Summary: The rapidly mounting costs of health care and the fact that access to health care is unavailable to a growing share of the American people have generated consensus that the U.S. health care model needs significant change. In this field hearing in Rochester, New York, the Comptroller General discussed the need for a better way to manage and finance America's health care system while preserving high quality and innovation. GAO has reviewed approaches developed in the U.S. and abroad that might help address these issues. Some common themes emerge in successful domestic and foreign programs, including universal coverage, a uniform system for managing payment of providers, and expenditure targets or caps for major categories of providers and services. Rochester, in particular, appears to have been more successful than most communities in controlling the twin problems of rapidly rising costs and dwindling access to health insurance. GAO is beginning a detailed study of the Rochester health care system to learn more about the roles of community rating and health planning.
