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UCLA: A Presidential Election Looming and Nation’s Framework for Health Care at a Crossroads

With a presidential election looming and the nation’s framework for health care at a crossroads, UCLA Fielding School of Public Health professor Dr. Gerald Kominski assesses the possibilities.

“We spend more than any other country on health care … and yet, we are far from being the healthiest country.”

Enactment in 2010 of the Patient Protection and Affordable Care Act, otherwise known as the Affordable Care Act (ACA) or Obamacare, represented a significant milestone in the effort to expand health coverage. But against the backdrop of political and legal challenges, the future contours of the U.S. health care system are far from settled. Dr. Gerald Kominski, a leading expert on health care policy, economics, and reform, has spent much of the last decade studying the expected and actual impacts of the ACA. Dr. Kominski, a professor in the Fielding School’s Department of Health Policy and Management and senior fellow at FSPH’s UCLA Center for Health Policy Research, spoke with FSPH’s Public Health Magazine about the state of the U.S. health care system and the future directions currently under discussion.

Q: From a public health perspective, what should be the goals of a national health system?

A: The ideal health system provides high-quality care in a timely manner, in an equitable fashion, and in a way that is cost-effective — not necessarily at the lowest cost, but the lowest cost given all of the other objectives that we’re trying to achieve. We have to ensure that cutting costs doesn’t result in poorer quality or poorer access.

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