Restructuring Health Care in the United States: A Proposal for the 1990s

• Published in: JAMA : the journal of the American Medical Association Vol. 265; no. 19; pp. 2516 - 2520
• Main Authors: Nutter, Donald O, Helms, Charles M, Whitcomb, Michael E, Weston, W. Donald
• Format: Journal Article
• Language: English
• Published: Chicago, IL American Medical Association 15-05-1991
• Subjects: American Medical Association; Bioethics; Biological and medical sciences; Biomedical Research; Cost Control; Federal Government; Government Regulation; Health Benefit Plans, Employee - economics; Health care; Health care industry; Health insurance; Health Policy - standards; Health Services Accessibility - economics; Health Services Accessibility - standards; Insurance Carriers - standards; Medical sciences; Medicare - standards; National Health Insurance, United States; Organizational Policy; Primary Health Care - standards; Prospective Payment System; Public health. Hygiene-occupational medicine; Quality Assurance, Health Care; Reforms; Schools, Medical; United States; United States; Human; Health system; Health insurance; Costs; Accessibility; United States; North America; Care; Employee; Health policy; Health economy; America; Planning; Public health; Firm; Health Care and Public Health; American Medical Association; Medicaid; Pepper Commission
• ISSN: 0098-7484; 1538-3598
• DOI: 10.1001/jama.1991.03460190092027

A PLAN for restructuring the US health care system to achieve universal access to medically necessary health care services has been developed by the Medical Schools Section of the American Medical Association (AMA). The plan is a pluralistic approach to comprehensive system reform that requires both individual and institutional responsibility for the achievement of quality health care. A set of broad strategies are proposed to reach the goal of universal access to care in the context of responsible containment of health care costs. The plan proposes to achieve universal access through reform of our existing system of health care as follows: by restructuring and reforming Medicaid and Medicare, by supporting universal provision of necessary health benefits through employers; and by the creation of regional insurance pools for those individuals who are not covered by government programs or through their workplace. The additional cost of these strategies for universal access would