Daniel Kessler of Stanford explains what he sees as the core realities of health reform in the United States. According to Kessler, real health reform must be aimed at reducing spending on low-value care and expanding coverage to at least some of the uninsured. It also must be self-financing. Given those goals, Kessler argues that the three principles of implementing health reform are: 1) there will be difficult tradeoffs, 2) more is not better, and 3) everybody has to pay more at the point of service. Kessler predicts that most Americans will experience a small to moderate price increase under the Affordable Care Act, and argues that price increases are not evidence that the ACA is bad policy. A case can be made, he says, that the redistributive effects are worth the costs. According to Kessler, that is the argument that ACA supporters need to accept.
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