RECOMMENDATIONS FOR REFORM OF THE AMERICANHEALTH CARE DELIVERY SYSTEM
This research assesses the major recommendations for reforming the American health care delivery system. As opposed to the consideration of specific reform proposals made by specific individuals and groups, reform proposals are considered on a generic basis. As an example, all reform proposals embodying the essence of the Canadian health care delivery system are considered as a single generic reform proposal. Each of the generic reform proposals are assessed with respect to four factors (1) resource allocation, (2) care quality, (3) care cost, and (4) access to care.
There are seven major generic reform proposals for the American health care delivery system. These proposals are (1) a national plan modeled on the Canadian health care system, (2) a plan requiring employers to provide basic health insurance for all employees, (3) pay or play proposals requiring employers to either provide health insurance for employees, or pay into a governmental pool that will furnish such health insurance, (4) a plan requiring all households to purchase health insurance, (5) a plan requiring health insurance companies to make available low cost core health insurance policies, (6) national health insurance along European models, and (7) a proposal to eliminate all federal health programs, and replace them with voluntary low cost health insurance. The essential elements of each of the seven reform proposals are described in the discussions that follow. A National Plan Modeled on the Canadian Health Care System
Proposals for a national health care plan based on the Canadian health insurance system have been made by both the National Association of Social Workers and Physicians for a National Health Program (Rovner, 1991d). The National Association of Social Workers envisions a universal coverage system administered by the federal government and operated by the state...