Paying for Medical Care

How to pay for medical care? This question, which periodically has been the subject of vigorous debate in the United States for more than half a century, has moved to the forefront of public attention in the wake of rapid increases in the cost of care and heightened concern about inequality of access. More than a dozen different proposals for some type of national health insurance have been submitted in Congress, and major interest groups — private insurance companies, hospitals, organized medicine, and organized labor — have staked out their positions in great detail. Before considering the pros and cons of national health insurance and the implications of alternative proposals, a few general remarks about medical care finance and the present U.S. system are in order…