Health insurance should enhance health and well-being

5.       Health insurance should enhance health and well-being by promoting access to high-quality care that is effective, efficient, safe, timely, patient-centered, and equitable.

                                    Grading Rubric 

A	B	C	D	F	Truant
The plan provides coverage for comprehensive care including preventative and screening services. It includes mechanisms for evaluation of systems performance and the medical liability system must be reformed to enhance patient safety.	The plan provides coverage for comprehensive care including preventative and screening services. It includes mechanisms for evaluation of system performance or the medical liability system will be reformed to enhance patient safety.	The benefits package is similar to Medicare. It includes mechanisms for evaluation of system performance or the medical liability system will be reformed to enhance patient safety.	The benefits package is similar to Medicare, but has fewer benefits (i.e. does not provide drug coverage). The plan does not provide for system evaluation and does not reform the medical liability system to enhance patient safety.	The plan provides coverage only for catastrophic medical expenses. The plan does not provide for preventative and screening services, address system evaluation, or include reform for the medical liability system to enhance patient safety.	No plan is offered.

 

Criteria for review: Basic benefit packages must include preventive and screening services, prescription drugs, dental care, and mental health care as well as outpatient and hospital services. Payment strategies should promote evidence-based medical care. Reforms such as malpractice reform should promote patient safety and enhance patient care.

 

Democrats

Obama: A

The Obama plan requires a comprehensive benefit plan including preventive services, mental health care and disease management.  "Medical home" type models would be encouraged.  Hospitals and providers must publicly report measures of health care costs and quality.  The plan will align reimbursement with achieving performance thresholds on physician-validated outcome measures.  The Obama plan establishes an independent institute to guide research on comparative effectiveness.  This plan will strengthen antitrust laws to prevent insurers from overcharging physicians for malpractice insurance.  The plan will promote new models for addressing physician errors to improve patient safety. The plan received an A because if offered a fairly comprehensive range of services covered through the purchasing pool and promised to look at new models for medical malpractice that would promote patient safety.

 

 

Republicans

McCain: C

The McCain plan would facilitate the development of national standards for measuring and recording treatments and outcomes.  Medicare compensation would be reformed to compensate providers for diagnosis, prevention and care coordination.  The plan promotes preventive services, health information technology and telemedicine.  It supports making more information about outcomes, quality of care, price and cost available to the patient.  The plan would promote tort reform with the goal of limiting frivolous malpractice lawsuits.  The plan received a C because it does not include a defined benefits package, it lacks specificity about how the quality of health care would be evaluated and the proposed malpractice reform would not enhance patient safety.