The Bay Area has been a global leader in health, pioneering advances from biotechnology to how healthcare organizations deliver care. However, like the rest of the United States, our costs are much higher than those in the rest of the world and our outcomes, in many areas, worse. We must work to build a system that creates more health at a more sustainable price to our society. And we must build a culture of health in which individuals are empowered to make healthy choices for their lives.



Long Overdue: Full Practice Authority for Nurse Practitioners

This report serves as an update to a report titled “Full Practice Authority for Nurse Practitioners Increases Access and Controls Cost”, which was released by the Economic Insititute in 2014. Through an extensive review of the literature and a quantitative analysis of three measures, this report explores how allowing nurse practitioners full scope of practice can increase access, maintain quality care, and lower costs in the healthcare industry.

Bay Area Homelessness

Until very recently, homelessness was considered the problem of individual cities and counties. For a metropolitan region like the Bay Area, which is divided into nine counties and 101 cities, this approach fails to meet the needs of an intraregionally mobile homeless population. In this report, a regional lens provides a new perspective on the homelessness crisis and offers new ways to address the problem.

A Universal Health System for California: The German Model

As the Affordable Care Act’s future continues to hang in the balance, the idea of implementing some form of universal healthcare system in California or nationwide has become increasingly popular. Much of this discussion has focused on the desirability and feasibility of adopting a Canadian-style single-payer or “Medicare for All” system. While Canada is a worthwhile case study to examine, there are other models for a universal healthcare system that may make more sense for California and the U.S., achieve better outcomes, and have a more feasible path to implementation. One such example is a “Universal European Health System,” inspired by the Bismarck model, most clearly exemplified by Germany. This report lays out what such a model could look like if implemented in California.

Price Controls or Managed Competition? Lessons for California

This report examines the ongoing, mostly state-based efforts aimed at lowering health care prices. It asks whether there are lessons California can learn from these experiments as well as limitations to importing similar practices into the state and expecting the same results. It also explores whether reinvigorating managed competition—a “made in California” alternative that tries to reduce total health care costs while improving quality of care—has the potential both to moderate prices and avoid the drawbacks of price controls.

Building a Climate-Smart Healthcare System for California

Climate change remains a serious threat to human health, and healthcare organizations in California, across the U.S., and globally can be catalysts in creating a climate-smart future.

Health Care Reform in the Balance

This report traces how California successfully built an Affordable Care Act (ACA) marketplace and what its options are in this period of retrenchment.

Improving Individual Health Insurance Markets

This report asks what steps could be taken to make the individual marketplaces more robust, stable, and affordable in the United States.

International Healthcare Systems and the US Health Reform Debate

The ongoing challenges within the US healthcare system include its high costs, uneven access, and tremendous complexity. When considering the desirability of reforms, whether they come from the right or the left, it makes sense to look at how other developed countries are tackling their own healthcare challenges.

A Pragmatic Approach to Medicaid Reform

A series of proposals at the federal level have focused on Medicaid, the healthcare coverage program for low-income people that goes by the name “Medi-Cal” in California. There has been an intense focus, in particular, on the budgetary cost of coverage through this program...

A Study of Affordable Care Act Competitiveness in California

California was the first state to pass enabling legislation and create its own insurance marketplace following the passage of the Affordable Care Act (ACA). Since then, the state has been a leader in the implementation of the ACA and has reduced the uninsured rate from 17.2 percent in 2012 to 8.1 percent in 2015 while seeing some of the lowest premium rate increases in the country...

Obamacare Critics — Be Careful What You Wish For

The following piece was written by Institute President Micah Weinberg in 2010, and despite its age, it still very relevant to the future of American health policy. August 9th, 2010 — Last week, opponents of …


Healthcare Jobs Are the New Manufacturing Jobs

The presidential election focused on the disappearance of manufacturing jobs in the United States as well as the move to repeal the Affordable Care Act, which if it does nothing else, will dramatically decrease the …

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