Beyond Universal Health Insurance to Effective Health Care
JAMA. 1991 May 15; 265(19): 2559-2562.
The history of the U.S. governmental health care reform indicates that efforts toward universal health insurance cannot be expected from a financially strapped federal government. Ambitious governmental programs such as veterans' services and Medicaid have encountered accessibility problems associated with location, arbitrary limitations of reimbursement criteria, and opposition from taxpayers due to the higher taxes and premiums necessitated by program reform. Nonfinancial obstacles to access include physicians migration away from minorities and the poor, the strained conditions of many public hospitals, and immigrants' isolation due to language barriers and paranoia over citizenship status. Ginzberg presents interim targets for the expansion of access to health care: the expansion of Medicaid, subsidized coverage for the near poor, private sector catastrophic insurance policies, expansion of the Federal Community Health Center program, expansion of the National Health Service Corps and State Educational Debt Forgiveness Programs, and state subsidies for uncompensated care. (KIE abstract)
Aged; Access to Health Care; Economics; Federal Government; Financial Support; Government; Health; Health Care; Health Care Delivery; Health Care Reform; Health Insurance; Hospitals; Immigrants; Indigents; Insurance; Physicians; Private Sector; Public Hospitals; Public Policy; State Government; Taxes;
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