Opinion leaders say Congress should also act to improve quality and safety, and ensure Medicare solvency.

Covering the uninsured should be Congress's top health care priority over the next five years, say 87 percent of health care experts polled recently. Other top priorities are improving quality and safety of care (including increased use of information technology, 69 percent) and reforms to ensure Medicare's solvency, 50 percent.

The Commonwealth Fund's Health Care Opinion Leaders survey encompasses a broad group of 1,155 health care experts from four sectors — academia, health care delivery, business/insurance, and government/labor/consumer advocacy. Nearly 320 experts responded to the survey.

Half to two-thirds of the respondents in all four sectors rank expanding access to group health insurance (such as the federal employees' health program or Medicaid/CHIP) as a priority. In contrast, fewer than one-fourth of respondents say expanding health savings accounts (22 percent) and tax credits for the uninsured to buy individual insurance (20 percent) are priorities.

Respondents also ranked pay-for-performance methods, such as rewarding efficient providers and effective disease management, and increased use of information technology as either the first or second priority for controlling health care costs and improving quality. These were ranked high by more than two-thirds of total respondents (69 percent and 67 percent, respectively).

Top priorities for Congress in the next five years


  1. Expand coverage to the uninsured
  2. Improve the quality and safety of medical care, partly by increased use of IT
  3. Institute Medicare reforms to ensure solvency
  4. Enact reforms to moderate the rising costs of medical care for the nation
  5. Reform Medicare payment to reward quality and efficiency
  6. Control rising cost of prescription drugs
  7. Address racial/ethnic disparities in care
  8. Reform malpractice compensation
  9. Simplify and standardize administrative functions
  10. Improve Medicare coverage
  11. Raise quality of nursing homes and long-term care facilities
  12. Control Medicaid costs

Source: The Commonwealth Fund

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