RAND Health, Santa Monica, California, USA.
Health Aff (Millwood). 2010 Jun;29(6):1142-6. doi: 10.1377/hlthaff.2010.0433.
The process by which Congress considers legislation rarely affords the public an opportunity to examine how the outcomes might change if components of the law were structured differently. We evaluated how the recently enacted health reform law performed relative to a large number of alternative designs on measures of effectiveness and efficiency. We found that only a few different approaches would produce both more newly insured people and a lower cost to the government. However, these are characterized by design options that seemed political untenable, such as higher penalties, lower subsidies, or less generous Medicaid expansion.
国会审议立法的过程很少让公众有机会审视法律的不同组成部分对结果可能产生的影响。我们评估了新颁布的医疗改革法在有效性和效率措施方面相对于大量替代设计的表现。我们发现，只有少数几种不同的方法既能让更多的新参保人受益，又能降低政府的成本。然而，这些方法的设计选项似乎存在政治上不可行的问题，例如更高的罚款、更低的补贴或不那么慷慨的医疗补助扩展。
