3 Health Econ. Pol'y & L. 1 (2008)

handle is hein.journals/hecpol3 and id is 1 raw text is: 

Health Economics, Policy and Law (2008), 3: 1-5
o Cambridge University Press 2008  doi 10.1017/S1744133107004409

Editorial



Emerging health care reform issues in the US
presidential debate

KENNETH E. THORPE*
Rollins School of Public Health, Emory University, Atlanta, USA

The 2008 presidential election in the United States has again elevated the issue
of health care reform to center stage. Reform proposals are proliferating in the
states as well as nationally. Virtually all candidates - both Republican and
Democratic - running for President have outlined their plans for reforming
health care. The renewed interest in health care reform reflects the fact that sev-
eral key measures of the performance of the US health care system continue to
deteriorate. Since 2000, the (nominal) cost of private health insurance has
doubled.1 Over the same period, the number of Americans without health insur-
ance has increased from 38.7 million to 47 million in 2006.2 Objective measures
of the quality of health care provided to chronically ill patients are also of
concern; such patients only receive approximately 56% of the clinically recom-
mended preventive health care (McGlynn et al., 2003).
   Of course, these problems plaguing the American health care system are
not new. However, what is new is the flurry of activity at the state level. Absent
federal leadership of the issue over the past seven years, two states - Vermont
and Massachusetts - have recently passed comprehensive health care reform
plans. Massachusetts passed an individual mandate that requires all residents of
the state to have health insurance. Health plans offered through the state's insur-
ance connector offer comprehensive benefits. Individuals can purchase a low
cost sharing or a higher cost sharing version of these plans (premiums differ by
about $35 per month for the two plans).3 Certain exceptions to the law were
made for individuals and families earning more than three times the US poverty
level. These individuals may apply for a waiver from the requirement and remain



*Correspondence to: Dr. Kenneth E. Thorpe, Robert W. Woodruff Professor and Chair, Department of
Health Policy and Management, Rollins School of Public Health, Emory University, 1518 Clifton Road,
NE, Atlanta, GA 30322, USA. Email: kthorpe@sph.emory.edu

   1 http://www.kff.org/insurance/upload/7670.pdf
   2 http://www.census.gov/prod/2001pubs/p60-215.pdf
   3 For more detail see, http://www.massresources.org/pages.cfm?contentID-81&pagelD-13
&Subpages-yes

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