Health Care Reform: A Recurring Theme

We will not make fundamental progress at reforming the health care system until we, as a nation, come to grips with the issue of how we should ration care. Although we have not been able to come to a consensus on this issue, we remain uncomfortable with our current hybrid system that is a mix of government programs and market options. Recent attempts at comprehensive reform failed because of a lack of agreement on the appropriate shape of reform. These experiences are specifically of interest to those engaged in policy-making with regard to the ongoing evolution of the U.S. health care system. However, we are all likely to be affected by policy changes that alter our health care systems, and it is important to understand what happened during our recent effort to seek health care reform and what is likely to occur in the future. To understand the issues underlying health care reform and the likely future of the American health care system, this paper addresses the following questions: What is the history of health care reform for the United States?; Why did we reengage health care reform in recent years?; What factors caused health care reform efforts to fail?; Does our health care system have major problems (have we begun to fix the problems; or have we decided that we don't know what to do yet)?; How do we compare to other countries?; and, Will health care reform come back again, and, if so, what are the questions we need to answer before then?