UNIVERSAL HEALTH-INSURANCE THROUGH INCENTIVES REFORM

被引:51
作者
ENTHOVEN, AC [1 ]
KRONICK, R [1 ]
机构
[1] UNIV CALIF SAN DIEGO,DEPT COMMUNITY & FAMILY MED,SAN DIEGO,CA 92103
来源
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION | 1991年 / 265卷 / 19期
关键词
D O I
10.1001/jama.265.19.2532
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Roughly 35 million Americans have no health care coverage. Health care expenditures are out of control. The problems of access and cost are inextricably related. Important correctable causes include cost-unconscious demand, a system not organized for quality and economy, market failure, and public funds not distributed equitably or effectively to motivate widespread coverage. We propose Public Sponsor agencies to offer subsidized coverage to those otherwise uninsured, mandated employer-provided health insurance, premium contributions from all employers and employees, a limit on tax-free employer contributions to employee health insurance, and "managed competition." Our proposed new government revenues equal proposed new outlays. We believe our proposal will work because efficient managed care does exist and can provide satisfactory care for a cost far below that of the traditional fee-for-service third-party payment system. Presented with an opportunity to make an economically responsible choice, people choose value for money; the dynamic created by these individual choices will give providers strong incentives to render high-quality, economical care. We believe that providers will respond to these incentives.
引用
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页码:2532 / 2536
页数:5
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