Cathy Schoen

..Signaling the need for reforms, the vast majority of US doctors surveyed said that the health care system needs fundamental change...

..If annual premium growth slowed by one percentage point, by 2020 employers and families would save $2,029 annually for family coverage...

..The United States in particular has opportunities to learn from diverse payment innovations and care redesign efforts under way in the other study countries...

..The paper estimates coverage and costs, and assesses the approach. Our findings indicate that the framework could reach near-universal coverage with little net increase in national health spending...

..Still, deficits in care management during hospital discharge or when seeing multiple doctors occurred in all countries. Findings highlight the need for system innovations to improve outcomes for patients with complex chronic conditions...

..The findings underscore the importance of policies that take a coherent, whole-system approach to change and address the interaction of access, quality, and cost...

..Deficiencies in transition care during hospital discharge and coordination failures among patients seeing multiple physicians underscore shared challenges of improving performance across sites of care...

..Including adults uninsured during the year, 35 percent (sixty-one million) were under- or uninsured. These findings highlight the need for policy attention to insurance design that considers the adequacy of coverage...

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..Contrasts across countries point to the potential to improve performance and to learn from international initiatives...

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..Patient-reported errors were high for those seeing multiple doctors or having multiple chronic illnesses. The United States stands out for cost-related access barriers and less-efficient care...

..If reforms succeed in slowing premium growth by 1 percentage point annually in all states, by 2020 employers and families together will save $2,323 annually for family coverage, compared with projected trends...

..S. adults were underinsured or uninsured. The underinsured report high levels of access problems and financial stress. The findings underscore the need for policy attention to benefit design, to assure care and affordability...

..S. managed care plans. The analysis explores the extent to which such a system helps to equalize access experiences with contrasts to the experiences of U.S. women...

..For US adults, comprehensive health reforms could lead to improvements in many of these areas, including reducing differences by income observed in the study...

..If reforms succeed in increasing the affordability of care for people in this income range, we could expect a 70 percent drop in the number of underinsured people and a steep drop in the number of uninsured people...

..We believe that opportunities exist for cross-national learning in disease management, use of teams, and performance feedback to improve primary care globally...

..Disease management capacity varies widely. Overall, findings highlight the importance of nationwide policies: Policy changes in the United States could lead to improved performance...

..In addition, expansion of Medicaid and the State Children's Health Insurance Program would benefit low-income, laid-off workers and their families who are ineligible for COBRA...

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..Making the program more like private insurance runs the risk of undermining a program that is working well from the perspective of beneficiaries...

..Congressional proposals to reform the health system could help uninsured young adults gain coverage and prevent others from losing it. This is the seventh edition of Rite of Passage, first published by The Commonwealth Fund in 2003...

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..6 trillion over 10 years...

..With few exceptions, benefits in the FEHBP standard option either meet or exceed those that state mandates require-indicating that a broad-based national benefit standard would include most existing state benefit mandates...

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..This issue brief, the sixth in a series, updates an earlier version of Rite of Passage..

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..The paper provides coverage and cost estimates and identifies potential sources of revenue to finance coverage...

..To the extent reforms succeed, patients and their families stand to gain from more accessible, safer, responsive, and less wasteful care...

..The incoming president and Congress should aspire to have the best health system in the world--not just assert it--and can do so by learning from examples of excellence within the U.S. and abroad...

..To document the child-rearing needs and pediatric health care experiences of parents with children from birth to 3 years old...

..To better understand the motivation for adolescent smoking and drinking and to identify the underlying risk and protective factors associated with these behaviors among adolescents...

..In the year 2000 Medicare and Medicaid outlays were an estimated $104 billion less than projected just 5 years ago-representing an estimated 45% of the budget surplus this year, or about $1 trillion of the 10-year surplus...

..Eliminating some of the excess payments to Medicare Advantage plans would yield savings that could be used to help finance premium subsidies for low-income beneficiaries...

..Costs are likely to be unaffordable for most uninsured older adults, even with large tax credits or in states with community rating. These findings indicate a need to include risk and age pooling to reach the uninsured in this age group...

..This paper highlights structural and functional barriers to counseling that persist in the Israeli system in the absence of financial barriers and discusses ways to overcome them...

..We discuss MMA's potential to improve quality and the need to monitor performance...

..With erosion of state and private sources of prescription benefits expected, the findings speak to the need for a national policy solution...

..The most crucial policy implication of these findings is that a focus on a small population of intensive health system users could have the potential to both control costs and improve care...

..Asked about future strategies to improve quality, executives in all five countries expressed support for making information technology an investment priority...

..In contrast, relatively few citizens reported problems getting needed health care. Low-income U.S. citizens reported more problems getting care than did their counterparts in the other four countries...