We Need to Learn What Works for Health

So people in Alaska get the same kind of care as people in Texas, and that in both places the quality of it is just as good—in a proven, scientific sort of way.

"When there is federal financing of healthcare, and there's a public good component to it, you would expect that beneficiaries would receive healthcare under a comparable set of rules," Moy says. But that kind of a system doesn't yet exist.

"If you're a diabetic, there are certain things that you need to have to manage the disease. And yet we see highly variable rates in people getting that care—often related to their insurance coverage, or their race, ethnicity, or the part of the country they're living in."

Moy says, "We don't like disparities because they indicate inefficiencies, departures from high-quality care."

He pointed to a study published in the New England Journal of Medicine by Rand researcher Elizabeth McGlynn several years ago that found that less than 55% of Americans received recommended, preventive, acute, or chronic care.

"The deficits we have identified in adherence to recommended processes for basic care pose serious threats to the health of the American public," the study concluded. ‘Strategies to reduce these deficits in care are warranted."

So maybe thinking about the health reform debate under a light of quality, rather than fairness, does put it in a different perspective.