Even if such a universal solution succeeded in reducing the rate of cost increases, it would have profound unintended consequences. Chief among these would be the emergence of a parallel, totally private health-care system for the well-off. This is already happening in countries with long histories of publicly funded and publicly provided health care, such as the U.K. and Canada. Whether to skirt waiting lists or avoid the denial of certain procedures, the affluent would seek private alternatives, while using the public system whenever it made economic sense (which is what happens in Britain today). In short, if the goal of any health-care system and policy is equity and social justice, we should be very wary of approaches that use terms like universal but end up creating a society of health-care haves and have-nots. CDHPs offer the prospect of a different future and deserve the political, financial, and innovative support that they need to succeed.
Reprint No. 05301
Gary Ahlquist ([email protected]) is a senior vice president of Booz Allen Hamilton based in Chicago. He specializes in the strategy-driven transformation of insurance companies, health plans, and health providers. In his 25 years with the firm, he has worked with clients on strategy, e-business, organization, and transformation programs.
David Knott ([email protected]) is a vice president in Booz Allen Hamilton’s New York office. He leads the firm’s strategy work with health services clients and has served many of the industry’s leading health plans, HMOs, large multispecialty group practices, pharmacy benefit managers, and other specialty companies.
Philip Lathrop ([email protected]) is a retired vice president of Booz Allen Hamilton and serves as a senior executive advisor to the firm, specializing in health-care finance, strategy, and operations.