Hot Topic

One of the most fundamental issues currently facing Medicare is the program's long-term financial stability.¹ As Medicare spending continues to increase, examining current spending and trends has become increasingly important. In particular, Medicare Advantage² has become a subject of high interest because of its recent growth in enrollees and its impact on Medicare spending.

The recent economic downturn has adversely affected job security, investments and retirement accounts, and consumer spending. In October 2008, the unemployment rate was 6.5 percent, 1.7 percent higher than the unemployment rate the previous year, and 0.4 percent higher than September 2008.¹ Some predict that the unemployment rate could increase to more than 8 percent.² Increased unemployment affects consumer spending, sales and income tax revenue, and access to affordable health insurance and care.

With a growing public interest in addressing problems in the current health care system, a variety of health care reform proposals are underway. A common theme includes recognition that high quality care should be rewarded and that consumers need information to identify the individual providers and hospitals which offer this type of care. But does the clearly desirable goal of promoting high quality health care in turn create disparities?
 

Americans agree that reforming the health system is a national priority. In fact, in a poll conducted just before the November elections, 77 percent of respondents said they would be more likely to vote for a presidential candidate whose top priorities include health care reform.¹ While increasing health care costs are not a new concern among Americans, the recent economic downturn may be strengthening the current call for reform.

Less than 60 days into the new administration, two significant pieces of legislation have been signed into law. Both offer pathways for coverage expansion at a time when job loss and economic crisis are putting families’ health care in jeopardy. On February 4, President Obama reauthorized the Children’s Health Insurance Program (CHIP) for the next 4.5 years.¹ On February 17, he signed the American Recovery and Reinvestment Act of 2009 (Recovery Act), much of which has direct application to the health care sector.

The $787 billion American Recovery and Reinvestment Act (ARRA) of 2009 (P.L.

An individual's health is determined by many factors and the health care system is just one piece in a complex web. Outside the realm of the clinical health care setting, individuals' health is affected by the environment in which they live, their socioeconomic status, education, access to insurance and providers, and their personal behaviors. These factors are collectively known as social determinants, and play a key role in shaping a person's health and well-being.

Looking across an array of inputs, including meetings, polls, and secondary review of existing poll data reveals remarkable consistency over time with respect to broad views about the health care system and health care in the United States.¹ Together with published scientific literature addressing public perceptions of and values regarding health care, this input provides some direction for policymakers considering health system reforms.