A true single-payer health care system would mean the discontinuation of employer-sponsored health insurance. Vermont Senator Bernie Sanders’ new single-payer proposal proceeds along these lines, making it unlawful for employers to duplicate the offerings of the new single-payer system once that system is fully phased in. However, a truly single-payer framework is not the only approach policymakers could take.

Dr. Tevi Troy, author of the paper and CEO of the American Health Policy Institute, says, “The federal government would be taking on the responsibility of providing health care to all Americans, a change so drastic with consequences ultimately so uncertain that it seems unlikely to win a majority of votes in Congress, especially considering how politically unfeasible it has proven on a much smaller scale even in very liberal states like Vermont.”

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Large employers are reexamining health care delivery systems and are looking for a more competitive marketplace, according to a new paper from the American Health Policy Institute. With health care policy front page news, it should be noted that the federal government is not the only institution taking a hard look at the subject and deciding whether changes are merited. Large employers who provide health care benefits to more than 170 million Americans are also reexamining current delivery systems. The paper illustrates longstanding concerns of large employers that have been intensified by the debate on the ACA, such as the lack of strong tools providing purchasers and consumers of health care with the information they need to evaluate the quality, cost, and effectiveness of the services being provided.

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Whether it is the Centers for Medicare and Medicaid Services (CMS) determining which treatments and technologies are worth covering and how much they are willing to reimburse for them; the Agency for Healthcare Research and Quality (AHRQ) mandating quality and safety standards; or the new Affordable Care Act exchanges setting the standard for benefit packages throughout the health insurance market, it is clear that government agencies and their mandates play a powerful role in guiding the provision of health benefits and the overall construct of the market.