Health Care: Some New Proposals

Health Care: Some New Proposals

The disruption caused by our chaotic medical system has reached such proportions that mainstream medical thought is beginning to call for a major revision of health services. As costs sprout upward the already limited care for low-income patients is further eroded while the middle classes increasingly feel the squeeze. Arnold Relman, the influential editor of the New England Journal of Medicine, suggests that
“we urgently need a new and more comprehensive approach to health policy. . . .” Only drastic measures can “repair or replace our present disastrously inadequate health care financing system.”

The January 12, 1989, Journal contains two proposals for reform. The first is relatively decentralized, based on competing health plans and mandatory coverage through employers. The second, of more interest to Dissent readers, calls for a national health-care system, funded through mixed sources but ultimately channeled through the federal government. This proposal, endorsed by over four hundred doctors from across the country, makes clear why physicians support a program that seems to contradict their financial interest, that is, why our current health system is failing.

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