Following Doug’s comments on the case for payment and delivery reform in the United States, Stuart Gerson was next to the podium to discuss whether the mandate is constitutional.
Stuart began by saying that it’s important to understand one thing – this discussion, besides the quality and efficiency issues, is about health insurance and not about healthcare itself. This is one of the real pitfalls of the US system – we provide healthcare to almost everyone, but it’s done through a series of cost-shifting and inefficiencies, and that’s what these programs are trying to address.
He added that he hoped to make his presentation interesting for non-Americans, many of whom live in systems with national health programs supplemented by private insurance. These countries feel that they have all the answers, and in some senses they do, with many of the countries providing a reasonable quality of healthcare at a vastly lower percentage of the GDP than what the US is doing. Although the US has some high end medicine, we also have a lot of inefficiency.