This book establishes a framework for assessing health care reform proposals and their implementation. It helps clarify objectives, identifies issues to be addressed in proposals, distinguishes between short- and long-term expectations and achievements, and directs attention to important but sometimes neglected questions about the organization and provision of health care services.

In addition, the volume presents a discussion and analysis of issues essential to achieving fundamental goals of health care reform: to maintain and improve health and well-being, to make basic health coverage universal, and to encourage the efficient use of limited resources.

The book is a useful resource for anyone developing or assessing options for reform.

Contents

• COMMITTEE ON ASSESSING HEALTH CARE REFORM PROPOSALS
• Preamble
• Extending Access to Health Care
  • BARRIERS TO ACCESS
  • FINANCIAL ACCESS
  • MORE THAN FINANCIAL ACCESS
• Containing Health Care Costs
  • COSTS IN CONTEXT
  • ELEMENTS OF A STRATEGY
  • MOVING FROM GENERAL TO SPECIFIC POLICIES
• Assuring the Quality of Care
  • DEFINING QUALITY
  • QUALITY MEASUREMENT AND IMPROVEMENT
  • CLINICAL PRACTICE GUIDELINES
  • SPECIFIC IMPLICATIONS
• Financing Reform
• Improving the Infrastructure for Effective Change
  • GOVERNANCE AND ADMINISTRATION
  • HUMAN AND PHYSICAL CAPITAL
  • KNOWLEDGE DEVELOPMENT
  • PUBLIC HEALTH POLICIES AND PROGRAMS
  • OTHER INFRASTRUCTURE ISSUES
• Conclusion
• References

This study was supported by the W. K. Kellogg Foundation endowment fund.

NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The members of the committee responsible for this report were chosen for their special competences and with regard for appropriate balance.

The Institute of Medicine was chartered in 1970 by the National Academy of Sciences to enlist distinguished members of the appropriate professions in the examination of policy matters pertaining to the health of the public. In this, the Institute acts under both the Academy's 1863 congressional charter responsibility to be an adviser to the federal government and its own initiative in identifying issues of medical care, research, and education.