality of care or patient outcomes. The Health Security proposal fit a combination of politics on Oliver’s analysis. It was a combination of entrepreneurial and incrementalism politics. According to Oliver (2006), “Incrementalism is a natural byproduct of “interest groups politics” that occurs when both benefits and costs are concentrated. With clear winners and losers, the level of conflict is high and the outcomes of any single proposal is highly unpredictable” (p. 211). The proposal was incremental at best because there were going to be 40 million uninsured American left without coverage and it did not do enough to provoke system wide cost containment (McLaughlin & Zellars, 1992, Cantor, Long & Marguis, 1995). Oliver defines entrepreneurial politics, where the benefits are shared so broadly that there are no impassioned, self- interested advocates and yet there is great opposition from interest that would bear the concentrated cost (McLaughlin & McLaughlin, 2015 p 280). There has to be an equitable sharing of benefits, cost, and burdens). There is no perfect solution to healthcare reform but, while pay-for- performance seems like the best alternative there are many questions that the new trend has raised (Andrus,

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