Events

The current state of health economics and health policy research in the U.S. has been primarily focused either on the details of the U.S. health care system, including rich models using unique micro data sets, or on country-wide health systems at an aggregate level. Our belief is that many nations outside of the U.S., particularly those in Europe, have much to offer in terms of models of health care delivery that lower cost, improve health, or both.

This conference was made possible by the generous support of Robert E. Field, President and Founder of the Real Reporting Foundation and healthsystemsfacts.org.

The Affordable Care Act (ACA or Obamacare) made significant progress in reducing uninsurance in the U.S. However, between the gaps left at the peak of the policy and the subsequent repeal efforts that undermined the original law, there remain significant gaps in even the basic aspects of the U.S. health care system. Further reforms are essential for achieving the goals of universal access to health care and efficient health care delivery. In the U.S., where health spending is much higher than in other developed nations (18% of GDP), there is increasing policy interest in changes to U.S. health care including expanding Medicare as is (the approach proposed by Joe Biden), offering public options to compete on ACA exchanges or single-payer “Medicare for All.” All of these present efficiency and fiscal trade-offs. Despite the policy interest, though, little is known, and even less spelled out in policy proposals, about how such changes would actually be designed and the degree to which they would achieve key goals in the U.S.

The goal of this initiative is to facilitate an informed conversation about the U.S. and international health systems in a way that i) provides actionable information in designing policy; ii) moves beyond the aggregate comparisons of spending and life expectancy that, ultimately, have only little to do with actual health care delivery; and iii) stimulates an ongoing shift in the academic study of these issues that integrates more international perspectives.

The current state of health economics and health policy research in the U.S. has been primarily focused either on the details of the U.S. health care system, including rich models using unique micro data sets, or on country-wide health systems at an aggregate level. Our belief is that many nations outside of the U.S., particularly those in Europe, have much to offer in terms of models of health care delivery that lower cost, improve health, or both.

Despite that, barriers to data and knowledge of other settings, as well as a lack of a clear U.S.-based publishing outlet have meant there is little research identifying and measuring such lessons.

The event took place on October 22nd and October 23rd, 2020. Speakers gave presentations based on their topical knowledge, drawing on recent research insights. Speakers focused on:

• What are key features of international health systems that differ from the U.S.?

• What evidence is there on the differential effectiveness of these alternative designs?

• How could this evidence be brought to bear in the U.S. reform policy discussion?