Health care policy traditionally has been seen as a three-legged stool. Three interdependent variables-cost, quality, and access-have largely defined the domain of health policy. Ignore one of the variables, and the stool topples. It is not surprising, therefore, that health care policymakers have tended to view the problem of access to health care resources primarily in economic terms. Economic analysis of the access problem is useful because it gives policymakers a common methodology, vocabulary, and set of analytical tools that provide insights into the related problems of cost containment and quality, as well as the access issue. This in turn provides insights into the economic tradeoffs that each variable entails for the other two. After defining, measuring, and analyzing access in economic terms, economic analysis naturally tends to frame solutions in economic terms.
Imagine, if only for a moment, that the Great Health Care Debate of 1994 had not sputtered and ultimately fizzled out. Suppose the financial barriers to health care had been removed and the ability to pay was no longer a factor in the cost-quality-access puzzle. What nonfinancial barriers would still impede access to health care goods and services? This question, or a similar one, was presented to the Texas Legislature, resulting in a grant to support a study on this issue. This study yielded the splendid report Nonfinancial Barriers to Health Care in Texas, as well as a conference and papers from which the articles for this Symposium issue of the Houston Law Review were derived.
In his foreword to a Symposium issue, the author discusses findings in The Nonfinancial Barriers to Health Care report, and introduces other articles in the Symposium. The author also argues that the mentioned report deserves to be reviewed carefully by all who are concerned with the access question, not only in Texas but nationwide.
Houston Law Review
Thomas Wm. Mayo, Nonfinancial Barriers to Health Care, 32 Hous. L. Rev. 1187 (1996)