Implementing Health Reform in California

Catching a wave--implementing health care reform in California.

1487 imagination.” Might opening this possibility defeat the purpose of the vaccine court and again potentially jeopardize market stability and vaccine availability? The Supreme Court noted that in place of litigation, the NCVIA “provides many means of improving vaccine design.”5 Among those listed were oversight by the FDA, voluntary reporting and monitoring of adverse events (both of which ar...

Washington State Health Services Act: Implementing Comprehensive Health Care Reform

In 1993, Washington State enacted the Health Services Act of 1993 (HSA) to guarantee universal access to health care through an employer mandate, with caps on premiums as the primary cost-control mechanism. The HSA represents the Nation's first formal experiment with managed competition. This article reports the results of a case study of the HSA's implementation. The study concludes that the W...

Research Brief PRODUCTIVITY IMPACT OF HEALTH CARE REFORM IN CALIFORNIA

Unchecked provider clout in California foreshadows challenges to health reform.

Faced with declining payment rates, California providers have implemented various strategies that have strengthened their leverage in negotiating prices with private health plans. When negotiating together, hospitals and physicians enhance their already significant bargaining clout. California's experience is a cautionary tale for national health reform: It suggests that proposals to promote in...

Avoiding side effects in implementing health insurance reform.

10.1056/nejmp0912181 nejm.org 1 policies directly to individuals now charge premiums based to some extent on characteristics thought to predict the risk of high-cost conditions; insurers also exclude some or all preexisting conditions from coverage and simply refuse to cover some people. Without such “risk rating” and coverage exclusions, insurers would be subject to substantial adverse selecti...