Universal HealthcareBy NextBestFit
Solution path · Chronic underfunding by government budgets

Spending-growth target tied to GDP, reviewed publicly

An independent board recommends the next year's budget against a growth target (e.g., GDP growth plus 0.5 points); departures must be justified publicly.

Draft decision:ChosenPhase 5: Stabilize & governConfidence: medium · not yet reviewed

Independent board with a growth target.

Review ledger

How this path connects

Addresses
Chronic underfunding by government budgets
This path
Spending-growth target tied to GDP, reviewed publicly
Creates or worsens
Requires difficult enforcement

    Concrete changes if chosen

    What would actually have to change in law, agencies, payment rules, or systems.

    1. Create an independent board with a spending-growth target
    2. Require public justification for departures

    Effects

    Each effect has its own page: the evidence, the case that it is or isn't a real cost, and whom it affects.

    What it fixes
    • Chronic underfunding by government budgets

      An independent board’s budget recommendations against a growth target balance stability and spending control. Requiring public justification for departures makes budget decisions transparent.

    What it creates or worsens

    Who's affected

    Who gains
    Who loses

    Where it has been tried

    • Massachusetts: Health Policy Commission sets a cost-growth benchmark.
    • Maryland: Hospital spending growth tied to state economic growth.
      Sources: CMS Innovation Center / RTI (2023)

    Works well with

    Dedicated trust fund with automatic indexingChronic underfunding by government budgetsChosenGlobal budgets for hospitalsU.S. prices are far higher than in other countriesChosen

    Other paths for “Chronic underfunding by government budgets”

    Dedicated trust fund with automatic indexingChronic underfunding by government budgetsChosenAnnual appropriations from general revenueChronic underfunding by government budgetsRejected