Lancaster Gilead I, O'Connell Ryan, Katz David L, Manson JoAnn E, Hutchison William R, Landau Charles, Yonkers Kimberly A
Heart Institute at Bridgeport Hospital, Bridgeport, Connecticut 06610, USA.
Ann Intern Med. 2009 Apr 7;150(7):490-2. doi: 10.7326/0003-4819-150-7-200904070-00113. Epub 2009 Mar 2.
Healthcare Professionals for Healthcare Reform is a group of physicians and others interested in health care reform who, recognizing the urgent need for change, convened to propose a universal health care plan that builds on the strengths of the U.S. health care system and improves on its coverage, efficiency, and capacity for patient choice. The group proposes a tiered plan, the core of which (Tier 1) would be lifetime, basic, publicly funded coverage for the entire population on the basis of the best evidence about which therapies are considered life saving, life-sustaining, or preventive. Optional coverage (Tier 2) would be funded by private insurance and cover all therapies considered to help with quality of life and functional impairment. Items considered to be luxury or cosmetic (Tier 3) would generally not be covered, as is the case under the current system. The entire system would be overseen by a quasi-governmental, largely independent organization known as "The Board," which would resemble the Federal Reserve and interact with U.S. Department of Health and Human Services agencies to oversee implementation and coverage. By building on the current health care system while introducing other features and efficiencies, the Expanding Medical and Behavioral Resources with Access to Care for Everyone (EMBRACE) plan for universal health insurance coverage offers several advantages over alternative plans that have been proposed.
医疗保健改革医疗专业人员组织是一群关注医疗保健改革的医生和其他人,他们认识到变革的迫切需求,召开会议提出一项全民医疗保健计划,该计划基于美国医疗保健系统的优势,在覆盖范围、效率和患者选择能力方面加以改进。该组织提出了一项分层计划,其核心(第1层)将是基于关于哪些疗法被视为挽救生命、维持生命或预防性疗法的最佳证据,为全体人口提供终身的基本公共资助保险。可选保险(第2层)将由私人保险资助,涵盖所有被认为有助于改善生活质量和功能障碍的疗法。被视为奢侈品或美容类的项目(第3层)通常不予承保,现行制度下也是如此。整个系统将由一个类似政府的、基本独立的组织“委员会”监督,该委员会类似于美联储,并与美国卫生与公众服务部各机构互动,以监督实施和覆盖情况。通过在现有医疗保健系统的基础上引入其他特点和提高效率,全民医疗保险覆盖的“扩大医疗和行为资源以惠及每一个人”(EMBRACE)计划比其他已提出的替代计划具有若干优势。