By Andrew Cohen
“Hybrid” is the new buzzword in America’s drive toward universal health care, and the Berkeley Center on Health, Economic & Family Security (Berkeley CHEFS) wants to be a central resource for policy makers on the issue.
The law school’s newest multidisciplinary research center, Berkeley CHEFS plans to provide research and technical help for policy makers who are developing hybrid reform models and reforms to the health care delivery system. The center is collaborating with the Philip R. Lee Institute for Health Policy Studies at UC San Francisco and UC Berkeley’s School of Public Health and Center for Labor Research and Education.
“We bring together researchers from different disciplines and combine their perspectives,” Berkeley CHEFS associate director Melissa Rodgers says of the center’s Health Security Partnership. “All our research will be pulled into a single web-based clearinghouse to help policy makers formulate these hybrid health reform models … and we’re positioned to answer their questions along the way.”
Hybrid health care describes universal coverage that combines elements of government-run programs and private-sector insurance plans. This type of health care system builds on existing employer-based coverage, creates a new, publicly funded and administered health plan, gives the uninsured choice among alternative plans, and expands access to existing public insurance programs.
Questions about hybrid models include who would be covered by the system and what it would cost individuals, employers, and the government; what the design features of a public plan are and how a public plan can help control costs and improve quality; and how to make sure there will be enough doctors to serve the uninsured once they start accessing health care. The center hopes to provide answers to these and other questions as lawmakers craft new laws and agencies roll out programs to the public.
In addition to pooling a deep reservoir of experts—health economists, sociologists, political scientists, lawyers, and physicians—Berkeley CHEFS plans to host a conference for California policy makers in 2009.
“We’re looking at the relationship between what’s happening on the national level and how that would impact California,” Rodgers says. “We’re also examining what California tried to do in the health care reform legislation that failed in 2007, and how we can derive lessons from that for national reform efforts.”
The Obama Administration and a growing number in Congress have declared support for hybrid reform—which has encountered resistance from the insurance lobby and some hospital groups who worry about competition from a public insurance plan.
Although California’s budget woes preclude a sweeping state health care bill anytime soon, Rodgers says it can still make preparations to implement federal legislation: “California can benefit from the center’s work on this, and other states can glean our insights on California’s experience and the impact of national efforts on a given state. Items such as regulating the insurance market at the state level, how employers respond to health care reform efforts, and the impact of such efforts on immigrant populations will be relevant to different states.”
Taking the lead
The center has already authored policy reports on these issues. In December 2008, Berkeley CHEFS faculty co-director Jacob Hacker released a major report, “The Case for Public Plan Choice in National Health Reform,” which argued that Americans should be able to choose between public and private insurance plans—and that offering a Medicare-like option is vital to taming expenses and achieving good coverage.
With health insurance premiums more than doubling over the past decade, there is powerful momentum for revamping the system. Hacker’s report says public-plan premiums cost about 75 percent of what private insurers charge for parallel benefits—and that hybrid health reform could save $1 trillion over 10 years by reducing costs and improving efficiency.
“This could help set a very high standard for private plans and encourage them to invest in long-term quality improvement,” he says. “A public plan option is essential to any national health care reform proposal.”
Similar policy analyses from other CHEFS partners can be expected in the months to come.