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The article by The Physicians' Working Group for Single-Payer National Health Insurance in this issue of THE JOURNAL should re-energize the much needed debate on universal health insurance. More than 40 million Americans lack health insurance and nearly 60 million are without health insurance for a portion of the year. Employers face rising health insurance premiums, and their employees face increasing cost-sharing. There are ongoing and increasing disagreements about health benefits coverage. Physicians, hospital administrators, home health agency financial officers, and others are increasingly frustrated with the confusion and inefficiencies of the current multiple payment mechanisms. In these fiscally troubled times, state legislators are having difficulty finding funds to support Medicaid and free-care pools. Clearly, there must be a simpler and better way.
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Rashi Fein (2003) studied this question.
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