Chronic Condition

This text provides an analysis of the causes of the current health care crisis and of the shortcomings of reform proposals. It also offers a framework for reform that, while minimizing government interference, should provide a means for financing care for the less affluent. Sherry Glied shows that rising health care spending is consistent with a rising standard of living. Since the United States can, as a nation, afford more health care, reform should address not the overall level of health care costs but the distribution of health care spending. Prior reform proposals, Glied argues, have failed to account for the tension between the clearly manifested desire for improving the quality of health care and the equally widespread interest in assuring that the less fortunate share in these improvements. After analysis of the ill-fated Clinton plan, Glied proposes a solution that should make the willingness to pay for innovation the means of financing health care improvements for the less affluent. While rejecting the idea that the distribution of health care should be perfectly equal, Glied's proposal should enable all Americans to benefit from the dynamics of the free market.