Structural Reforms

Comparative effectiveness

Should the U.S. invest in research to determine the most effective regimens, drugs, supplies and therapies for various diseases and conditions?

Yes. We need to study what works so everyone is able to deliver care based on the best clinical standards.
No. Clinical decisions are based on individual needs and what a local delivery system has to offer. It would be a mistake to make general rules when situations are not the same.
Yes, but. We should study what is most effective, but not use the results of the research to define and limit treatments.

Evidence-based medicine

Should we develop a set of national treatment guidelines?

Yes. Decades of research have shown wide variation in the amount of medical care used in different parts of the country, resulting in vast cost differences for treating the same conditions. This variation isn't caused by differences in degree of illness, and higher use of medical care does not seem to produce better health. In fact, because most treatments carry some risk, more care can be worse for your health.
No. There's great diversity in culture and resources in this country, so it's appropriate to deliver care according to community standards. Also, doctors should be free to try new approaches. That's how clinical practice advances. And guidelines don't always translate into what's best for an individual patient.

Government (or quasi-government) health board

Should there be an independent federal board, like the Federal Reserve - or independent state boards - to decide such things as which medical tests, treatments and technologies should be covered; the rules health insurers must follow; and what insurance rates and benefits should be?

Yes. If we are to have meaningful health care reform, tough decisions have to be made. Someone has to figure out how to create a more rational system, and that should be experts, not politicians.
No. No small group - especially a group of political appointees that isn't accountable to the people - should have the power to determine how medicine is practiced, how medical care is delivered, or how the medical economy should work.

Data aggregation

Should health plans be required to contribute their claims data to a national data pool?

Yes. Personal health information can be protected. And we need the data to research the effectiveness of treatments, the performance of all the players in the health care system, and ways to better integrate care.
No. The data belong to the health plans that collect it. Some of the data would reveal business secrets that would undermine competition. And it's hard to guarantee that confidentiality would be protected.

Tort reform

Should the laws be changed so doctors have more protections against medical malpractice lawsuits, jury awards for pain and suffering are limited, and cases are taken out of the regular court system and are decided in special health courts?

Yes. The extra tests and procedures doctors order up to protect themselves in the event of a lawsuit drive up costs. Patients who are injured by irresponsible doctors should be compensated for their injuries, but the system can't afford runaway jury awards for non-economic and punitive damages.
No. Frivolous lawsuits generally go nowhere. And people who are injured should have unbridled access to the courts. The way to reduce costs is to reduce medical errors.

Health insurance tax exemption

Should there be a tax on the health benefits employees receive through their employers?

Yes. This is the biggest loophole in the tax code and is unfair to those who buy their own insurance with after-tax dollars. Taxing just half of the employer-sponsored premiums would generate almost $1.2 trillion in the next 10 years - which would go a long way toward paying for reforms. Taxing premiums worth more than $15,000 would generate $420 billion. Also, the tax treatment of health insurance encourages employers to offer more insurance, which encourages people to use more care.
No. For years, this benefit has been a part of the compensation package of millions of Americans. The sudden tax increase would hit the middle class hard - especially employees of companies in urban areas, or with large numbers of old people, women of childbearing age or unionized workers.

Health Care Reform

Watch Healthcare Video: Why Do We Need Health Reform?