Universal Access to the U.S. Health Care System

Health Care is a Right

In 2010, the Patient Protection and Affordable Care Act (ACA) became law in the United States. The ACA resulted in millions of Americans receiving health insurance for the first time and brought major change to the health care landscape. Today, nearly 26 million more Americans have access to health care through the individual Marketplaces and the expansion of Medicaid since the law was established.

Our priorities

Health care is a right, not a privilege. Americans deserve affordable access to health coverage, no matter the age, income, or health status. That’s why our path to achieving a more balanced, sustainable health care system should not be political. Now is the time for a public, private partnership.

To achieve a more sustainable health care system we must:

  • Ensure and enhance access to health coverage for all people;
  • Build on what works and continue to find ways to make health care better;
  • Maintain choice for all consumers, empowering them to be active participants in their own health care; and
  • Lower costs, especially when it comes to prescription drugs.

While opportunities exist to improve Medicaid, Medicare, and the employer market, it is primarily the individual market that is broken and in critical need of significant changes.

Achieving a Sustainable Health Care System

Projections of National Health Expenditures and Their Share of Gross Domestive Product, 2013-2023

Source: The Henry J. Kaiser Family Foundation Projections of National Health Expenditures and Their Share of Gross Domestic Product, 2013-2023

Achieving a Sustainable Health Care System

The cost of health care remains the top concern for most Americans. Instead of creating a new unproven system from scratch, policymakers, insurers, providers, hospitals, business, and communities should focus on solutions that lower costs for everyone. This means addressing the cost of chronic diseases, lowering prescription drug prices, and harnessing technology to better address health needs.

Americans are best served by a competitive, private health insurance market that offers quality and choice that individuals deserve, at a price they can afford.

This can be done through:

  • Reimagining how consumers pay for health care, allowing for greater flexibility and funding options;
  • Returning insurance regulatory oversight and authority back to states;
  • Creating a sustainable Marketplace premium subsidy structure based on age, income, and geography;
  • Building incentives for people to stay covered throughout the year;
  • Shifting from pay-for-service to pay-for-performance models, emphasizing quality and outcomes;
  • Establishing transparent and measurable guidelines that tie outcomes to cost, especially within the pharmaceutical world; and
  • Rewarding innovation and experimentation in pharmaceutical manufacturing, while ensuring affordable access to generic and biosimilar drugs in a timely and cost-conscious manner.

The future of health care

The American system is a global leader in health care innovation and has some of the world’s best hospitals and treatments.

People in the U.S. have more personal choice than anywhere else in the world when it comes to health insurance. But 28 million Americans continue to be left without access to the system.

In order to move forward, we need to come together and put aside our differences to find solutions that provide predictability and certainty for consumers.

Transitioning to a Better Market Structure

Moving Forward

We should not give up on what’s good about the American health care system. But we must be committed to working with partners throughout the health care industry to make sure everyone has access to quality, affordable care.

  • We must maintain choice so that people can access the quality coverage and care that best meets their needs at an affordable price.
  • We need to continue to improve care and use advanced data and evidence-based approaches to help people get healthy faster and stay healthy longer.

Accelerating the Transformation of Health Care

Changing the Delivery of Health Care

Moving forward, we have to fundamentally change how health care is delivered to improve quality, efficiency, cost, and outcomes. Independence is already taking steps needed to move forward by:

  • Developing innovative approaches to working with hospitals and doctors that are designed to engage both the insurer and the health care provider to improve quality of care and reduce health care costs for members through better care coordination.
  • Engaging consumers in health care decisions. Consumers need the right information at the right time to be able to take an active role in their health care. They need the right tools to understand the services available to them, so they can make the right decisions for themselves and their families.
  • Making it easier for physicians and hospitals to do their jobs by giving them the support they need through clinical programs, tools, and reports.
  • Creating a two-way exchange of data, so that insurers, hospitals, and physicians have a complete view of patients’ health issues in order to make better informed decisions. This exchange of data can also help address larger issues, like helping to tackle or avoid dangerous drug prescribing patterns or identifying potentially avoidable emergency room visits.
  • Reviewing products, networks, and policies — using industry benchmarks and best practice standards — to ensure members receive high-quality care in the safest, most cost-appropriate settings.

Accelerating health care one relationship at a time

We are accelerating health care in southeastern Pennsylvania by collaborating with area health systems and physician groups in new and innovative ways.