The Healthcare Bargain

Flexibility may be the best policy for U.S. health and healthcare reform

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With or without the Affordable Care Act (ACA) in place, the road to a long-term health and healthcare solution in the U.S. still lies ahead and there is no clear consensus on what should be done or how to go about doing it.

One critical issue is the dizzying array of differing needs. While urban, suburban, and rural communities struggle with very different issues, even within a community the health needs and interests may vary widely.

That means that no one solution will work across the board and the most effective mechanism for reform may be working within the existing system by advancing the mechanisms of flexibility that already exist. That flexibility represents a political bargain where both sides of the isle get to advance their own agendas in their own backyards - so long as they can find the right way to implement such programs.


Policy on the Left

Flexibility opens the door for strategic investments in population-health programs that abide legitimate controls for accountability and cost-effectiveness.

Examples include:

  • Capturing federally-matched funding for public-health programs that impact health

  • Developing sustainable community-based partnerships

Private Sector

Flexibility will change business models and create opportunities for those business and community leaders who can best adapt to the rapidly changing landscape.

Examples include:

  • Health Systems develop new lines of business beyond the traditional continuum of care

  • Sustainable funding for cost-effective, community-based programs

Policy on the right

Right-leaning administrations can responsibly implement programs that enforce accountability, cost-effectiveness, and consolidate public-health programs in the private sector.

Examples include:

  • Shifting implementation of public-health programs to cost-effective private partners

  • Implementing analogues to per-capita caps in Medicaid

  • Structuring arrangements that incent private partners aiding in workforce participation