Word: systemically
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...several months, Capitol Hill has been ground zero for the battle over President Obama's ambitious effort to reform the health-care system. But there are growing indications that if and when Congress actually manages to pass a bill, the real action may well be in the states, which could have a surprising degree of autonomy in determining how they implement the federal legislation, and whether it delivers on the promise of curbing soaring costs and providing coverage for the nearly 50 million uninsured. Though most everyone recognizes that the Federal Government can't impose a rigid approach, some critics...
...amendment passed that would allow states to opt out of parts of federal health reform if they could "provide health-care coverage that is at least as comprehensive" as provided for in the Baucus bill and prove their state proposal "would lower health-care-spending growth, improve the delivery-system performance, provide affordable choices for all its citizens, expand protections against excessive out-of-pocket spending, provide coverage to the same number of uninsured and not increase the federal deficit." Another Finance Committee member, Delaware Senator Thomas Carper, is reportedly considering introducing a proposal on the Senate floor to allow...
...exchange is to negotiate, assure capacity of insurance plans and collect information - that's a big new function that most states would not be set up to do." Baucus' bill would not have exchanges negotiate with insurers, but an amendment added to the bill does call for a "rating system for plans entering the state exchange based on relative quality and price." These ratings would be posted on exchange websites to allow consumers to compare prices and quality for similar plans...
...innovating on delivery and payment reform, working with local health-care providers to make care more efficient and affordable. "It's very hard for the feds to experiment," says Rhode Island's Koller. "What we can do much better is work with providers and work with the delivery system...
...Much of the reason Baucus molded his bill to give states more control was to allay concerns of moderate Democrats (and Republican Olympia Snowe) that the Federal Government was inserting itself too deeply into the health-care system. But if the states aren't up to the task, those same politicians could find themselves blamed for health-care reform that doesn't deliver, with less tools than they might have...