The goal of healthcare reform is to make medical services more affordable and accessible while improving quality. In general, this involves reducing cost and improving access to care through community-based public health programs; providing education and support to promote healthy behaviors; and encouraging patients to be more active in their own care (e.g., following-up on prescriptions).
Another major aspect of healthcare reform is focusing on changing the behavior of health care actors. This involves getting them to do things that will improve outcomes and performance, such as changing patient health-seeking behavior, professional/doctors’ behavior (e.g., smoking cessation), treatment compliance, and lifestyle and prevention behaviors.
A third major aspect of healthcare reform involves transforming the structure and funding of health care. This can include promoting universal health insurance (e.g., financed by employers and/or general taxation) to provide everyone with access to a basic set of services; privatizing the public sector; or combining both (e.g., through the use of internal markets and purchaser/provider splits in tax-funded systems).
Until recently, quite a few health policy makers still wanted to somehow restructure healthcare to get back to some level of an entirely mythical “good old days”-the days when Marcus Welby-like physicians knew everything about each patient and made great, scientific, personalized decisions for them without interference from anything like health plans, government regulations or even scientific, performance-tracking databases! It turns out, however, that a real-world quality chasm remains and that the people of this country are ready for somebody to design and build a bridge across it.