The American Health Care System

Abstract

Repeated, unsuccessful efforts throughout this century to create a national scheme of health insurance have left a clear message: most Americans prefer private insurance to plans mandated or operated by the government to finance their medical care. This preference is unique among the industrialized nations. But now, largely in response to soaring medical expenditures and demands by employers that costs be constrained, the very nature of the insurance industry is changing. Its fundamental risk-bearing function is being assumed by its best customers (employers), and carriers are entering the new world of managed care. This blurring of functions leaves the future . . .