Caring for the uninsured: choices for reform

Article Abstract:

Only 10 percent of Americans are satisfied with their current health care system, compared with 56 percent of Canadians, 27 percent of the British, and 41 percent of West Germans. In spite of this, over half of Americans reported that they were very satisfied with their personal care. Only the Canadians were personally more satisfied. There is broad support for some form of universal health insurance, even if it requires an increase in taxes. The May 15, 1991 Journal of the American Medical Association presents 13 well constructed proposals for universal health care. Some plans favor compulsory, employer-based insurance supplemented with government insurance of nonworkers. Others require employers to provide insurance or pay a tax into a general fund. Other suggestions include income-related tax credits for private insurance, and an all-government insurance system. Careful evaluation of these plans should help to bring about a consensus regarding an acceptable reform. In the 1970s many health care reform initiatives were introduced in Congress, but legislators, interest groups, and the public could not reach an agreement on them. The problem is much worse now, and perhaps that will help bring about an agreement, but solutions must also be found to the nonfinancial barriers the keep people from having access to medical care. (Consumer Summary produced by Reliance Medical Information, Inc.)

Economic aspects, Reports, Demographic aspects, Medically uninsured persons, Health insurance, National health insurance, editorial

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Bridging the gap between expert and public views on health care reform

Article Abstract:

Policy experts and the general population agree on the need for substantial reform in the nation's health care system but differ markedly in their perception of the issue and its causes and solutions. According to 28 national surveys taken between 1990 and 1993, Americans see cost to them personally as the main health care issue. Experts, however, view the health care problem as a symptom of a sick economy and link it to slow growth and the budget deficit. Experts blame the problem on factors such as the public's demand for costly medical technology, the third-party payer system and an aging population. The public views malpractice, greed and fraud as the root of the problem. Experts' solutions all call for some measure of public sacrifice and increasing the public's sensitivity to the high cost of medical care. A plan that may be acceptable to both parties would ensure universal access to care funded both privately and publicly. It would have a regulatory system that maintained government oversight but that left day-to-day operations to others.

Public opinion, Medical policy, Health policy

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Making the critical choices

Article Abstract:

There are seven issues that must be addressed by any proposal to reform health care financing in the US. Insuring all Americans would require either federally-guaranteed coverage or subsidies to allow individuals to purchase their own. Under federally-guaranteed coverage, the government would either fund a national health plan, require employers to 'play or pay' or require individuals to purchase their own insurance. Funding for guaranteed access would come from taxes, employers or from money saved by reducing payments to doctors and hospitals. Medicaid would either be retained, eliminated or replaced with another public insurance program. Coverage would either be minimal, average or comprehensive. Health care costs would be reduced by using a single payer or all-payer system, or encouraging competition among health services suppliers. The plan would be administered by state or federal agencies or many private insurers.

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