注册 登录  
 加关注
   显示下一条  |  关闭
温馨提示!由于新浪微博认证机制调整,您的新浪微博帐号绑定已过期,请重新绑定!立即重新绑定新浪微博》  |  关闭

liusongjifan2的博客

读书是同智者交流;读书是对神奇世界的探访;读书是和挚友娓娓谈心 !

 
 
 

日志

 
 

【转载】The 2016 US Election: a platform for improving health  

2016-10-25 17:16:48|  分类: 社会生活 |  标签: |举报 |字号 订阅

  下载LOFTER 我的照片书  |
Search Terms Search within      All Content     Article Title, Abstract, Keywords     Authors     Article Title     Abstract   Advanced

【转载】The 2016 US Election: a platform for improving health - liusongjifan2 - liusongjifan2的博客
 
Volume 388, No. 10049, p1025, 10 September 2016
Editorial

The 2016 US Election: a platform for improving health

Published: 10 September 2016
Article has an altmetric score of 37

The US presidential election, on Nov 8, 2016, sits squarely on the horizon. On a grand scale, this election represents an ideological battle between extending a progressive agenda established under the Obama Administration and a potential conservative overhaul. American health and health care, often overlooked on the political mainstage, are very much at stake.

For health and health care in the US, it is the best of times and the worst of times. 6 years after the passage of the Affordable Care Act (ACA), nearly 30 million Americans remain uninsured. Americans spend more on health care per person, yet overall life expectancy sits at the bottom of a list of comparable nations. Long the frontrunner in medical innovation, stagnant funding of biomedical research has begun to erode America's edge. In the starkest assessment, American health is at the brink of crisis and the election's outcome will be unprecedented for determining whether it remains at peril.

For politicians, focusing on three core challenges may have the greatest potential impact: protecting and refining the ACA, working to lower health-care-related costs, and strengthening the commitment to biomedical research and global health.

Protecting and refining the ACA. The ACA has had many successes, including insuring an additional 20 million Americans, increasing access for minorities, spurring the expansion of Medicaid in 32 states, driving health sector growth, and enhancing health outcomes. Nevertheless, the ACA is not without serious shortcomings. New quandaries have emerged as several major commercial insurers have pulled out of the marketplace, citing losses as a result of underpricing where the risk pool of enrollees are actually sicker, poorer, and more likely to use health care than expected. These effects can be felt more acutely in states that failed to expand Medicaid. Revisiting the previously dismissed idea of a public option, a government-run insurance provider that would compete alongside private options, would be a logical extension of the current system. Distinct from a single-payer plan covering everyone, a public option could be tailored to meet the needs of individual states and paid for by premiums as opposed to subsidies.

Lowering health-care-related costs. The controversy of prescription drug pricing has garnered keen bipartisan interest. Large price hikes by pharmaceutical companies, often without explanation, have raised the ire of consumers and politicians alike and highlighted some of the fundamental issues, such as the government's restricted ability to regulate drug prices because of outdated legislation. With an increasing number of new, costly, yet more effective drugs without generics, the situation has continued to worsen, with patients forced to absorb costs or forego treatment. Scrutiny is the first step, but translating greater oversight into effective regulation will require political resolve and eschewing pressure from the pharmaceutical industry.

Price inflation is also manifest in highly variable fees for service, procedures, and visits. New approaches to control costs need to be rigorously explored and promoted through, for example, accountable care organisations (ACO), which move away from transaction-based payment models toward reimbursements that incentivise population health and outcomes. As with Medicare beneficiaries, the ACO model has similar potential to control costs and improve outcomes for privately insured patients.

Strengthening research and global health. America spends about US$117 billion annually on biomedical research, about $32 billion of which is the National Institutes of Health's budget. Although funding has begun to see slight gains after more than a decade-long slump (because of Alzheimer's disease research expansion and the Precision Medicine Initiative), the allocation of federal funds is still subject to political wrangling. The US Centers for Disease Control and Prevention's ongoing battle to secure adequate funding to fight Zika virus has been met with great resistance from Congress. Funds have dwindled and money has had to be diverted from other research programmes to meet the demand. The Zika virus outbreak is a prime example of a public health crisis that transcends national boundaries, illustrating the need for America to continue to be the foremost leader in global health. Appreciating and staunchly supporting the role of the US in global health is imperative for the next president.

To improve the current state of health in the US will need strong executive leadership, skilful negotiation between political parties, and the ambition to build consensus. The political goal must be to provide better and less expensive care to more people, a goal that will need compromise but should not itself be compromised.

To read more on The Lancet's coverage of the US Election 2016 seehttp://www.thelancet.com/USElection2016

Thumbnail image of Figure. Opens large image
Adrian Roots
  评论这张
 
阅读(3)| 评论(0)
推荐 转载

历史上的今天

在LOFTER的更多文章

评论

<#--最新日志,群博日志--> <#--推荐日志--> <#--引用记录--> <#--博主推荐--> <#--随机阅读--> <#--首页推荐--> <#--历史上的今天--> <#--被推荐日志--> <#--上一篇,下一篇--> <#-- 热度 --> <#-- 网易新闻广告 --> <#--右边模块结构--> <#--评论模块结构--> <#--引用模块结构--> <#--博主发起的投票-->
 
 
 
 
 
 
 
 
 
 
 
 
 
 

页脚

网易公司版权所有 ©1997-2017