Understanding the new health care reform law: part I.

Analyzing National Health Reform Strategies With a Dynamic Simulation Model. Milstein B, Homer J, Hirsch G. Proposals to improve the US health system are commonly supported by models that have only a few variables and overlook certain processes that may delay, dilute, or defeat intervention effects. We use an evidence-based dynamic simulation model with a broad national scope to analyze 5 policy proposals. Our results suggest that expanding insurance coverage and improving health care quality would likely improve health status but would also raise costs and worsen health inequity, whereas a strategy that also strengthens primary care capacity and emphasizes health protection would improve health status, reduce inequities, and lower costs. A software interface allows diverse stakeholders to interact with the model through a policy simulation game called HealthBound. Am J Public Health. 2010;100:811±819. The Certitudes and Uncertainties of Health Care