Universal access versus universal insurance.

Abstract

Debate over the nature of the American healthcare system reemerged in 1989. Advocates of universal health insurance and "universal access" argued their positions in the New England Journal of Medicine, and a Harris poll indicated that 89 percent of Americans feel the United States needs to make a fundamental change in its healthcare system. An adequate assessment of these reform proposals requires a clear understanding of what we want from our healthcare system. In 1981 the U.S. bishops specified six principles for U.S. healthcare policy. The bishops asserted that U.S. policy should (1) assume that healthcare is a right, (2) promote pluralism of delivery systems, (3) promote good health in addition to treating disease, (4) give consumers a choice of providers, (5) make healthcare planning essential, and (6) include methods of controlling costs. The bishops' principles help clarify both proposals' strengths and weaknesses.