Leading policy-makers and scholars explain how market forces, deregulation, and consumer choice can work to improve health care for all Americans.


Revolutionizing health care
Robert Goldberg, Ph.D., Manhattan Institute, 1-11-06

Goldberg, a senior fellow at the Manhattan Institute, argues that the Medicare drug benefit is the leading edge of a health care revolution that will empower patients with more choice and control.

In Medicare Part D, 42 million Americans have the ability to choose. First they'll choose a plan based on the brand, the formulary, the premium and services offered. Once enrolled, they'll have to make choices about drug switching encouraged by the plan and whether they want to participate in available services. They'll have to determine how to pay for drugs after they used up their benefits. Finally, they'll be evaluating their own level of satisfaction with the plan, assessing other available options, and determining whether to re-enroll or choose a new plan at the end of the year. In an effort to keep customers, drug plans have added over a hundred drugs—primarily brands—to their 2006 formularies over and above what Medicare requires and reduced the portion people have to pay for new drugs since the Part D plans were approved last fall.

As I will elaborate on in a subsequent column, in the future drug-benefit competition will center on health outcomes, responsiveness to specific medical needs, the ability of plans to reduce total health spending and the capability of plans to develop a suite of tools to personalize care. Such tools will allow individuals to compare different drug plans to Medicare managed-care offerings that combine prescription drugs as part of a coordinated health program.

Comparing health outcomes will be a critical part of the growth in consumer-driven health care. The government can lead this revolution by using its enormous database of Medicare patients to produce reliable, easy-to-understand information that can guide patients to the best health-care providers, and physicians to the best treatments. This project may turn out to be Medicare's real innovation.

Project FDA.
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