We propose an approach to health insurance reform that promotes high-quality, fiscally sustainable health care for all. Our solution is a departure from both the current system and the Affordable Care Act reforms that begin in 2014.
Reducing end-of-life costs will do little to curb the growth in Medicare spending overall. But end-of-life care provision should be reformed to match the values of patients.
To reduce spending and more appropriately limit geographic variation in utilization among Medicare beneficiaries, the program should consider the utilization-management techniques employed in the private sector as a model.