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Date Updated: November 9, 2011

Health System Reform Policies


Policy: All Americans must have access to affordable essential healthcare. The care must be patient-centered, safe, and at least equal in quality to healthcare in other developed nations. An appropriately sized and distributed health workforce must be competent to provide these services. These are required conditions to protect the health of the public.

The ongoing national debate over reform of the US healthcare system addresses one of the most critical policy and economic challenges of our times. This debate engages the National Board of Medical Examiners (NBME), whose overarching mission is to protect the health of the public through state-of-the-art assessment of health professionals. We are deeply concerned that the health professionals whose proficiency we assess are currently working in a dysfunctional healthcare system. The very structure of this system is an impediment to public health. An outline of some of the evidence supporting the need for reform of our health system is provided in the Appendix: Evidence of the Need For Reform.

An extensive national dialogue on healthcare reform has exposed to public view compelling evidence of the untenable ways in which the system has failed its consumers and its practitioners. The overwhelming evidence of the need for reform and the threat of the current system to NBME’s mission compel us to add our voice to those who support recent reform legislation and call for additional urgently needed reforms, including how healthcare is structured and delivered and how clinicians and institutions are held accountable for providing acceptable quality.

Our quality problems are evident: US outcomes compare poorly with other developed nations that have universal coverage and functional systems, yet we spend substantially more for our poorer outcomes. Such quality lags are unacceptable. Our system’s practices and outcomes must meet or exceed, by accepted measures and assessments, the highest standards achieved in the healthcare systems of other developed countries.

All Americans must have access to essential healthcare services at an affordable cost. Such access requires that healthcare professionals are adequate in number and appropriately distributed. Concurrently, our system must also address quality of care provided: patient-centeredness, safety, and outcomes equal to the best available anywhere in the world. These are required conditions to protect patients as well as to enable the professionals whose proficiency NBME assesses to go forth to serve the public health.

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