Oberlander explores why health care reform fails: a NEJM perspective
October 26, 2007 | |
Jonathan Oberlander, PhD, in the lead perspective article in the Oct. 25 issue of the New England Journal of Medicine, explores what lessons can be learned from past failures in health care reform. Oberlander is an associate professor of health policy and administration and social medicine at the University of North Carolina.
Oberlander compares the environment for health care reform now with the situation in 1993-94 when the Clinton administration presented a plan for health care reform. He explores why the Clinton plan was unsuccessful, and suggests what political and health care leaders today can learn from that failure. Oberlander’s article, and an audio interview with him, are available at www.nejm.org. In the article, Oberlander says, “Perhaps the Clinton administration’s greatest mistake was excessive ambition. The plan attempted simultaneously to secure universal coverage, regulate the private insurance market, change health care financing through an employer mandate, control costs to levels enforced by a national health board, and transform the delivery system through managed care.” He compares key factors affecting the demand for health care reform in the early 1990s and now, and suggests there is a similar window of opportunity to make significant changes in the nation’s health care system. But he offers six lessons current reformers can learn from the Clinton plan’s failure.
Most sobering of all, Oberlander says, is the realization that Clinton is only the latest in a list of presidents who tried and failed to reform health care. Others include Franklin Roosevelt, Harry Truman and Richard Nixon. # # # School of Public Health contact: Ramona DuBose, director of communications, (919) 966-7467 or ramona_dubose@unc.edu. |
|