Comprehensive Prepayment Plans as a Mechanism for Meeting Health Needs

The comprehensive prepayment plan occupies an anomalous position in current health insurance developments. Long supported by leading medical educators, it has received the repeated protection of the courts, including the United States Supreme Court. In 1959 it obtained unenthusiastic but official endorsement of the American Medical Association House of Delegates. National press has been highly favor able, and, in those areas where plans operate, the local press has usually been friendly. Nevertheless, comprehensive pre payment has not kept pace with the general increase in health insurance enrollment. The larger plans have continued to grow, but, as a general mechanism for meeting health needs, comprehensive prepayment remains limited to a few geograph ical areas and probably covers no more than 2 to 3 per cent of all health insurance enrollees. There appear to be two main reasons for the slow growth: the opposition of organized medicine and slow public acceptance. Industry and labor have been the most open-minded sectors of the community on the issue, and from them comes much of the financial support required for the building of clinics and hospitals. One con clusion seems clear. If comprehensive prepayment does not establish itself as a generally available method of providing medical care for the American people, a principal alternative to increasing government intervention in medical care will have been eliminated.—Ed.