Health care reform

(This article is about political movements affecting the delivery of health care and health care systems. For more information about movements to improve health, see Health reform.)

Health care reform is a general rubric used for discussing major policy creation or changes --for the most part, governmental policy --that affects healthcare delivery in a given place. Health care reform typically attempts to:
 * Broaden the population covered by private or public health insurance
 * Expand the array of health care providers consumers may choose among
 * Improve the access to health care specialists
 * Improve the quality of health care
 * Decrease the cost of health care
 * Decrease the cost of health insurance

In the United Kingdom a massive programme of attempted reform of the British National Health Service had begun as of 2007. In the United States, health care reform was a major concern of the Bill Clinton administration headed up by First Lady Hillary Clinton; however, the Clinton health care plan was not enacted into law. More recently, President George W. Bush signed into law the Medicare Prescription Drug, Improvement, and Modernization Act which included a prescription drug plan for elderly and disabled Americans. U.S. efforts to achieve universal coverage began with Theodore Roosevelt and continue to today.

As evidenced by the large variety of different health care systems seen across the world, there are several different pathways that a country could take when thinking about reform. Germany for instance, makes use of sickness funds, which citizens are obliged to join but are able to opt out (Belien 87). The Netherlands uses a similar system but the financial threshold for opting out is lower (Belien 89). The Swiss, on the other hand use more of a privately based health insurance system where citizens are risk-rated by age and sex, among other factors (Belien 90). The United States government provides health care to just over 25% of it's citizens through various agencies, but otherwise does not employ a system. The free market provides the balance of health care services, generally centered around modestly regulated private insurance methods.

The United States is in a unique position with regard to health care, being the clear world leader in medical innovation, while at the same time leaving the free market to deliver most health services. For example, researchers in the US earn The Nobel Prize in medicine approximately twice as often as researchers in the rest of the world combined, and research dollars dwarf those of any other nation, including the EU. As a result, the medicines and medical technology developed in the US not only benefit US citizens, but spread broadly into health care systems of other nations, relieving the rest of the world a substantial burden in research.

When the health care expenditures per capita and GDP per capita for developed countries are graphed, a nearly linear relationship is revealed, with the United States the clear outlier.