Reforming Healthcare Reform

Healthcare reform is not a singular event but, instead, a constant process that will continue into the foreseeable future. This Article proposes - for the first time - a creative solution to the acrimonious and debilitating method we currently use in assessing and implementing healthcare reform proposals. Current scholarship has not addressed the systemic problems that occur in the process of implementing healthcare reform, tending instead to focus on proposing singular reform measures to cure specific problems or on constitutional problems related to the Affordable Care Act. To address that gap, this Article carefully analyzes a case study of Medicare's efforts to control unnecessary hospital admissions over the course of 30 years, efforts that have been subject to almost universal criticism, and uses this case study to illustrate perennial problems with reform more generally. The paper then explores other cultural and regulatory processes that function better than healthcare reform in similar circumstances, specifically the tax regulatory system, and proposes a series of changes to healthcare related regulatory processes. The thesis of this Article is simple. Assuming healthcare reform is a constant and enduring aspect of the healthcare system, and in light of the problems healthcare reform causes, the system needs to be reformed so that it progresses in a manner that is less adversarial, more tolerant of unintended consequences, and better able to manage the concerns of risk-averse participants