Payment Mechanisms under a National Health Program

A national health program is once again on the nations agenda. The term national health program refers to a universal health care financing mechanism at the state or federal level, or both, that replaces the current voluntary system of private multiple health insurers. In the statements of many health care experts and political figures, the failure of the current private health insurance structure is revealed by the fact that 35 million Americans are without any health insurance whatsoever. But in addition, the record of American health care shows failure in yet another basic area: despite multiple cost-containment efforts by the fed-eral and state governments and by private insurers, the costs of health care continue to rise rapidly. If the problem of the uninsured were the sole major criticism of American health care, limited legislation specifically aimed at helping this group might be effective. After all, that is in the tradition of Medicare and Medicaid; both programs have addressed only those groups in great-