A decade prior to passage of the ACA, the ambitious World Health Report 2000, which ranked the health care systems of nearly 200 nations, provided what appeared to be a data-driven argument for dramatic health reforms in the United States. Its most notorious finding—the relatively low U.S. ranking (37th) in “overall performance” as defined by WHO—has been repeatedly offered as objective evidence of the overall failure of U.S. health care by advocacy groups.
Contrary to the naively drawn inferences from that study, the WHO study’s methods and conclusions were heavily criticized in a body of peer-reviewed literature by international academic experts who examined the study in detail. Fundamental flaws in methodology, large margins of error in data, overreliance on markedly flawed measures of health care quality, and highly subjective inputs based on ideological bias put forth as data—even in cases when no actual data was available—have undermined the legitimacy of the WHO’s comparative rankings.
The World Health Report 2000 can be considered, at best, deceptive—a document that was essentially a ranking of countries based on their alignment with a specific political and economic ideology—socialized medicine—rather than an objective measurement of health system quality. Indeed, Mark Pearson, head of health for the Organization for Economic Cooperation and Development, when asked about the WHO report, told the Wall Street Journal in October 2009, “Health analysts don’t like to talk about it in polite company. It’s one of those things that we wish would go away.”
Beyond the scandalous bias of the WHO document, the facts throughout the world’s leading medical journals disproved the false narrative that was promulgated through the popular press to justify the ACA. The distortions continue today, as our politicians push for a single payer system. Yet peer-reviewed data consistently demonstrate that access to care, as well as quality of care, are factually worse in single-payer systems than they were in pre-ACA America.
Americans need to see past the fear mongering about the need to preserve certain parts of the law and understand that the ACA indeed must be eliminated and replaced. Its misguided amalgam of regulations generated skyrocketing insurance premiums, reduced patient choice in doctors, funneled millions more poor people into substandard programs, and accelerated consolidation throughout the health care industry—all of which are serious consequences that directly harmed patients.
Reducing the price of medical care in a more freely functioning market represents the fundamental basis for improving access to affordable, high quality care without eliminating the choice that Americans demand, and without impeding the innovations in health care that we all hope for and need. Broadly available options for cheaper, limited mandate, high deductible coverage; markedly expanded HSAs; and targeted tax incentives to leverage their use are keys to increasing price sensitivity and reducing health care prices. Adding new incentives to consider costs with reforms to strategically increase the supply of medical care would generate significant competition and reduce the price of health care overall.
A comprehensive reform plan joining these important incentives with common-sense deregulation would achieve high quality health care at reduced cost. Such a plan would conservatively decrease private expenditures by $2.7 trillion and federal spending by $1.5 trillion, shifting the policy paradigm from one of “raising taxes or reducing benefits” to one using incentives to achieve quality and value. These should be the goals ..