Testimony--U.S. Health Reforms to Improve Access, Outcomes and Value: International Insights and Innovative Policies - The Commonwealth Fund

by Cathy Schoen

As other countries adopt innovative policies to improve performance, incorporate incentives to enhance value, and harness markets and competition in the public interest, we as a nation have opportunities to learn from these international strategies and reforms. The key question confronting U.S. policymakers contemplating national reforms is how to expand coverage to everyone and slow the growth in health care costs while maintaining or improving the quality of care. Looking at other countries, it is clear that each has developed, and continues to develop, its own approach, with policies and health systems evolving from their unique histories and institutions. Similarly, the U.S. will need to craft policies and adapt changes that fit our history, institutions, and values. Still, we can learn from the values and strategies that cut across diverse countries and from examples of incentives, policies, and practices that contribute to higher performance. The international experience provides insight regarding the potential direction and effectiveness of U.S. insurance, payment, and delivery system reforms.

Five lessons from the international experience stand out:
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