Featured Research

from universities, journals, and other organizations

Collaboration Between States, Federal Government Key To Health Care Reform

Date:
October 21, 2008
Source:
JAMA and Archives Journals
Summary:
In order to achieve comprehensive health care reform, states cannot do it alone. States and the federal government must partner and collaborate to overcome barriers and challenges to create high-quality, affordable health care, according to the authors of a commentary in the Journal of the American Medical Association.

In order to achieve comprehensive health care reform, states cannot do it alone. States and the federal government must partner and collaborate to overcome barriers and challenges to create high-quality, affordable health care, according to the authors of a commentary in JAMA, a theme issue on the Health of the Nation.

Ezekiel Emanuel, M.D., Ph.D., of the National Institutes of Health, Bethesda, Md., presented the commentary at a JAMA media briefing at the National Press Club in Washington, D.C.

Dr. Emanuel and co-author U.S. Senator Ron Wyden, J.D., write that when Massachusetts passed a health reform bill in 2006, numerous state legislatures met and sought to enact legislation providing health care for all state residents, but not one was successful. "States cannot reform health care on their own. Governors and state legislators, in concert with federal officials, must reconceive federal-state health care relations so that together they can meet the health care needs of all Americans."

The barriers to states implementing substantial health care changes on their own are substantial. They include programs and factors out of states' control: changing federal tax laws related to health insurance, self-insured employers regulated by ERISA (Employee Retirement Income Security Act), modifying Medicare and Medicaid, and the health coverage programs for federal employees in the state, the military, and veterans. Other barriers to state reform are the substantial costs with financing reform and reforming the health care delivery system. In fact, excluding Massachusetts' health reform bill, which is still in evolution, every time states have enacted a comprehensive reform effort it has failed.

Although states cannot make the changes alone, they can play three critical roles in health care reform. They can be facilitators, regulators, and innovators, the authors write. "First, states should be facilitators by creating and overseeing insurance exchanges. They are the logical place to develop insurance exchanges, manage enrollment, help state residents choose from a variety of plans to meet their needs, and provide informational materials to consumers and employers. In a new federal-state health partnership, the states should serve as the point of contact for self-employed individuals, workers in small businesses, and those who would be part of a reformed individual market."

"Second, states should be important regulators. The logical place to regulate health insurance plans is at the state level. States oversee these plans today through insurance commissioners in each state. They should continue to protect consumers in a new federal-state health partnership, ensuring that plans sold in the state prohibit discrimination against individuals with preexisting illnesses, provide for fair marketing practices, and oversee grievances and appeals. States should oversee the development of standardized common claim forms and uniform billing practices to reduce administrative waste."

"Third, states should be important innovators," they write. "… states should be granted a broad waiver authority to develop innovative programs tailored to meet the unique needs of their citizens. In addition, neither the federal government nor business has taken sufficient initiative regarding wellness and prevention programs. States can develop novel programs around wellness and prevention that focus on the entire state population. … Plans could also push for the development of more effective uses of health information technologies. States could require insurance plans that enroll state workers to open electronic medical records for them at the expense of the private insurer."

"The American public wants what only the federal government can guarantee—that all Americans, regardless of where they reside or work or any other characteristic, have high-quality, affordable health care. It is impossible to have one level of government oversee all aspects of health care for 300 million Americans. States will and should have a role in any comprehensive health care reform, but they cannot do it alone. The federal government will have to take initiative to achieve sustainable and successful reform," the authors conclude.


Story Source:

The above story is based on materials provided by JAMA and Archives Journals. Note: Materials may be edited for content and length.


Journal Reference:

  1. Emanuel et al. A New Federal-State Partnership in Health Care: Real Power for States. JAMA The Journal of the American Medical Association, 2008; 300 (16): 1931 DOI: 10.1001/jama.2008.536

Cite This Page:

JAMA and Archives Journals. "Collaboration Between States, Federal Government Key To Health Care Reform." ScienceDaily. ScienceDaily, 21 October 2008. <www.sciencedaily.com/releases/2008/10/081021120749.htm>.
JAMA and Archives Journals. (2008, October 21). Collaboration Between States, Federal Government Key To Health Care Reform. ScienceDaily. Retrieved October 21, 2014 from www.sciencedaily.com/releases/2008/10/081021120749.htm
JAMA and Archives Journals. "Collaboration Between States, Federal Government Key To Health Care Reform." ScienceDaily. www.sciencedaily.com/releases/2008/10/081021120749.htm (accessed October 21, 2014).

Share This



More Health & Medicine News

Tuesday, October 21, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

CDC Revamps Ebola Guidelines After Criticism

CDC Revamps Ebola Guidelines After Criticism

Newsy (Oct. 21, 2014) The Centers for Disease Control and Prevention have issued new protocols for healthcare workers interacting with Ebola patients. Video provided by Newsy
Powered by NewsLook.com
WHO: Ebola Vaccine Trials to Start a in January

WHO: Ebola Vaccine Trials to Start a in January

AP (Oct. 21, 2014) Tens of thousands of doses of experimental Ebola vaccines could be available for "real-world" testing in West Africa as soon as January as long as they are deemed safe in soon to start trials, the World Health Organization said Tuesday. (Oct. 21) Video provided by AP
Powered by NewsLook.com
First-Of-Its-Kind Treatment Gives Man Ability To Walk Again

First-Of-Its-Kind Treatment Gives Man Ability To Walk Again

Newsy (Oct. 21, 2014) A medical team has for the first time given a man the ability to walk again after transplanting cells from his brain onto his severed spinal cord. Video provided by Newsy
Powered by NewsLook.com
CDC Issues New Ebola Guidelines for Health Workers

CDC Issues New Ebola Guidelines for Health Workers

Reuters - US Online Video (Oct. 21, 2014) The U.S. Centers for Disease Control and Prevention has set up new guidelines for health workers taking care of patients infected with Ebola. Linda So reports. Video provided by Reuters
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:

Strange & Offbeat Stories


Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins