A new study released Wednesday by the Commonwealth Fund finds a national insurance exchange could reduce national health expenditures by an estimated $1.2 trillion.
As lawmakers wrangle with how to bring down healthcare costs through reform legislation, the study, titled "Fork in the Road: Alternative Paths to a High Performance U.S. Health System," defends a Democratic proposal of providing a federally run health exchange, with care provided under private plans.
The study, conducted by the Lewin Group for CWF, suggests that reimbursing healthcare providers at rates somewhere between current Medicare rates and private plan rates could save $2 trillion over 11 years, while a public plan that reimburses providers at current Medicare rates could save $3 trillion.
The CWF analysis finds that the potential savings for families, businesses and the federal government vary markedly depending on the health reform plan.
Cathy Schoen, Karen Davis, Stuart Guterman and Kristof Stremikis say their study is the first to compare three different scenarios:
- a public health insurance plan option with pay rates midway between current Medicare rates and private plan rates,
- one that includes a public plan option that links payments more closely to Medicare rates,
- and one that includes no public plan, instead relying exclusively on private plans.
According to the study, each of the scenarios envisions a national health insurance exchange that would provide consumers with a choice of insurance plans, as well as federal assistance to make coverage affordable. And each reform path would include significant reforms to the way the nation pays for care, in order to reward value and efficiency rather than volume.
"We are in the midst of an economic crisis that will grow worse if we continue on our current path," said Davis, the Commonwealth Fund's president. "The nation will be spending one out of every five dollars on healthcare by 2020, with millions more uninsured – undermining the health and financial security of families, businesses and the government. This analysis shows we have a choice of paths that could lead to access for everyone, lower costs and improved quality of care."