Wars and other national crises force society to act differently for awhile. But in doing so, they highlight organizational actions and innovations that should not end with the crisis and should be allowed to play a greater role in the future. The coronavirus disease 2019 (COVID-19) pandemic has similar features, and it should spur policy makers who shape the US health care system, to-as Apple Computer cofounder Steve Jobs often urged-"think different."The US response to the COVID-19 pandemic highlights several strategies that should be emphasized more in the management of the health care system. These strategies include using waivers to boost federalism, reconsidering the role of hospitals and other institutions as hubs for care, expanding the use of telehealth, and bringing together funds from multiple programs to improve the delivery of health care and health-related services.
Using Waivers to Boost FederalismAlthough frustrations about the failure of federal leadership often get highlighted, the real story is that states have been the key drivers of action and adaptation. The federal government has tools to
Abstract:The deficiencies of the Medicare program are rooted in its defined-benefit structure and in its use of price controls. Medicare should be transformed into a defined cash contribution made to beneficiaries' private plans or to the traditional Medicare program. The Federal Employees Health Benefits Program (FEHBP) is essentially such a system and is a good model for Medicare reform. The FEHBP has been highly successful at holding down costs while offering a wide range of benefits and types of plans. Its features for consumer information and plan standards also would be useful in a reformed Medicare program.
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