News Release

Universal health care coverage would be lasting achievement for next US president

Peer-Reviewed Publication

The Lancet_DELETED

An Editorial in this week's Lancet says that universal healthcare coverage combined with the highest-quality, evidence-based practice would be a singular and lasting achievement for the next US president. And the remaining candidates should focus on evidence-based healthcare reform that works for all. US healthcare is also the subject of this week's World Report.

The Editorial describes the current US health system as "broken", saying that healthcare quality depends on a bewildering array of factors -- whether the person is insured, what such insurance does and doesn't cover, and geographic variations in treatment to name but a few. It says: "The result is a hodgepodge of science, ideology, politics, economics, and folklore. "Decentralised" is perhaps the kindest adjective that can be applied to it. Should this melange define 21st-century medical practice?"

It analyses the proposals put forward by the US Institute of Medicine, Knowing What Works in Health Care: A Roadmap for the Nation. It recommends a national clinical effectiveness effort -- 'The Program' -- be established through Congress. Among other things, the proposed organisation would be responsible for producing unbiased, credible information about what works in health care, through the development of systematic reviews, standards of evidence, and guidelines. An advisory board, with representatives from the private sector and public services, would oversee The Program and set priorities for determining evidence-based practice. The Program would establish methodological standards and a common language for evidence, as well as assess research capacity and expand training opportunities in systematic reviews and comparative methods of assessing effectiveness.

But the Editorial says that the IOM report is "a worthy plan that seems unlikely to be implemented. It concludes: "Nevertheless, the ideas behind it are especially important now, for one reason: Nov 4. The next presidential election will likely determine the foreseeable future of the practice of medicine in the USA. Among Democratic voters, health care is reported to be the most important issue. Thus, the Democratic candidates have made health-care reform a cornerstone of their platforms. Although all have shied away from a single-payer system, the Democrats, by contrast with their Republican rivals, who generally favour more industry-friendly reform, are focused on universal coverage. Universal coverage combined with the highest-quality, evidence-based practice would be a singular and lasting achievement for the next president. As the number of contenders in the presidential race narrows, those left standing ought to put a high priority on developing a plan of thorough reform of health care, one based on evidence, one that 'works'and one that works for all."

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PDF OF EDITORIAL: http://multimedia.thelancet.com/pdf/press/USelections.pdf


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