If we knew for certain what could cause better care to be provided, we would already be providing “better care.” However, we cannot be certain of how to do this. Today, there are two main visions of how to provide better care.
One vision is the Democratic vision. In this school of thought, the way to provide better care is to give government more control. Medicare costs are to be driven down through panels that decide what sorts of care should be covered. Quality of care is to be guaranteed through regulation.
The other vision is the Republican vision. In this vision, market competition is the way to provide better care. Medicare costs would be driven down by, perhaps, giving seniors vouchers to buy insurance and letting insurance companies compete to lower costs. Quality of care would be guaranteed through competition because insurance companies and physicians would want to provide good care so they could attract and keep customers.