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Robert H. Brook, MD, ScD

JAMA. 2009;301(23):2486-2487.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

Another health policy window has opened; through it will stream proposals to reform the US health care system. President Obama has demanded that reform proposals improve both coverage and quality of care and make health care more affordable for all Americans. Extending coverage without worrying about costs would be relatively easy. Improving quality of care without worrying about costs might also be achievable. But extending coverage and improving quality while also making coverage more affordable will be difficult.

The first step in pursuing the President's goals is to review what science has revealed about the system. Two studies could provide the context for health care reform. The first, the RAND Health Insurance Experiment (HIE),¹ was conducted more than 3 decades ago and would cost about 1 billion dollars to replicate today. The second, actually a combination of studies conducted mainly in the United States, is . . . [Full Text of this Article]

Author Affiliation: RAND Health, Santa Monica, California.

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