A Way to Achieve National Health Insurance in the United States

Abstract

The current crisis in the health care system in the United States, including constantly escalating costs and ever more limited access, calls for fundamental reform. Current reform proposals, including managed competition, would not solve the basic problems of cost and access as they continue to rely on employer-provided health insurance, which is the source of these problems. Rather, what is needed is radical reform, replacing current coverage by a system of national health insurance. The Medicare expansion plan represents a simple and workable way to obtain such a system, via a phased change in the age of eligibility for the Medicare program. It would start by enrolling children up to age 5 and pregnant women and then expand coverage by adding 5 more years of age for eligibility in both the younger and the older population each year until, eventually, by the year 2000 everyone would be enrolled. Medicare expansion offers a viable alternative to the current system of employer-provided health insurance, with a single payer/single collector system for basic care and with reliance on increased Social Security taxes for funding. The private health insurance industry would have a role as providers of supplemental coverage and as subcontractors for the expanded Medicare program.