Envisioning a Better U.S. Health Care System for All: Coverage and Cost of Care

Ryan Crowley, American College of Physicians, Washington, DC (R.C., H.D.).
Hilary Daniel, American College of Physicians, Washington, DC (R.C., H.D.).
Thomas G. Cooney, Oregon Health & Science University and Portland Veterans Affairs Medical Center, Portland, Oregon (T.G.C.).
Lee S. Engel, Louisiana State University Health Sciences Center, New Orleans, Louisiana (L.S.E.).


This paper is part of the American College of Physicians' policy framework to achieve a vision for a better health care system, where everyone has coverage for and access to the care they need, at a cost they and the country can afford. Currently, the United States is the only wealthy industrialized country that has not achieved universal health coverage. The nation's existing health care system is inefficient, unaffordable, unsustainable, and inaccessible to many. Part 1 of this paper discusses why the United States needs to do better in addressing coverage and cost. Part 2 presents 2 potential approaches, a single-payer model and a public choice model, to achieve universal coverage. Part 3 describes how an emphasis on value-based care can reduce costs.