Health Security
CHEFS will advance research and policy solutions in the area of health care reform with a goal of universal health care at the federal level, while supporting local and state efforts to provide greater access to health care in the absence of federal action.
Faculty Research
Prescription for Success: Lessons from California for National Health Reform (June 2009)
The Case for Public Plan Choice in National Health Reform: Key to Cost Control and Quality Coverage (December 2008).
Health Care for America: A proposal for guaranteeing affordable health care for all Americans building on Medicare and employment-based insurance, Jacob Hacker, January 11, 2007
Lewin Group Report The Lewin Group, Cost Impact Analysis for the "Healthcare for America" Proposal, March 15, 2008
Fighting Childhood Obesity Through Performance-Based Regulation of the Food Industry, Stephen D. Sugarman (with Nirit Sandman, 56 Duke L. J. 1403-1490) (2007)
Fixing the Left’s Health-Care Prescription Jacob Hacker, Better Medicine: Fixing the Left's Health Care Prescription, Slate Magazine, Oct 10, 2006
A Mandate Isn’t Necessary Jacob Hacker, LA Times, Feb. 26, 2008
The "New" Medicare Mark Schlesinger and Jacob Hacker, Secret Weapon: The "New" Medicare as a Route to Health Security, Journal of Health Politics, Policy and Law, Vol. 32, No. 2, April 2007
Healing Our Sicko Health Care System, Jacob Hacker, New England Journal of Medicine, Vol. 357, No. 8, August 23, 2007
A Tear in the Safety Net: Hospitals Fail to Ensure Financial Assistance for Low-Income Californians, Melissa Rodgers, The Health Consumer Alliance, November 9, 2006
Sick and In Debt: Improper Practices that Cause Medical Debt for Low-Income Californians, Melissa Rodgers, The Health Consumer Alliance, September 2004
Denti-Cal Denied: Consumers' Experiences Accessing Dental Services in California's Medi-Cal Program, Melissa Rodgers, The Health Consumer Alliance, January 2003
CHEFS Projects
Hybrid Health Reform
On December 17, 2008, Berkeley CHEFS Faculty co-director Jacob Hacker released a report that makes a vital case for a public plan in any healthcare reform proposal by Congress or the president-elect. Hacker's "The Case for Public Plan Choice in National Health Reform" says that a public insurance plan like Medicare, offered alongside private health plans, is crucial to controlling healthcare costs and improving quality of care. Please go to our home page for links to the paper.
The purpose of this initiative is to create the infrastructure and capacity to provide reliable, responsive, research-based technical assistance to policy makers at the national, state and local levels who are grappling with tough policy issues in the development of hybrid health reform models. Through this initiative, Berkeley CHEFS and the UCSF Philip R. Lee Institute for Health Policy Studies will collaborate to develop a set of valuable tools for policymakers, policy experts, and concerned participants in the policy process. These will include (1) an intellectual support network of researchers and policy experts with the capacity to rapidly respond to inquiries for technical assistance, (2) a web-based clearinghouse and linked repository of research-based information on hybrid health reform models, and (3) a set of action-oriented research-based products on issues related to the development of hybrid health reform models.
Two states, Massachusetts and Vermont, as well as the City of San Francisco, have adopted universal health plans that build on existing employer-based health coverage, create new institutions to allow individuals to choose among alternative health plans, and increase access to public health insurance programs. More states, including California, are currently considering such public/private partnerships for health reform – what we call “hybrid health reform” models – and Congress and the next Administration are certain to engage in a robust national debate over universal health coverage, grounded in the widespread sense that the hybrid health reform is one of the only viable paths forward.
Our notion of “hybrid” health reform reflects the broad array of experts currently and potentially involved in this project. Hybrid models may range from government-sponsored frameworks with multiple competing plans, such as the Federal Employees Health Benefits program, to public delivery systems operating in parallel with public plans, such as the new San Francisco model, to single payer systems for the most expensive and difficult to insure types of care interlocking with private plans for other coverage. In our view, hybrid health reform is characterized by a willingness to build upon the expertise and strengths of existing organizations and the public sector but markedly improve how they organize and deliver care. Hybrid reform is also characterized by a willingness to eschew the ideologically pure systems of either governmentally run care or total reliance on market mechanisms.
In spite of this view which relates to the broad middle ground of potential proposals for reform, little exists in the way of a central pool of experts or repository of research-based information on hybrid health reform models: how such models can and should be structured, what is essential to making them work and what can be altered to achieve political compromise, how much they would cost and how many people they would cover, and how they could be adapted over time to changing market and political conditions.