Trends in Health Care Coverage and Financing and Their Implications for Policy

The nation's preoccupation with the transformation of the health care delivery system to managed care has tended to obscure the importance of a number of other, simultaneous trends. These include the declining ability of health care providers to deliver uncompensated care,1 the declining proportion of people with private insurance, despite a robust economy,2 the continued growth in the total number of uninsured people,2 an expected increase in the rate of inflation in health care costs,3 and budget reductions in Medicare and Medicaid. Some of these trends, such as the decline in uncompensated care, result directly from widespread managed care; others . . .