By NextBestFitPhase 5: Stabilize & govern · Step 5.3
Run an independent evaluation and the Year-10 review
Annual reports; Year 10 vote · Independent evaluator (National Academies + GAO); CongressDiscuss this step
How other countries handled this same piece of implementation, what happened, and what it means for this plan.
Side by side
| Country | Approach | Result | Lesson for this plan |
|---|---|---|---|
| This plan (U.S.) | An independent evaluator reports annually on access, quality, waits, health outcomes, costs, and the labor market. In Year 10 Congress must vote on the duplicative-insurance ban and the cost-sharing standby option based on that evidence. | ||
| Canada | CIHI publishes standardized national health system indicators. | Transparent comparisons across provinces. | Independent statistics agencies keep debates evidence-based. |
| Netherlands | Mandated evaluations of the 2006 reform. | Adjustments to risk equalization and deductibles. | Built-in evaluation leads to course corrections. |
Canada
- What they did
- CIHI publishes standardized national health system indicators.
- What happened
- Transparent comparisons across provinces.
- Lesson for this plan
- Independent statistics agencies keep debates evidence-based.
Netherlands
- What they did
- Mandated evaluations of the 2006 reform.
- What happened
- Adjustments to risk equalization and deductibles.
- Lesson for this plan
- Built-in evaluation leads to course corrections.
More precedent
- Oregon Health Insurance Experiment-style evaluation; Canada's CIHI reporting.