Can HMOs Be Fixed?  

In part one of this essay (“The HMO Revolution: How It Happened, What It Means,” Dissent, Spring 1998) I explored the rapid growth of HMOs, noted potential advantages that prepaid group practices held over traditional fee-for-service arrangements, and considered a …



The HMO Revolution: How It Happened, What It Means  

Shortly before writing this essay I received a questionnaire from the Democratic Senatorial Campaign Committee. It asked that I choose between the Democratic and Republican positions on nine “critical” issues: crime, the balanced budget, environmental protection, campaign-finance reform, education, religious …



Rashi Fein Replies  

Few Americans, of whatever political persuasion, would disagree with David Plotke’s four “good things that health care reform should try to do.” My own list of the aims of health financing reform (as distinguished from delivery system reform) includes those …



The Politics of Health Care Reform  

This essay focuses on the basic design of the Clinton administration’s health-care-reform policy. It examines how the president’s early decision in favor of employment-based private insurance rather than tax-based social insurance led to an unnecessarily complex program. While recognizing that …



What We Need in Health Care  

It is clear that President Clinton will submit a health care reform package to Congress. It even seems clear that something labeled health care reform will be enacted. What is not clear is what that something will look like. The …



National Health Insurance  

The problems of the American health care system have been with us a long time. In 1948 Harry Truman fought for National Health Insurance (NHI); in the 1950s and 1960s political efforts concentrated on Medicare, yet even that was viewed …



A Model for Health Insurance  

Universal medical insurance and universal access to care under a system of responsible cost containment remain on the American agenda. Since Harry Truman proposed national health insurance (NHI), debates about this vital policy issue have waxed (as in the early …