Innovative Strategies and Insurance Consequences for Implementing Universal Health Insurance in the United States.

Rainer W G Gruessner
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Abstract

Universal Health Insurance does not exist in the United States for two reasons: (1) there is a general unwillingness to dismantle the historically grown framework of the world's most complex mix of public and private sector health coverage and (2) mere cost considerations. The first concern can be abated by establishing a Universal Health Insurance system which retains many or most of the historically grown infrastructure. Cost containment of such a reform is addressed herein in that the two proposed pathways comprise either (1) a leveled solution through Medicare-expansion for the uninsured only or (2) a more complex solution through a national, 2-tier healthcare system for all Americans. Both pathways are based on solid financing without major tax increases by using existing and/or yet untapped funding sources. The insurance consequences for both options are assessable. They are minor for the Medicare-expansion and more wide-ranging, yet also achievable, for a national, 2-tier healthcare system. Universal Health Insurance must no longer be an illusion that continues to haunt our society in the 21st century.

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在美国实施全民健康保险的创新战略和保险后果。
美国没有全民健康保险有两个原因:(1) 人们普遍不愿意拆除历史上形成的世界上最复杂的公共和私营部门混合健康保险框架;(2) 只是出于成本考虑。建立全民健康保险制度,保留许多或大部分历史上发展起来的基础设施,可以缓解第一种担忧。本文将讨论这种改革的成本控制问题,建议的两种途径包括:(1) 仅通过扩大医疗保险范围为未参保者提供公平的解决方案;(2) 通过为所有美国人建立一个全国性的两级医疗保健系统提供更为复杂的解决方案。这两种方案的基础都是在不大幅增税的情况下,利用现有和/或尚未开发的资金来源进行稳健融资。两种方案的保险后果都是可以评估的。对于扩大医疗保险来说,其影响较小,而对于全国性的两级医疗保健系统来说,其影响范围更广,但也是可以实现的。全民医疗保险决不能再成为 21 世纪继续困扰我们社会的幻想。
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来源期刊
CiteScore
0.50
自引率
0.00%
发文量
6
期刊介绍: The Journal of Insurance Medicine is a peer reviewed scientific journal sponsored by the American Academy of Insurance Medicine, and is published quarterly. Subscriptions to the Journal of Insurance Medicine are included in your AAIM membership.
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