NEJM Perspectives Examine California Health Reform Efforts, Individual Health Insurance Mandates

• "California Dreamin' -- State Health Care Reform and the Prospect for National Change," New England Journal of Medicine: The perspective by Stephen Isaacs of the consulting firm Isaacs-Jellinek and Steven Schroeder of the University of California-San Francisco discusses efforts by California lawmakers to overhaul the state's health care system and examines six obstacles to achieving universal coverage: employer mandates, individual mandates, cost, containing costs, benefits package design and partisan politics. The authors write that although a few state experiments in health reform are unlikely to create major change, affordable reforms enacted by a dozen or more states could generate national action and new models on which a health system overhaul could be based (Isaacs/Schroeder, NEJM, 4/10).
  
  
• "Universal Coverage One Head at a Time -- The Risks and Benefits of Individual Health Insurance Mandates," NEJM: In the perspective, Sherry Glied, a professor at Columbia University's Mailman School of Public Health, discusses the benefits of using an individual health insurance mandate to create a universal health coverage system, as well as concerns related to such mandates. Glied also discusses subsidies that would be needed along with the mandate and ways to prevent privately insured people from dropping coverage to enroll in a subsidized plan (Glied, NEJM, 4/10).