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Policy experts outline five critical issues to improve US health system

The next U.S. president should make advancing health care and the health of Americans a priority, according to an editorial published in the Annals of Internal Medicine.

"The most important action the next president can take to advance health and health care in the United States is to articulate an overarching vision and set of core principles to guide the nation toward better health," the authors wrote. "The vision should be to ensure that all people living in the United States have the opportunity to live healthy, productive lives. This vision would recognize the decades of research revealing that the social determinants of health — our physical and social environments and health behaviors — are the major determinants of our health."

Stephen M. Shortell, PhD, MPH, MBA, from the University of California, Berkeley, and Diane Rittenhouse, MD, MPH, from the University of California, San Francisco, highlighted five principles that they believe are essential in improving the nation’s health:

• implement policies supporting health by increasing collaboration between the public and private sectors;
• eliminate wasteful spending in the health care system and invest in determinants of health;
• stabilize the health insurance market;
• expedite the switch to value-based payment models that incentivize quality of care; and
• increase transparency of performance data.

"Without actions and policies to create healthier communities by addressing the cross-sector underlying social determinants of health; expanding insurance coverage; and removing waste from our health care system by aligning payer, provider, and patient incentives, the biomedical advances made by the [NIH], our research universities, and private research institutes will be suboptimized," Shortell and Rittenhouse concluded. "Too many Americans will not be able to afford them, and the health care delivery system will not be able to incorporate them efficiently or effectively. Despite the likelihood of a divided Congress, even modest progress on some of the issues identified will move the country toward better health for generations to come, for which the next president can be deeply proud." – by Chelsea Frajerman Pardes

Disclosures: Dr. Shortell reports grants from Commonwealth fund, CDC, Agency for Healthcare Research and Quality and personal fees from Kaiser Permanente Institute for HealthPolicyAdvisory Board outside the submitted work.