Universal HealthcareBy NextBestFit
Phase 5: Stabilize & govern · Step 5.1

Set a spending growth target

Annual, starting Year 5 · Payment Rates Board; Congress (veto)Discuss this step

Pros & cons of this step

Pros
  • +U.S. health spending has grown faster than GDP for most of 60 years; a binding target changes that.
  • +Shared savings give providers a stake in meeting it.
Cons
  • −Too tight a target produces Canadian- or British-style queues.
  • −Congress overrode Medicare's Sustainable Growth Rate formula 17 times between 2003 and 2015 before repealing it.
  • Cost control vs. access: the target is the dial between them.