Expand the scorecard for health-care reform to achieve a better result and enhance clinical and translational science.

Clinical and translational science is vitally dependent on the nation's underlying health care policies and programs. In a reciprocal fashion, data generated by clinical and translational research can inform both health policy and health care delivery. It is important, therefore to rate health reform proposals comprehensively on a set of criteria that reflect the broad goals of reform, including the potential impact on clinical and translational science and medical education. I propose that the criteria include achieving universal coverage, reducing administrative costs, retaining one's chosen primary care physician, encouraging care coordination, empowering physicians, freeing industry from choosing and administering health plans, providing choice of specialists and hospitals, providing patient education, preventing patient overuse of services, rationalizing resource allocation, encouraging competition, limiting government's role, supporting medical education, training, and research, and freeing industry to make personnel decisions based on business criteria rather than the impact on health care costs to the company. I discuss the rationale for each element and offer a rating of current proposals relative to a proposal previously made.